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Medicaid Health Plans (MCO) Highlights
National in scope, yet local in focus, Coventry’s Medicaid division offers a national network in all 50 states and local health plans that operate in 9 states. Because we believe that health care delivered locally is the best way to meet your needs, our health plans are based right in the communities we serve.
- Quality care management programs in asthma, maternity, HIV, high blood pressure, Early Periodic Screening, Diagnostic and Treatment (EPSDT), immunizations and woman care
- Several plans accredited by National Committee for Quality Assurance (NCQA) or URAC
- Experienced with Temporary Assistance for Needy Families (TANF), Aged, Blind and Disabled (ABD), State Children’s Health Insurance Program (SCHIP), Old Age Assistance (OAA), Children in State Custody and Pregnant Woman programs
- Woman, Infant and Children (WIC) Referrals
- Coordination with Maternal Support Services/Infant Support Services (MSS/ISS)
- Affiliation agreements with local health departments, community agencies and community health clinics
- Provider performance recognition programs
Other State Health Services
Providing the necessary tools for better management.
As the nation's leading provider of integrated clinical management services for public sector healthcare clients, Coventry First Health Services provides states with the tools they need to better manage their Medicaid medical benefits, pharmacy, mental health and long-term care programs.
At First Health Services Corporation, we effectively integrate advanced clinical management services, superior operational administration and leading systems technology to help states manage their healthcare programs in a way that promotes access to clinically appropriate and quality care, in a cost-effective manner.
Serving Medicaid and other public sector programs in 25 states and the District of Columbia, First Health Services provides a wide variety o f health care management services including:
Pharmacy Benefit Administration
First Health Services provides full Pharmacy benefit Administration services including point-of-sale pharmacy, clinical and utilization management services, and specialty pharmacy support. This can include assistance with establishment and management of a Preferred Drug Management program with an option of choosing to participate in two of the leading supplemental rebate contracting and rebate administration pools - the NMPI and TOP$.
Health Care Management
Our Healthcare Management Division provides a wide range of services to states that are trying to improve the management of their fee-for-service Medicaid, long term care, community-based care, MR/DD and behavioral health programs.
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