Network Management

An important part of our job is making sure our health plan members have appropriate access to:

We measure our performance in this area regularly by looking at survey results, member complaints and grievances, and member services telephone records. If we identify any issues with access to specific practitioners, groups, or services, we work to immediately address the issues.

We also continually measure the geographic distribution of our members to determine how effectively our provider network meets their needs (as outlined by the Defense Health Agency, CMS, and the Maine Bureau of Insurance regulations). Using GeoNetworks software, we routinely generate reports to identify opportunities for network enhancement. We look at parameters such as the number of members by market area and their average time to reach one to five providers in our network. If we identify any areas not meeting the access standard, we rectify the situation as soon as possible.

Customer feedback 

All customer feedback regarding provider office quality, safety, or accessibility is reviewed by the Network Management Department to determine the need for a site visit.

If a provider/office has been cited in two or more cases, your Network Representative will conduct a site visit within 60 days. There may be instances in which we request a site visit for issues related to the quality, safety, or accessibility of a practitioner office that do not exceed the threshold of two or more cases. Site visits may require further action on the part of the provider/office.

Martin's Point will work with you to ensure that we are providing quality, safe, and accessible care to our members. If you have questions or would like more details, please call 1-800-348-9804.