Not a SWH Provider? Learn More.
You take care of your patients,
we take care of the rest.
At Senior Whole Health we keep it simple.
We deliver quality health care and improve medical outcomes in a cost effective way to low-income seniors who have MassHealth Standard and Medicare (dual-eligibles).
Our model of health care supports the Patient-Centered Medical Home initiative. Clinical staff collaborates with participating primary care physicians, specialty providers and local community services to effectively coordinate medical, behavioral, pharmaceutical, and social and community based services.
The result is a comprehensive, team-based care plan that anticipates and adapts to the changing needs of each member, striving to keep them secure, independent and living in the comfort of their own home.
Senior Whole Health offers many financial and operational enhancements to our working partners, including:
- Prompt, accurate claims processing, EDI compatible
- No co-pays, deductibles or co-insurance to collect
- Single payment source — no secondary billing required
- No withholds, no capitation, no risk
- Increased reimbursement based on Medicare fee schedule
- Enhanced covered benefits
- Monthly Medical Home Fee
- Reimbursement for Telephonic case management time
- Care management team to assist you and your staff with care planning, organizing at-home interventions and support, and follow up care
- Around-the-clock access to a Senior Whole Health Nurse Care Manager for information and to facilitate service coordination
- Senior Whole Health Nurse Care Managers conduct in-home assessments
- Ability to maintain current referral patterns
- Comprehensive, local provider network
- Reduced administrative burden
- Access to the Senior Whole Health Centralized Enrollee Records (CER), an automated health record including prescription activity, providers and authorized services