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How Choosing a Personal Doctor Makes Your Health Journey Simple

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What is Network Health’s Clinical Integration Program and How Does Choosing a Personal Doctor Help Me?

By Nancy Weber, clinical integration program manager at Network Health

Whatever stage of your life you’re in, there are plenty of health insurance organizations and health plans available for you to choose from. One of the many reasons Network Health members appreciate our unique approach to health insurance is our commitment to quality and clinically integrated care.

Like it sounds, clinical integration is an initiative that seeks to provide health care to our members that is high quality and integrated with providers. Network Health partners with local, hometown providers so the potential for success is maximized every day. We continue to foster trusting and credible relationships with our members and our provider partners, bringing together seamless coordination of care that delivers best-in-class service.

How do we integrate our care?

Beyond building and maintaining communication-driven relationships with our provider network, we’re owned by two of the most prolific provider networks in Wisconsin. Ascension Wisconsin and Froedtert and the Medical College of Wisconsin share ownership, limiting the number of hand-offs between your doctors, nurses, specialists, practitioners, technicians, etc. and your Network Health care team. As a member, you can call in and speak with a nurse or pharmacist to help answer questions about your health care.

How do we ensure quality health care?

Rather than a barrier to high-quality care, we’re a partner and facilitator. Achieving this means working to streamline the experience of selecting a provider in our network, while also making sure those providers are meeting our high standards.

While our contracted providers are held to high standards, our members can assure they receive service excellence by the following.

  • Selecting a personal doctor from a contracted Network Health provider
  • Notifying Network Health who you choose (either by updating this in the member portal or calling the Network Health Member Experience team), and
  • Establishing a solid, trusting relationship with your personal doctor to make sure you are confident in your approach to health and wellness.

Because finding these personal doctors or specialists can be a bit of a process, in and of itself, we actively outreach to members, in partnership with your chosen providers. Having alignment between you, the patient, your health care provider and us, your health plan, ensures high-quality care that is seamlessly integrated.

How to update your primary care provider in the member portal

Updating your personal doctor/primary care provider in your member portal is a simple process.

  1. Using a desktop computer, navigate to and click LOGIN in the upper right-hand portion of the screen.
  2. Sign-in using your member portal credentials.
  3. In the upper right-hand portion of your member portal splash screen, click [YOUR NAME]’s ACCOUNT.
    screenshot of member portal 1
    screenshot of member portal 2
  5. Search the last name of your personal doctor. Once they populate, click their name.
    member portal doctor selection 3
  7. You have updated your personal doctor and are free to log out of your member portal.

Our members should feel confident in the following aspects of their health care services, and its important enough that we survey our members regularly to see how you are feeling about this.

  • Getting the care, you need and getting it quickly, when necessary
  • Receiving coordinated care among primary care providers and specialists/specialty providers
  • Improve and maintain physical and mental health throughout your lives
  • Improve bladder control and minimize urinary incontinence concerns
  • Reduce the risk of falling and sustaining a serious life-changing fracture
  • Consistently afford and take medications as prescribed by your provider
  • Recommend your providers and Network Health to your friends and family

We appreciate your input when contacted to rate the services you get from Network Health and your health care providers, and we take concrete steps to ensure our members have high-quality, fully integrated care, including the following.

Encouraging and providing vaccinations for young and aged

Whether measles, mumps, rubella, human papillomavirus, the flu or COVID-19, immunizations are one element of preventive care that we make sure our members have access to.

Access to appropriate health care

If you have cold/flu symptoms on a Saturday morning, your Network Health plan will help you find an urgent care provider. On the other hand, chest pain can be a possible heart attack and that calls for a trip to the emergency room. We’ll make sure you have access to both when and how you need it.

Preventive care through screenings

Helping to detect the earliest signs of dangerous illnesses or infections, screenings are a crucial part of care. Our active member outreach helps ensure our members are up to date on all preventive screenings, such as breast cancer screenings, colorectal cancer screenings, and cervical cancer screenings.

Help members prevent or manage diabetes

A prediabetes or diabetes diagnosis may be a reason to think your life is changing in a major way. We help our prediabetic members prevent diabetes Type 2 and our diabetic members manage their care needs through Healthy Living with Diabetes.

We also partner with our provider partners to make sure that our members with diabetes have the following.

  • Controlled blood sugar and blood pressure throughout the year
  • Regular eye exams to assure you are not developing an eye disease called diabetic retinopathy, which can lead to blindness
  • A statin medication that you can tolerate and afford, to protect your heart from developing vascular blockages that are more common for people with diabetes,
  • Regular evaluation of your kidney functions to assure you are not developing kidney failure, another common complication that develops in people with diabetes.

Clinically integrated care makes the difference

When it comes to advantages in your health plan, clinically integrated care is a significant benefit to our members, our providers and our internal care professionals and teams that are on hand to help you.

By ensuring care meets a high standard of quality, we help make sure our members get the care they need and in a way that respects their time.

For more information on our care management programs and how quality integrated care can help you get the health care you need, contact us today.

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Network Health
1570 Midway Place
Menasha, WI 54952
Mon., Wed.-Fri.: 8 a.m. to 5 p.m.
Tuesday: 8 a.m. to 4 p.m.

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