AHPN Provider Directory - Find providers within AHPN’s network. Please confirm payor coverage before making a referral.   

AHPN Ancillary Directory - Find ancillary facilities within AHPN’s network. Please confirm payor coverage before making a referral.   

Download AHPN’s 2025 Provider Guidebook - Your reference for all network-affiliated payor contact information and sample ID cards. 

Clinical Care Pathways - Download the chronic condition care guides.  

• Anatomy of the Clinical Pathways Dashboard  
• Clinical Care Pathways - Chronic Kidney Disease 
• Clinical Care Pathways - Heart Failure 
• Clinical Care Pathways - Hypertension 

Clinical Documentation Integrity (CDI) Support - Access coding and documentation support documents.  

• AHPN CDI Tip Sheets
• CDI Playbook 2024 FINAL.pdf 

Fraud, Waste and Abuse Compliance - Training on how to prevent Medicare and Medicaid fraud and abuse. 

• Compliance Training Requirement | AdventHealth Provider Network  

Visit ACO Website - Learn more about our Accountable Care Organization (ACO). 

Education Modules - Find mini education modules for continued learning. 

Provider Performance and Enablement  

The Provider Performance and Enablement team helps both PCPs and specialty medical practices achieve their practice transformation goals and improve their performance standings in the network by delivering the following services: 

• Value-based onboarding and education  
• Annual and quarterly incentive programs  
• Value-based performance questions  
• Performance support tools  
• Performance visits with practices  
• Practice transformation  
• Attribution questions   

The Provider Performance and Enablement team also supports all practices with network participation, claims support, contracting, credentialing and maintaining accurate practice records for the network directory.  

If you have any questions or are unsure of who to contact, call us at 1-800-741-4810 or email PHSO.Network.Support@AdventHealth.com and we'll be happy to help. 
 

Quality  

The PHSO Quality team reviews and closes gaps for quality metrics tied to a CIN contract. The team works with the physician and office staff to review EMR documentation and assist with gap closure.  

The Quality team is comprised of subject-matter experts in quality metrics, chart abstraction, metric definition (including numerator and denominator) and national benchmarks. The team is available for education and assistance with any quality concerns.  

Clinical Documentation Integrity Coding  

The Clinical Documentation Integrity Coding (CDI) team assists with risk-adjustment questions and provides complimentary resource materials for coding and documentation best practices. The CDI team can explain hierarchical condition codes and assist with payor incentive programs. This team has a group of senior CDI specialists available to visit clinical practices in person to directly assist network providers and staff.  

Please submit any CDI questions or request a visit with a senior CDI specialist by emailing PHSO.CDI.RAF@AdventHealth.com.  

Care Management  

Care Management is a multidisciplinary team consisting of highly trained RNs, social workers, pharmacists and whole-health coordinators providing whole-person care management to address the physical, mental and social needs of your high- and rising-risk patients. The goal of the program is to improve the overall health of these patients as evidenced by lower readmission rates, improved clinical outcomes and decreased total cost of care.  

Referral criteria include one of the following:  

• Frequent avoidable utilization (Any combination of 3+ ED, inpatient visits or observation discharges in a rolling 12-month period)   
• Positive depression screening requiring behavioral health care coordination   
• Positive social determinant of health (SDoH) screening requiring assistance with connecting to community resources   
• One or more of these disease states clinically assessed as poorly controlled:  
• Asthma (pediatric or adult)  
• Chronic kidney disease  
• Chronic obstructive pulmonary disease  
• Congestive heart failure  

When referring a patient to the PHSO Care Management program, complete all of the required information with this form, while also including:  

1. If the request is urgent (outreach within one business day) or routine (outreach within three business days)  
2. Patient preferred language (PHSO Care Management is staffed to provide care in English, Spanish, Portuguese and Hindi)  
3. Referral reason(s)  

If you have any questions related specifically to the PHSO Care Management program, please contact the Care Management team directly using the information below.  

Email: PHD.CareManagement@AdventHealth.com 

Fax: 813-929-5912  

Epic Referral Pool: CM OUTPT PHD CARE MGMT  

ED Care Coordination Center  

The ED Care Coordination Center (EDCC) is a program that targets certain populations with the goal of reducing inpatient admissions. A team of nurses follows members in the EDCC and communicates with the EDCC provider to offer alternatives to inpatient admission.  

The most frequently requested service by EDCC providers is a next-day appointment with the member’s PCP. This team will reach out to the member's PCP to request expedited appointments to avoid an inpatient admission and notify the practice if one of their members is a high EDCC utilizer, is a complicated case or needs specialist care or treatment.  

For more information, contact Dianne Duncan at Dianne.Duncan@AdventHealth.com.