Special Needs Plans (SNPs) Resources for Providers

Learn about our SNP plans

Our chronic condition special needs plans (C-SNPs) and dual-eligible special needs plans (D-SNPs) include tailored benefits for members with complex health needs.

How you support SNP members

For members in our D-SNP and C-SNP plans, there are additional ways we coordinate with providers to support our members’ care.

1. Verify a member's chronic condition

For newly enrolled C-SNP members, Centers for Medicare & Medicaid Services (CMS) requires verification from a treating provider that the member has at least one of the qualifying chronic conditions. A current provider must verify that the member has a qualifying condition within 60 days of enrollment for the member to stay on the plan.

At Devoted, all of our C-SNP plans are Group 4 plans, meaning members must have one of the following conditions:

Diabetes mellitus (pre-diabetes does not qualify)
Chronic heart failure
Cardiovascular disorders (cardiac arrhythmia, coronary artery disease, peripheral vascular disease, chronic venous thromboembolic disorder, and/or valvular heart disease)

Without provider verification, the member cannot remain enrolled in our C-SNP plan and will lose access to their coverage and specialized benefits designed to help them manage their chronic condition. If you receive a request from Devoted Health to verify a qualifying chronic condition for one of your patients, please respond as soon as possible.

How to verify a chronic condition

There are multiple ways providers can complete the verification form.

We will fax the verification form to your office. Complete the form and fax it to 1-833-434-0535.
Call us at 1-877-762-3515 to verify the member’s condition by phone (Monday -Friday 8 a.m. to 5 p.m. local time).
Download and upload the completed form directly from the Devoted provider portal. This option is only available for participating primary care provider groups.

2. Encourage members to complete a Health Risk Assessment (HRA)

We conduct HRAs within 90 days of signing up, then annually thereafter. This helps us get a better picture of a member’s health.

3. Help us develop Individualized Care Plans (ICPs)

ICPs for new members are available about 3 months after their start date. We’ll share them with the member’s identified care team members, such as the member’s PCP, via fax.

To provide feedback on a member’s ICP, fax 1-888-973-8821 or call 1-877-762-3515.

4. Review our Model of Care

CMS requires all special needs plans (SNPs) to train providers annually on our Model of Care.

Our Model of Care outlines how providers like you play a key role in coordinating care for our SNP members.
Learn how we can work together — and how we can support you — in caring for these members

Review our Model of Care Training and share it with your team.