Clinical Specialties - Option Care Health

About Clinical Specialties

Since 1996 Clinical Specialties has been adding value to the traditional home health network model for patents, payers and providers. Starting out over 20 years ago to support the home health needs of our local pharmacy infusion patients, we have expanded to a Network of 500+ credentialed home care providers in OH, IN, KY, MI and IL. Clinical Specialties is owned by Option Care Health – the largest independent home and alternate site infusion service provider in the United States. Clinical Specialties operates as a line of business under Option Care Health and continues to support the home care needs of patients by linking providers and payers and aligning care for skilled nursing, therapies, and hospice.

20+

years partnering with home healthcare providers

98%

provider retention rate¹References:
1. Clinical Specialties has earned a reputation for high quality patient interaction and outcomes by building and maintaining strong, long-term relationships with all of our partners. We’re proud that over 98% of our contracted network agencies have remained with us over the past five years.

2.4M+

home health visits processed in 2018¹References:
1. Clinical Specialties has earned a reputation for high quality patient interaction and outcomes by building and maintaining strong, long-term relationships with all of our partners. We’re proud that over 98% of our contracted network agencies have remained with us over the past five years.

500+

home health providers participating in the region¹References:
1. Clinical Specialties has earned a reputation for high quality patient interaction and outcomes by building and maintaining strong, long-term relationships with all of our partners. We’re proud that over 98% of our contracted network agencies have remained with us over the past five years.

For Patients

Clinical Specialties offers:

Care coordination to align you with the “best” home care companies throughout our service area to provide for a full array of needs including skilled nursing, skilled therapies, and hospice support.
Detailed benefit verification and authorizations to confirm the appropriate care and covered services

We are dedicated to providing quality home health care and making your transition to home care, comfortable, and easy.

Learn More

For Providers

(Home Care Providers)

Clinical Specialties can assist with:

Expanding your referral base
Gaining access to multiple Commercial and Medicare Advantage plans through one single contract
Coordination of eligibility, benefits and authorizations
- Clinical Specialties performs member eligibility, benefit verification and service authorization function on your behalf.
Providing online tools for real time communication of referral and authorizations
Claims Management
- Rather than having to manage continuously changing rules that differ from payer to payer, our network agency partners benefit from a single set of billing rules and processes. Our extensive experience with the payers enables us to submit clean claims quickly, allowing for timely processing and payment. If a claim issue should arise, we manage the resolution process with the payer.
Decreasing your administrative costs and burden
- Save time and resources by allowing us to manage time-intensive interactions with payers to meet specific and sometimes unique requirements
Providing ongoing training and support for all of our agencies

Provider Portal

For Partners

(Payers)

Delegated credentialing and ongoing data maintenance consistent with NCQA standards
Contract management
Network quality monitoring and reporting
Provider training and education regarding payer programs and policies
CSI reduces out of network costs through referral management, statewide coverage, and absorption of out of network provider charges
CSI handles all aspects of provider customer service including billing, claims status and payment questions
CSI aggregates all provider claim submissions reducing payer claim issues and ensuring clean claims
Development and implementation of successful care management programs resulting in, reductions of hospital re-admissions and corresponding costs while improving outcomes
Under this section should we add below info?
- Discharge Planners/Case Managers

Refer a Patient

Provider Network Request

Online Provider Network Request

Home Health Agency Name*
DBA Names*
Primary/Corporate Location*
Street Address Address Line 2 City State / Province / Region
Agency Phone*
Agency Fax
Contact Name*
First Last
Contact Email*
Contact Phone*
General Business Review
Established*
Number of Locations*
Total Gross Revenue (previous year)*
Medicare Certification mo/yr*
Accrediting Organization*
Current Medicare Star Ratings*
Total Average Daily Census
Average # New Patient Starts per Month*
# of Full Time Employees*
# of Part Time/Per Diem Employees*
Payer Mix: Traditional Medicare %*
Managed Care %*
Medicaid %*
Other % (please describe)
Does Your Agency Bill Electronically*
- Yes
- No
Billing*
- Centralized Billing
- Individual Billing by Location
Name of Billing Software
Sub-Contracted Billing? If yes, who provides billing services*
Service Review
Counties Serviced*
Services Provided (Rank 1-9):*
SN, PT, OT, ST, HHA, IVRN, LISW, PEDS, Other (please describe)
Specialty Programs*
If other, please describe
Payer Review
Please list any current payer agreements you have
Please detail any payers NOT accepted
Referral Source Review
Please list your top three referral sources and % of total business:*
Date Completed
MM slash DD slash YYYY
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Find a Location

6288 Hudson Crossing Parkway, Hudson OH 44236
Phone : 888-873-8999
Fax: 440-550-8835
Email: agencyupdategroup@optioncare.com

Contact Us

Intake Department regarding new referrals option 1, option 2
Authorizations Department option 3, option 2
Claims Resolution Department option 5
Contracting option 6