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Select Health Network
About the Select Health Network
Together, area physicians and Saint Joseph Regional Medical Center created Select Health Network to better serve the healthcare needs of our community. Select Health is a physician-hospital organization uniting the Saint Joseph Regional Medical Center campuses located in South Bend, Plymouth and Mishawaka, Ind. and nearly 600 area physicians. With hospitals, ancillary providers and physician practices located throughout St. Joseph and Marshall counties, the Select network promotes quality care, cost control and personal choice for employer health plans.
Select Health Network has the largest physician network in St. Joseph and Marshall counties representing an elite group of primary care physicians and specialty physicians who are required to be either board-certified or board eligible. Select Health Network providers are put through a rigid credentialing process following nationally recognized certification standards.
Available services to contract with us
- Case management services.
- Utilization management services.
- Network access.
- Wellness.
- Select Your Health.
Case management
- Active management of complex and costly care.
- Target catastrophically or chronically ill patients.
- Optimum value for clients and reimbursement sources.
- Appropriate providers and facilities across the continuum of healthcare.
- Available resources are timely, cost effective and efficient.
- Focus on patient advocacy, communication, education, and facilitation of healthcare by registered nurses certified in case management.
Utilization Management
Prospective review and precertification for:
- Inpatient services.
- Outpatient procedures.
- Concurrent reviews.
- Retrospective review.
Utilization Management of inpatient care includes:
- Rehabilitation.
- Long-term acute care.
- Sub-acute services.
Precertification of outpatient services may include:
- Surgical and diagnostic procedures.
- Referrals to specialists.
- Durable medical equipment rental and purchase.
- Discharge planning.
The Utilization Management program uses InterQual and SIMs criteria, which are nationally recognized criteria for utilization management. The UM program adheres to the strictest applicable guidelines, including state regulations, NCQA guidelines and URAC standards. The Utilization Management medical director plays an active role in the delivery of UM services and interacts with network physicians on a regular basis.
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