Resources and Support

Helpful Links

Welcome to the helpful links section of our site. Here, you access resources designed to enhance your experience and provide valuable patient care tools. We encourage you to explore these resources and discover the wealth of information available at your fingertips.

Availity

Availity is a secure payor portal Including Highmark Health Options and Highmark Commercial.  Availity is designed to streamline processes such as patient verification, eligibility and claims management. Quality Blue reports and Clinical Quality Feedback (CQF) are accessible via this site.

Go Anywhere SFTP (Share File)

Use the SFTP to securely transfer sensitive patient data and medical records. Confidentially share information with KidWell. This is the required method of sharing for any documentation containing PHI. Analyzed monthly data from all contracted payors are available via the SFTP.

NaviNet

NaviNet is a secure payor portal that connects health care providers to health plans, including Amerihealth Caritas. It allows you to access and share information with health plans, simplifying tasks such as eligibility verification, real time claims and secure messaging. Supplemental data can be submitted via the Navinet portal.

NemoursLink

Nemours Link is used to connect providers with care that is received at Nemours. Providers can access patient information, submit referrals, communicate directly with Nemours providers and view healthy planet data reports via Nemours link.

Refer a Patient to Care Management

Care management is a collaborative practice model that involves the patient and patient’s family, nurses, social workers and physicians. We partner with home care, insurance providers, caregivers and the community on behalf of our patients and families.

Our care management team helps facilitate communication, coordinate resources and referrals, and provides the tools and guidance to help patients achieve optimal health.

Learn More

Referral Criteria for Care Management

  • Patients up to age 21
  • On a shared KidWell Network contract

Patients may be referred for education and disease self-management of the following:

  • Children with medical complexities
  • Children with uncontrolled or newly diagnosed diabetes
  • Children with high-risk or uncontrolled asthma
  • Children with sickle cell disease
  • Behavioral health
  • High utilization/high cost
  • Other poorly controlled or complex disease
  • Patients needing assistance with resources related to social determinants of health

Any patient you think may benefit from the services of care management, but are unsure of eligibility, you may refer for evaluation by a care manager.

Care Management Intake Form

Access a Certified Coder

If you have questions related to coding for patients covered under a KidWell Network Value-Based Program, email codingintegrity@nemours.org to connect with a certified coder.

Pharmacy Services

The pharmacy team is available to support medication related needs for both your practice and your patients and families. This includes strategies related to the networks value based care contracts and direct clinical support to patients and families.

Contract support:

The pharmacy team supports the evaluation of pharmacy costs impacting our value-based care contracts and medication cost containment strategies. The team is also a key stakeholder in evaluation, strategy and implementation for medication-related quality measures such as the asthma medication ratio (AMR).

Clinical support:

The pharmacy team is a resource to your patients who may need additional clinical medication support. This may include coordination of pharmacy care, providing medication and disease state education, longitudinal follow up for patients with chronic conditions, medication adherence evaluation and strategies to overcome barriers.

Who should be referred to the pharmacy team?

The pharmacy care team can help patients who:

  • have questions or concerns about their pharmacy benefits, medication costs or side effects.
  • have been identified as nonadherent to their medication plan of care.
  • may benefit from follow up after starting a new medication.
  • are on medication that may need additional monitoring.
  • have experienced a transition of care with several new medications.
  • need a comprehensive medication review to help support clinical decision making.

How can patients be referred to the pharmacy team?

There are a few ways to to get in touch with the pharmacy team:

  • Email: VBSOPharmacy@nemours.org
  • NemoursLink referral to: “Referral to VBSO Pharmacy”
  • Care Coordinator: your assigned care coordinator can put you in touch with the pharmacy team.

Nemours KidsHealth

Committed to transforming the health of kids through education. Nemours KidsHealth® is the most-visited site for dependable information on children’s health, behavior and development from before birth through the teen years.

Learn More About What KidsHealth Can Do