Southeastern Health Partners is an clinically integrated network (CIN) formed as a joint venture between AnMed Health, Bon Secours St. Francis and Spartanburg Regional Healthcare System.
- A Clinical Integrated Network (CIN) is a group of doctors and other healthcare providers who agree to work together to give you the best possible care.
- The goal of the CIN is to support your doctors and their care teams in caring for you by making sure they have the most up-to-date information about your health and your care. For you, this means your doctors communicate better with each other, and avoid administering duplicate tests or answering the same questions over and over.
- Working together, your doctors and their care teams can do more to monitor your health, make sure you receive the highest quality care. They may hire additional staff to help meet your unique care needs, depending on what works best for you.
- CINs may take different approaches to giving you coordinated care. Some CINs may have additional clinical personnel, who are members of your doctor’s care team, that help you set up appointments or make sure your medications are in order when you enter or leave a hospital. Other CINs may help your doctors get you equipment for monitoring your medical conditions better at home, if you need it.
- Most CINs use advanced systems that let them more carefully coordinate your care and ensure your doctor has the most up-to-date information about your health.
- Doctors and other healthcare providers choose to participate in a CIN because they’re committed to providing you with a better care experience. They may also be entitled to rewards
- If a doctor is participating in a CIN, you’ll see a poster with information about CINs and his or her participation displayed in the patient area of their facility.
Doctors in CINs may have greater access to the expertise, staff, and technologies they need to make sure your care is coordinated across all the places you get services. For you, this coordination could mean avoiding unnecessary tests, or more help for you in dealing with any health conditions.
You don’t need to do anything right now. Even though a doctor is participating in an CIN, your Medicare or insurance benefits won’t change. You’ll still have the right to use any doctor or hospital that accepts Medicare or your insurance provider, at any time.
Only your doctor participates in the CIN. As the patient, you do not participate in the CIN. You can continue getting care from your doctor. Or, you can choose to see a doctor who doesn’t participate in a CIN.
- You can still go to any doctor, hospital, or other provider that accepts Medicare or your insurance provider. Nobody can restrict which providers you see.
- You’re still entitled to all the same services, benefits, and protections offered by Medicare or your insurance provider.
- That said, some of the benefits of the CIN may not be available should you see providers who are not members of the SEHP CIN network
You can still choose to go to any doctor, hospital, or other health care provider that accepts Medicare or your insurance provider. Nobody – not even your primary doctor – can prevent you from seeing the doctors, hospitals or providers you want. Please know that some of the benefits of the CIN may not be available should you seek care outside of the SEHP CIN network.
To help doctors who participate in an CIN give patients like you the best possible care, some additional information about your care may be shared with the CIN. This information includes things like doctor, hospital, and pharmacy visits in the past and going forward. Your health care information helps the CIN track the services you’ve already received, understand where you may need more care, and find ways to smooth the path for you if you have to transfer in or out of a hospital, or from the care of one doctor to another.
If you do not want Medicare to share your health care information with the CIN for the purpose of coordinating your care, you must call 1-800-MEDICARE (1-800-633-4227). Tell the representative that your doctor is part of an CIN and you don’t want Medicare to share your healthcare information. TTY users should call 1-877-486-2048.
After you talk with someone at 1-800-MEDICARE, Medicare will update its records to show that you don’t want to share your healthcare information. If you call 1-800-MEDICARE, you’ll get a letter confirming this change. It’ll take about 45 days for this change to take effect. Even if you decline to share your healthcare information, Medicare will still use your information for some purposes, including certain financial calculations and determining the quality of care given by your healthcare providers participating in CINs.
If you change your mind in the future, call 1-800-MEDICARE (1-800-633-4227). Tell them you’ve changed your mind and that now you want to share your healthcare information with any CIN in which your doctor or other healthcare providers participates. You’ll get a letter confirming this change.