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For Physicians

Northwest Community Health Partners (NWHP) BCBSIL sites 503 & 770

This partnership exists to provide comprehensive, integrated and coordinated healthcare at the optimal price point for both patients and providers. NWHP has formed a Clinical Integration Network (CIN) that spans a range of settings and efforts, from multi-setting care coordination initiatives focused on a single condition to networks of caregivers accessing and exchanging a variety of clinical and financial information to deliver quality care. Clinical integration is a continuous process of alignment across the care continuum that supports the triple aims of healthcare:

  • Improving the quality of care
  • Reducing or controlling the cost of care
  • Improving access to care and the overall patient experience

We’ve entered into agreements with more than 450 dedicated primary care and specialty physicians to make the CIP as robust as possible. Its purpose is to evaluate and modify practice patterns to create a high degree of interdependence and cooperation among providers in order to improve the quality and efficiency of healthcare in the communities served by NWHP.

Our mission is to provide high-quality care with innovative treatment and state-of-the-art technology to all our members. Our PHO has been awarded 4 out of 5 stars in Quality Measures by Blue Cross and Blue Shield of Illinois (BCBSIL) for the past five years—the highest rating that can be received, demonstrating “excellent performance.”

NWHP is delegated by BCBSIL to administer their HMO products, including Blue Advantage, HMOI, Blue Precision and Medicare Advantage. 

Join the PHO

There are many benefits to joining our PHO, such as:

  • Having a voice in the decision-making process at Northwest Community Healthcare (NCH)
  • Expertise dedicated to building your practice
  • Innovative means to connect providers with each other and with their patients to improve quality of care
  • Group contracting with payers at a higher fee schedule, which you may not have under individual contracts

However, we do have membership criteria set in place to ensure that we maintain the highest levels of care for our patients. These criteria state that:

  • All physicians must be members of our medical staff to be eligible to apply
  • Physicians must be American Medical Association (AMA) board certified
  • Physicians must have current state licensure and state and federal controlled substance licenses/certificates
  • Minimum malpractice coverage and full disclosure of malpractice liability history are required
  • Physicians must be able to arrange reasonable coverage through another PHO participating provider for patients contracted through the PHO
  • Required to utilize Northwest Clinical Laboratories for PHO patients

You can express interest in joining NWHP partners by completing the application request form and submitting it to NCH Medical Staff Services at medicalstaffservices@nch.org or fax to 847-618-5669.

FAQs

Have questions? We can help. Hopefully, you can find the answers you’re looking for here.

Who is eligible to join the PHO?

All physicians who are active members of our medical staff are eligible to apply.

How long does it take to be credentialed?

The PHO usually credentials a complete application and enrolls to managed care entities within 120 days. Process time is shorter if you are currently on our medical staff.

What is the contracting process?

Once your application is approved, you will be given a PHO Risk and CI contract to sign. All physicians seeking membership must take all risk products and participate in CI. There are additional managed care plans that you can opt in or out of; a form will be provided with those options.

Are there any other requirements?

Each physician is responsible for applying and completing a CAQH application. A CAQH number is necessary to enroll in managed care plans. Each physician is responsible for ensuring his or her office meets ADA requirements and must provide a completed form to the PHO.

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