PSW: Founded on the belief that your health care needs should be between you and the provider you trust.
Navigating the health care system can be overwhelming, but you don’t have to do it on your own. The PSW team is here to help. We work with your health care providers and Medicare Advantage plans Humana and Premera, to make sure members get the care and support they need.
PSW is ready to help you make your Medicare Advantage insurance decision-making easier.
Learn more about our health plan partners
How can we help?
Utilization Management (UM) decision making is based only on appropriateness of care and service and existence of coverage. PSW does not specifically reward practitioners or other individuals conducting utilization review for issuing denials of coverage. Financial incentives for UM decision-makers do not encourage decisions that result in under-utilization.
Healthy Living Tips
Advanced Care Planning
Planning for care at the end of life and ensuring your wishes about your healthcare are understood is important. Our staff is available to support you and your caregivers in preparing this valuable, non-legal document, that will helps you describe what good care means to you, whether you are seriously ill or not and ensure others know exactly what you want.
PSW is committed to the advancement of shared decision making and has staffed trained in the Honoring Choices Curriculum. PSW is able to offer Advance Care Planning to members, their families as well as provide your staff training and materials.
Finding the right medical provider is one of the most important steps in managing your health care. Our network represents more than 500 physicians and other medical providers in the communities we serve, and our Find a Provider tool makes your search easy. Let us put you in touch with a provider who meets your specific needs.
Start Your Search For A New Provider
Processing Claims is one of the many ways PSW assists our members and contracted providers. By delivering the administrative expertise to manage the claims processing requirements of payers, physicians or other partners, PSW’s Claims Department helps smooth the process of handling claims.
To get in touch with our Claims Team, please visit our Contact Us page and select Claims as the Department.
Medicare Advantage members often benefit by having help accessing health care referrals, health education, and coaching for chronic health conditions. Our trained health care professionals, including nurses and social workers, can provide these services for you.
What is care management?
Care management is about helping the patient and their healthcare providers manage medical conditions more effectively. Did you know that as part of your Medicare Advantage health plan you have access to a team of health care professionals available to support your care? At no additional charge, PSW provides patients a variety of services designed to meet their health care needs, including:
- Evaluate the safety of your home.
- Manage your medications.
- Understand your medical bills and procedures.
- Recuperate safely after hospitalization with the help of home visits.
- Get referrals, schedule appointments, coordinate transportation and find helpful resources.
For more information, view PSW’s Care Management Services flyer:
Medicare Advantage plans can often provide extras you don’t receive with Medicare. These may include, fitness club membership to support overall good health. And some Medicare Advantage plans include hearing, vision, limited dental benefits as well as other benefits all designed to promote optimal health.
Every year there are changes that take place that may affect your Medicare Advantage plan including premiums, co-pays and available providers. For this reason it’s important to check with your health care provider to confirm which Medicare Advantage plans they are accepting for 2020. If your health care or prescription drug needs have changed, this is a great time to learn about available plans and products. It’s worth the time to ensure you select the plan that best meets your health care needs and provides the best value.
Whether you are turning 65, or you are evaluating Medicare Advantage plan options, one of these plans may be the option you are looking for: