The Network Development Section of P/GLTC is responsible for developing, educating, maintaining, and monitoring P/GLTC’s network of medical, dental, in-home, long-term and behavioral health providers to ensure the full array of ALTCS services is available to our members. Once contracts are finalized, the Network Coordinators will serve as the primary contact between P/GLTC and Providers. Problems requiring mediation or intervention should be directed to the Network Development Section for resolution.
The Network Development Section of P/GLTC is responsible for the following areas:
- Developing, procuring, awarding and monitoring contracts
- Rate negotiations
- Disseminating updated information to both contracted and non-contracted providers
- Furnishing technical assistance to providers, as needed or requested
- Scheduling new provider orientation and ongoing education with appropriate P/GLTC staff
- Coordinating Quarterly Provider meetings
- Updating and distributing Provider Directories
- Assistance with claim problems not resolved with the P/GLTC Accounting and Information System Section
- Developing, updating, and distributing the Provider Manual
- Coordinating all provider communication, including new and terminated contracts, newsletters, etc.
- Coordinating Peer Review and Pharmacy & Therapeutic (P&T) Committees
- Credentialing of practitioners
- Appeals and claim disputes
Whether you are a new or existing provider, the Network Development staff is available to furnish training and education on topics such as your contract, ALTCS requirements, credentialing, referrals and billing. Network Development regularly sends out information related to contract requirements, policy updates and other process changes. Such information may be provided through direct mailings, provider newsletters, e-mails or website updates.