The document discusses ways for members of Harvard Pilgrim health plans to save on healthcare costs, including staying in-network, using lower-cost providers for procedures and tests, and only using the emergency room for actual emergencies. It also provides an overview of new benefits from Harvard Pilgrim like a Medicare Supplement plan and fitness reimbursement, and resources available to members.
This document summarizes a medical insurance plan from GlobalHealth Asia. It offers comprehensive personal and family medical insurance globally. Key features include coverage for pre-existing conditions, worldwide emergency assistance, a wide range of plan options for individuals and groups, and benefits like traditional Chinese medicine coverage. It provides peace of mind through affordable premiums and high reimbursement limits.
Pioneer Future Tech Healthcare IT is a healthcare services provider that offers innovative eHealth and mHealth solutions. They provide services like telemedicine, emergency support, home visits, and medical discounts through their eMedicard program. They also work with schools on a "Healthy Schools" program that provides medical checkups, health education, and insurance benefits to students.
As business, you have two choices: let rising healthcare costs continue to eat away at your profits – or do something about it. The old healthcare model does not work, and healthcare reform laws will not lower your costs. Employees are overweight, more susceptible to illness and chronic disease and have no understanding of the true costs of healthcare or even know how to find the best care. A new paradigm is needed to control rising healthcare costs. In the care setting, the traditional insurance models distort the reality of health care for its most important consumer – the patient. Employers should shift the paradigm to allow the patient to step above the fog and find themselves as powerful consumers with the ability to demand higher value and more cost-effective care.
This document provides an overview of health insurance. It discusses what health insurance is, the types of health insurance plans available including individual, group, critical illness, and specific disease plans. It covers factors that determine premium costs such as age, medical history, job, and term of the policy. Tips are provided for choosing the right health insurance plan and saving on premium costs. The steps for filing a health insurance claim are outlined. Recent government incentives for health insurance in India are also mentioned.
This document provides information about the Assurant Health MaxPlan Elite individual medical insurance plan. It offers:
- $25 million lifetime maximum benefit. Unlimited prescription drug benefits with $15 copays for generic drugs.
- Deductible options from $500 to $25,000, with rate guarantees of up to 36 months for some deductibles.
- Coinsurance options of 0%, 20%, 30%, or 50%. Coinsurance out-of-pocket maximum ranges from $0 to $9,500.
- Coverage for doctor visits, preventive care, hospitalization, transplants, prescription drugs and more.
- Optional benefits like dental/vision insurance, life insurance, and
This document promotes an affordable healthcare savings program offered by Secure Health Benefits. It summarizes the program's benefits which include discounts of 20-60% on healthcare services from over 1 million providers through networks like Careington. The program offers discounts on doctors visits, prescriptions, dental care, vision care, chiropractic care, and other services. It claims the average family could save over $1,200 annually on their healthcare costs by enrolling. The document provides pricing plans starting at $25 per month and guarantees approval for the program.
Leveraging Technology to Empower and Engage PatientsDaniel Sands
This document summarizes a presentation about leveraging technology to empower and engage patients. It discusses how patient portals can be used to provide services like prescription refills and appointment requests. It also notes that e-communication can help provide patients with education and allow them to securely communicate with their doctors. The presentation argues that patients want to be more engaged in their care through improved communication and access to information, but that current systems do not always meet these desires. It advocates for a model of participatory medicine where patients and doctors work as partners.
This document summarizes a medical insurance plan from GlobalHealth Asia. It offers comprehensive personal and family medical insurance globally. Key features include coverage for pre-existing conditions, worldwide emergency assistance, a wide range of plan options for individuals and groups, and benefits like traditional Chinese medicine coverage. It provides peace of mind through affordable premiums and high reimbursement limits.
Pioneer Future Tech Healthcare IT is a healthcare services provider that offers innovative eHealth and mHealth solutions. They provide services like telemedicine, emergency support, home visits, and medical discounts through their eMedicard program. They also work with schools on a "Healthy Schools" program that provides medical checkups, health education, and insurance benefits to students.
As business, you have two choices: let rising healthcare costs continue to eat away at your profits – or do something about it. The old healthcare model does not work, and healthcare reform laws will not lower your costs. Employees are overweight, more susceptible to illness and chronic disease and have no understanding of the true costs of healthcare or even know how to find the best care. A new paradigm is needed to control rising healthcare costs. In the care setting, the traditional insurance models distort the reality of health care for its most important consumer – the patient. Employers should shift the paradigm to allow the patient to step above the fog and find themselves as powerful consumers with the ability to demand higher value and more cost-effective care.
This document provides an overview of health insurance. It discusses what health insurance is, the types of health insurance plans available including individual, group, critical illness, and specific disease plans. It covers factors that determine premium costs such as age, medical history, job, and term of the policy. Tips are provided for choosing the right health insurance plan and saving on premium costs. The steps for filing a health insurance claim are outlined. Recent government incentives for health insurance in India are also mentioned.
This document provides information about the Assurant Health MaxPlan Elite individual medical insurance plan. It offers:
- $25 million lifetime maximum benefit. Unlimited prescription drug benefits with $15 copays for generic drugs.
- Deductible options from $500 to $25,000, with rate guarantees of up to 36 months for some deductibles.
- Coinsurance options of 0%, 20%, 30%, or 50%. Coinsurance out-of-pocket maximum ranges from $0 to $9,500.
- Coverage for doctor visits, preventive care, hospitalization, transplants, prescription drugs and more.
- Optional benefits like dental/vision insurance, life insurance, and
This document promotes an affordable healthcare savings program offered by Secure Health Benefits. It summarizes the program's benefits which include discounts of 20-60% on healthcare services from over 1 million providers through networks like Careington. The program offers discounts on doctors visits, prescriptions, dental care, vision care, chiropractic care, and other services. It claims the average family could save over $1,200 annually on their healthcare costs by enrolling. The document provides pricing plans starting at $25 per month and guarantees approval for the program.
Leveraging Technology to Empower and Engage PatientsDaniel Sands
This document summarizes a presentation about leveraging technology to empower and engage patients. It discusses how patient portals can be used to provide services like prescription refills and appointment requests. It also notes that e-communication can help provide patients with education and allow them to securely communicate with their doctors. The presentation argues that patients want to be more engaged in their care through improved communication and access to information, but that current systems do not always meet these desires. It advocates for a model of participatory medicine where patients and doctors work as partners.
This document promotes an affordable healthcare program that provides discounts on medical services and prescriptions. It details savings averages of 20-60% on services like doctor visits, dental care, eyewear, chiropractic care and prescriptions. Specific savings examples are provided showing over $1,200 in potential annual savings for a family. Success stories are shared of families saving over $1,500 on dental and over $2,300 total on healthcare costs in a year through the program. The program is described as not being insurance but rather providing discounts through contracts with healthcare providers for a low monthly fee.
Innovation in commissioning and provisioning of community healthcare - Counti...Clever Together
Benedict Hefford is Director of Primary and Community Services at Counties Manukau Health, where he is also the executive lead for integrated care:
http://www.countiesmanukau.health.nz/AchievingBalance/System-Integration/system-integration-home.htm. As Director, Benedict is responsible for both operational delivery and commissioning of health and social care services in South Auckland – a culturally diverse and economically deprived area of New Zealand with over 500,000 residents.
Benedict has 20 years healthcare experience encompassing senior management, commissioning, and strategic roles in both New Zealand and the UK. Prior to joining CM Health, he was Director of Commissioning (Social Care and Health) in central London. Benedict’s previous experience also includes re-designing community care services at Hammersmith and Fulham PCT and Capital Coast Health, as well as developing national health strategies as a Senior Policy Analyst with the NZ Ministry of Health. Benedict holds an MSc in Public Services Policy & Management from King’s College London; a Postgraduate Diploma in Health Services Management; and a BSW (Hons).
This document discusses an integrated wellness solution that identifies risks, plans incentives, and measures outcomes. It analyzes data to identify cost drivers and provide money-saving solutions. The solution assists with establishing wellness programs that incentivize participation and health improvements through premium adjustments. It provides services like biometric screenings, online tools, and support with appeals and regulations to implement effective wellness programs.
Consumer Driven Health (CDH) plans are growing in popularity as a way to engage consumers and reduce healthcare costs. There are five key factors for CDH success: [1] meaningful consumer engagement tools and incentives, [2] the right plan design with an employer-funded account, [3] a long-term strategy for changing consumer behavior, [4] a consumer-friendly administrative platform, and [5] comprehensive employee communications. The document also provides a case study of Fowler White Boggs, which implemented a CDH plan in 2006 and saw reduced costs, increased preventive care usage, and high employee engagement through wellness programs.
1) This plan has no deductible for in-network services and a $0 copay for primary care visits. Coinsurance is 30% in-network and 50% out-of-network, with a $7,500 individual/$15,000 family out-of-pocket maximum. Preventive care has a $30 copay in-network.
2) This plan has a $2,500/$5,000 deductible and 20% coinsurance in-network and 50% out-of-network. The out-of-pocket maximum is $5,000/$10,000 in-network and $10,000/$20,000 out-of-network. Primary care
This document provides information about advanced directives. It defines an advanced directive as a legal document that specifies a person's wishes for medical treatment if they become unable to make decisions. It discusses the importance of advanced directives for patients, families, and physicians. It also describes different types of advanced directives like living wills, medical powers of attorney, and do not resuscitate orders.
What We're Working On Now: Getting the "System" to be a Real System for Heart...3GDR
The document discusses the efforts of Partners HealthCare to create an integrated system for managing heart failure patients. It outlines several components of the heart failure program including enrollment numbers in remote monitoring programs over time, readmission outcomes, and an overview of the heart failure population within Partners. It also discusses challenges in patient identification, engagement, determining the most effective care delivery approach, managing patients efficiently across different care settings and providers, and integrating different systems and communications channels.
The document describes Tunstall's services for reducing avoidable hospitalizations and readmissions. Tunstall provides a range of connected care services including appointment scheduling and reminders, physician referral services, remote patient monitoring, and 24/7 after hours support. They handle nearly 2.5 million calls per year and are committed to supporting partners in delivering positive health outcomes through a dedicated, HIPAA compliant contact center.
This document discusses advance care planning and advance directives. It defines key terms like advance directives, living wills, durable power of attorney for healthcare, Do Not Resuscitate orders, palliative care, hospice care, and comfort care. It explains the importance of advance care planning and having conversations with loved ones about end-of-life wishes. However, it notes that many people do not complete advance directives due to lack of knowledge, difficulties with paperwork, and potential family disagreements. The document provides resources for individuals to learn more about advance care planning.
Understand what kind of practice you have
Real life examples of how to be more profitable
Specifics on what and how to implement at your practice
ZHC Dashboard & Benchmark Tool
The document provides information about employee benefits offered by Accelerated Rehabilitation Centers, including:
1. Flexible spending, vision, 401(k), medical, dental, disability, and continuing education benefits.
2. Eligibility requirements for benefits and details on dependents that can be covered.
3. An overview of the company's health insurance plans including costs and coverage details for medical, prescription drugs, dental, and vision.
Better to Best Patient Centered Medical HomePaul Grundy
Better to best -- consensus meeting between large employers, HHS, CMS, DOD OPM, hospitals, Primary care association, AMA, healthcare plans around the elements that add value in the Patient Centered medical home. coordination of care, access to care Health information technology and payment reform.
Start the Discussion: The Importance of Advance DirectivesSummit Health
This presentation discusses the importance of advance directives and provides information about them. It notes that the Patient Self Determination Act of 1990 requires certain healthcare facilities to provide information to patients about advance directives. An advance directive allows patients to communicate their treatment preferences if they become unable to make decisions. It can take the form of a healthcare proxy or living will. The presentation provides guidance on completing an advance directive form and sharing it with one's healthcare providers and agent. It also discusses POLST forms, which provide instructions for life-sustaining treatment.
This document provides information about Medicare coverage of home health care services. It outlines who is eligible for home health care benefits, what services are covered including skilled nursing care, physical therapy, occupational therapy and more. It also discusses how Medicare pays for home health care through 60-day episodes of care. The document notes some services that are not covered like 24-hour care, delivered meals or personal care services.
It is an ethical obligation to maintain continuity of care. Is your agency prepared in the event of an in-house disaster such as the entire facility flooding and having to close for a month?
View the video here: https://www.youtube.com/watch?v=zepUrQlq2Vk
Counseling CEUs for ethics can be earned here: https://www.allceus.com/member/cart/index/product/id/696/c/
This document provides information about Medicare, Medicaid, and the Community Insurance Outreach Services (CIOS) organization. CIOS is a nonprofit that provides insurance education and assistance to residents in the Youngstown, Ohio area. The document outlines Medicare enrollment periods, eligibility for Medicaid programs, and CIOS's services, which include insurance literacy programs, claims assistance, and a career pathway program in the insurance industry.
This document provides an overview and summary of a webinar presentation on health care consent and advance care planning. The presentation covers the legal framework for health care decision making in Ontario, including who can provide consent, the definition of capacity, substitute decision makers, informed consent, advance care planning, and resolving disagreements. It was presented by Judith Wahl from the Advocacy Centre for the Elderly.
The document introduces the Society for Medicare, an Indian NGO focused on health education, advocacy, and awareness. It aims to extend healthcare access to underprivileged communities through various communication mediums like print, television, radio, and the internet. The organization believes that healthcare should be consumer-centric and available to all. It hopes to coordinate with other groups, stimulate medical tourism, and set globally reputed medical institutions to provide quality and affordable healthcare.
An overview of the Initial Design and Prize Guidelines for a proposed $10M+ Healthcare X PRIZE, released for public comment on April 14, 2009. Please help us design the best competition possible in creating an Optimal Health paradigm that engages and empowers individuals and communities in a way that will dramatically improve health value.
Concierge Medicine Brave New World Of Health CareJames Kane
This document summarizes concierge medicine and specialty medical services tailored for individuals. Concierge practices offer enhanced services like same-day appointments in exchange for annual fees, though they remain small. Critics argue they could worsen healthcare access, while proponents say the current system is unsustainable. The document provides tips for what to ask if your doctor transitions to concierge care. It also discusses specialty services that can provide referrals to top specialists for complex illnesses and emergency care while traveling globally through virtual consultations.
This document discusses applying the thoughts of William Godwin and Paulo Freire to the author's own life and career decisions. It reflects on how the author was initially influenced by others to pursue architecture, but realized through problem-posing education concepts that graphic design aligned more with their own goals and desires. The author learned from their experience in architecture but concluded it is best to follow one's own convictions rather than letting other people's opinions outweigh their own.
This document promotes an affordable healthcare program that provides discounts on medical services and prescriptions. It details savings averages of 20-60% on services like doctor visits, dental care, eyewear, chiropractic care and prescriptions. Specific savings examples are provided showing over $1,200 in potential annual savings for a family. Success stories are shared of families saving over $1,500 on dental and over $2,300 total on healthcare costs in a year through the program. The program is described as not being insurance but rather providing discounts through contracts with healthcare providers for a low monthly fee.
Innovation in commissioning and provisioning of community healthcare - Counti...Clever Together
Benedict Hefford is Director of Primary and Community Services at Counties Manukau Health, where he is also the executive lead for integrated care:
http://www.countiesmanukau.health.nz/AchievingBalance/System-Integration/system-integration-home.htm. As Director, Benedict is responsible for both operational delivery and commissioning of health and social care services in South Auckland – a culturally diverse and economically deprived area of New Zealand with over 500,000 residents.
Benedict has 20 years healthcare experience encompassing senior management, commissioning, and strategic roles in both New Zealand and the UK. Prior to joining CM Health, he was Director of Commissioning (Social Care and Health) in central London. Benedict’s previous experience also includes re-designing community care services at Hammersmith and Fulham PCT and Capital Coast Health, as well as developing national health strategies as a Senior Policy Analyst with the NZ Ministry of Health. Benedict holds an MSc in Public Services Policy & Management from King’s College London; a Postgraduate Diploma in Health Services Management; and a BSW (Hons).
This document discusses an integrated wellness solution that identifies risks, plans incentives, and measures outcomes. It analyzes data to identify cost drivers and provide money-saving solutions. The solution assists with establishing wellness programs that incentivize participation and health improvements through premium adjustments. It provides services like biometric screenings, online tools, and support with appeals and regulations to implement effective wellness programs.
Consumer Driven Health (CDH) plans are growing in popularity as a way to engage consumers and reduce healthcare costs. There are five key factors for CDH success: [1] meaningful consumer engagement tools and incentives, [2] the right plan design with an employer-funded account, [3] a long-term strategy for changing consumer behavior, [4] a consumer-friendly administrative platform, and [5] comprehensive employee communications. The document also provides a case study of Fowler White Boggs, which implemented a CDH plan in 2006 and saw reduced costs, increased preventive care usage, and high employee engagement through wellness programs.
1) This plan has no deductible for in-network services and a $0 copay for primary care visits. Coinsurance is 30% in-network and 50% out-of-network, with a $7,500 individual/$15,000 family out-of-pocket maximum. Preventive care has a $30 copay in-network.
2) This plan has a $2,500/$5,000 deductible and 20% coinsurance in-network and 50% out-of-network. The out-of-pocket maximum is $5,000/$10,000 in-network and $10,000/$20,000 out-of-network. Primary care
This document provides information about advanced directives. It defines an advanced directive as a legal document that specifies a person's wishes for medical treatment if they become unable to make decisions. It discusses the importance of advanced directives for patients, families, and physicians. It also describes different types of advanced directives like living wills, medical powers of attorney, and do not resuscitate orders.
What We're Working On Now: Getting the "System" to be a Real System for Heart...3GDR
The document discusses the efforts of Partners HealthCare to create an integrated system for managing heart failure patients. It outlines several components of the heart failure program including enrollment numbers in remote monitoring programs over time, readmission outcomes, and an overview of the heart failure population within Partners. It also discusses challenges in patient identification, engagement, determining the most effective care delivery approach, managing patients efficiently across different care settings and providers, and integrating different systems and communications channels.
The document describes Tunstall's services for reducing avoidable hospitalizations and readmissions. Tunstall provides a range of connected care services including appointment scheduling and reminders, physician referral services, remote patient monitoring, and 24/7 after hours support. They handle nearly 2.5 million calls per year and are committed to supporting partners in delivering positive health outcomes through a dedicated, HIPAA compliant contact center.
This document discusses advance care planning and advance directives. It defines key terms like advance directives, living wills, durable power of attorney for healthcare, Do Not Resuscitate orders, palliative care, hospice care, and comfort care. It explains the importance of advance care planning and having conversations with loved ones about end-of-life wishes. However, it notes that many people do not complete advance directives due to lack of knowledge, difficulties with paperwork, and potential family disagreements. The document provides resources for individuals to learn more about advance care planning.
Understand what kind of practice you have
Real life examples of how to be more profitable
Specifics on what and how to implement at your practice
ZHC Dashboard & Benchmark Tool
The document provides information about employee benefits offered by Accelerated Rehabilitation Centers, including:
1. Flexible spending, vision, 401(k), medical, dental, disability, and continuing education benefits.
2. Eligibility requirements for benefits and details on dependents that can be covered.
3. An overview of the company's health insurance plans including costs and coverage details for medical, prescription drugs, dental, and vision.
Better to Best Patient Centered Medical HomePaul Grundy
Better to best -- consensus meeting between large employers, HHS, CMS, DOD OPM, hospitals, Primary care association, AMA, healthcare plans around the elements that add value in the Patient Centered medical home. coordination of care, access to care Health information technology and payment reform.
Start the Discussion: The Importance of Advance DirectivesSummit Health
This presentation discusses the importance of advance directives and provides information about them. It notes that the Patient Self Determination Act of 1990 requires certain healthcare facilities to provide information to patients about advance directives. An advance directive allows patients to communicate their treatment preferences if they become unable to make decisions. It can take the form of a healthcare proxy or living will. The presentation provides guidance on completing an advance directive form and sharing it with one's healthcare providers and agent. It also discusses POLST forms, which provide instructions for life-sustaining treatment.
This document provides information about Medicare coverage of home health care services. It outlines who is eligible for home health care benefits, what services are covered including skilled nursing care, physical therapy, occupational therapy and more. It also discusses how Medicare pays for home health care through 60-day episodes of care. The document notes some services that are not covered like 24-hour care, delivered meals or personal care services.
It is an ethical obligation to maintain continuity of care. Is your agency prepared in the event of an in-house disaster such as the entire facility flooding and having to close for a month?
View the video here: https://www.youtube.com/watch?v=zepUrQlq2Vk
Counseling CEUs for ethics can be earned here: https://www.allceus.com/member/cart/index/product/id/696/c/
This document provides information about Medicare, Medicaid, and the Community Insurance Outreach Services (CIOS) organization. CIOS is a nonprofit that provides insurance education and assistance to residents in the Youngstown, Ohio area. The document outlines Medicare enrollment periods, eligibility for Medicaid programs, and CIOS's services, which include insurance literacy programs, claims assistance, and a career pathway program in the insurance industry.
This document provides an overview and summary of a webinar presentation on health care consent and advance care planning. The presentation covers the legal framework for health care decision making in Ontario, including who can provide consent, the definition of capacity, substitute decision makers, informed consent, advance care planning, and resolving disagreements. It was presented by Judith Wahl from the Advocacy Centre for the Elderly.
The document introduces the Society for Medicare, an Indian NGO focused on health education, advocacy, and awareness. It aims to extend healthcare access to underprivileged communities through various communication mediums like print, television, radio, and the internet. The organization believes that healthcare should be consumer-centric and available to all. It hopes to coordinate with other groups, stimulate medical tourism, and set globally reputed medical institutions to provide quality and affordable healthcare.
An overview of the Initial Design and Prize Guidelines for a proposed $10M+ Healthcare X PRIZE, released for public comment on April 14, 2009. Please help us design the best competition possible in creating an Optimal Health paradigm that engages and empowers individuals and communities in a way that will dramatically improve health value.
Concierge Medicine Brave New World Of Health CareJames Kane
This document summarizes concierge medicine and specialty medical services tailored for individuals. Concierge practices offer enhanced services like same-day appointments in exchange for annual fees, though they remain small. Critics argue they could worsen healthcare access, while proponents say the current system is unsustainable. The document provides tips for what to ask if your doctor transitions to concierge care. It also discusses specialty services that can provide referrals to top specialists for complex illnesses and emergency care while traveling globally through virtual consultations.
This document discusses applying the thoughts of William Godwin and Paulo Freire to the author's own life and career decisions. It reflects on how the author was initially influenced by others to pursue architecture, but realized through problem-posing education concepts that graphic design aligned more with their own goals and desires. The author learned from their experience in architecture but concluded it is best to follow one's own convictions rather than letting other people's opinions outweigh their own.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Общая информация о компании SearchInform - признанного лидера на рынках информационной безопасности России и стран СНГ. Данное решение используются в многих крупных организациях, работающих в самых разных отраслях – от банковского дела до машиностроения. Работа продуктов SearchInform на тысячах компьютеров красноречиво свидетельствует о доверии пользователей к ним.
This document provides guidance on developing strong financial habits through setting goals, creating budgets, and tracking spending. It recommends determining one's current financial situation, setting goals, and evaluating alternative courses of action. Key steps include creating a budget and financial plan, reviewing it regularly, and tracking expenses daily. Tips are offered on mindful spending and saving habits like using cash instead of credit, thinking before purchases, cutting coupons, and shopping locally. Resources for further financial education are also listed.
El documento describe 4 experimentos realizados por estudiantes para calcular alturas y áreas de objetos en su escuela utilizando conceptos geométricos como la semejanza de triángulos. Midieron la sombra de un farol y de una compañera para calcular la altura del farol. Usaron el mismo método para medir la altura de un árbol. Calcularon el área total de un monumento al descubrir que sus piezas en forma de trapecio estaban en progresión aritmética. Finalmente, usaron a un compañero como "poste
This document provides information about Medicare Advantage plans from Humana, including:
1) Humana has offered Medicare plans for nearly 30 years and focuses on partnering with members to support their health goals.
2) Members have access to various programs and services from Humana to help protect their health and finances, maximize well-being, and manage any health conditions.
3) The document addresses frequently asked questions about enrolling in a Humana Medicare plan, choosing a primary care physician, finding network pharmacies, paying premiums, and getting help with costs.
Why Precise, Tailored Patient Registries Lead to Cost-Effective Care Manageme...Health Catalyst
Early this year, CMS began a per member per month reimbursement for Medicare beneficiaries with two or more chronic conditions. It immediately validated the need for care management programs. Three models are used to measure the savings of an effective care management program:
Historical or intent-to-treat design
Matching comparison design
Randomized control design
All three place a heavy reliance on data and precise, tailored patient registries. Reliable patient registries are one of the most valuable tools in the care management toolbox. And the means to that reliability is an enterprise data warehouse, which essentially gives program managers an all-access pass to stratifying patient risk and leads to a more successful population health initiative.
Ado Empowering A Healtheir Workforce 2012Grene Jeffrey
Activ Doctors Online (ADO) provides an online suite of healthcare solutions to empower employees including personal health records, online second medical opinions, and a virtual clinic. ADO's services help employees become more engaged healthcare consumers, decrease absenteeism and healthcare costs for employers, and increase productivity. Over 130,000 members worldwide use ADO's platform to organize their health information and receive medical support and advice remotely through ADO's network of over 1,400 physicians.
Our message is simple: RETHINK the way you view healthcare. Welcome to eHealth Companion, a Personal Healthcare Management System designed to help companies' of all sizes and their employees successfully transition to Consumer Directed Health Plans.
Journal Communications implemented a value-based benefit design to improve health outcomes and control costs. They promoted high-quality, low-cost providers and reduced barriers to preventive care. They also managed chronic diseases through a pharmacy compliance program offering coaching and incentives. Wellness programs were integrated, using data to connect participants with the right resources and motivate healthy behaviors. Through engagement and prevention, they achieved better health outcomes while lowering healthcare spending.
This document summarizes an innovative healthcare strategy that provides affordable, flexible plans through medical cost sharing and preventative wellness services. It offers two major plan categories - Self-Managed plans for healthy individuals who pay out-of-pocket up to an initial amount, after which medical costs are shared, and Physician-Managed plans for those wanting predefined pricing and networks similar to traditional insurance. Both plan types provide medical cost sharing through a community to limit out-of-pocket costs from major medical expenses above the initial unshared amount. The strategy aims to control costs through various wellness, advocacy, and technology services.
Becoming the Change Agent Your Healthcare System NeedsHealth Catalyst
I’ve met many clinical and operational leaders across the U.S. and seen how many have become progressively cynical and disengaged when faced with important healthcare reform issues like cost cutting and tight budgets. These clinicians would agree that equally important are quality and safety issues. However, most don’t have the tools available to actually measure that quality or patient outcomes. When clinicians do have access to the ability to measure, and the work together, I’ve seen enormous energy arise as they ask questions they really care about: What is quality? What do we measure? How do we achieve the best outcome?
The healthcare needs of the people have changed over time with the emergence of new ailments, and so has the healthcare industry. Following the steep rise in the cost of medical treatments, the necessity for some sort of cover to provide protection during a medical emergency has increased. Considering the changing lifestyle and needs of the people, the medical schemes in South Africa have also evolved over time.
Over 70% of ER, urgent care, and doctor visits can be safely handled over the phone. The healthiestyou platform provides 24/7 access to licensed US doctors through phone, video, or email who can diagnose, prescribe, and treat the top 9 reasons for doctor visits such as allergies and bronchitis. Studies have found telehealth reduces costs by 21% compared to in-person visits. The healthiestyou program offers personalized online wellness programs and resources designed by Dr. Kelly Traver to empower individuals to achieve their health goals through weekly action plans and tracking progress.
Health insurance helps cover the cost of medical care. It protects individuals financially from expensive medical bills. Health insurance is commonly offered through employers and is important for anyone to have, as medical costs continue to rise. When choosing a health insurance plan, consider the health benefits covered, the costs including premiums and out-of-pocket maximums, the network of physicians covered, and whether any prescriptions are included. Health insurance terminology includes deductibles, coinsurance, networks, and other terms that define coverage and costs. Understanding these terms is key to utilizing health insurance benefits.
Health insurance helps cover the cost of medical care. It protects individuals financially from expensive medical bills. Health insurance is commonly offered through employers and is important for anyone to have, as medical costs continue to rise. When choosing a health insurance plan, consider the health benefits covered, the costs including premiums and out-of-pocket maximums, the network of physicians covered, and which prescriptions are included. Health insurance terminology includes deductibles, coinsurance, networks, and other terms that define coverage and costs. Understanding these terms is key to utilizing health insurance benefits.
Over 70% of ER, urgent care, and doctor visits can be safely handled over the phone. The healthiestyou platform provides 24/7 access to licensed US doctors through phone, video, or email consultations to diagnose, prescribe medications, and provide medical advice for common conditions like allergies and bronchitis. It offers a personalized online wellness program and prescription drug price comparison tool to empower people to improve their health while potentially reducing costs. Member surveys found high rates of satisfaction and that issues were typically resolved in under 30 minutes through the telehealth service.
Six Need-to-Know Guidelines for Successful Care ManagementHealth Catalyst
In a job that changes every minute, care managers don’t have much time to think as they tackle unpredictable situations. Care managers stay on track amid the distractions by following six key elements of successful care management:
Act as an advocate for the patient.
Practice cultural competence.
Garner support from leaders.
Develop effective communication skills.
Prioritize patients based on up-to-date data.
Don’t ever forget that the patient is a human being first.
As care managers practice these six crucial components for successful care management, the patient’s health and well-being will always be the top priority for everyone involved, which translates to better outcomes and lower costs.
This document provides an overview of the Heal n Cure medical wellness center and its Inspire program. Key points include:
- Heal n Cure offers primary care services through board certified physicians to treat the underlying causes of illness.
- The Inspire program implements recommendations to deliver multi-component wellness care including behavioral changes, medical treatment, education and personalized plans.
- Research shows the Inspire program reduces healthcare costs by decreasing urgent visits and invasive treatments for conditions like obesity, diabetes and heart disease treated through the program.
When you combine an experienced and efficient non-profit health cost sharing organization with an expert wellness education and management platform, you get the most comprehensive health sharing program available today – Health Excellence Select!
Healthcare problems that have plagued the employee health for years, don't have the be norm. Leveraging direct primary care, pharmacy and other scopes of work can dramatically improve access to quality care while reducing the costs.
This document provides an overview of population health management strategies and tools. It discusses delivering benefits from one website, engaging employees, simplifying benefits delivery, and improving satisfaction. It also outlines problems with traditional benefits delivery and how population health management can help address these issues through outcomes-based wellness incentives, modifiable risk factor reporting, and lifestyle risk calculators that correlate behavior costs to retirement health. The document contains proprietary information for brokers and employers.
Employer toolkit: Eight Steps to Building a Successful Wellness ProgramNicole Edwards
AdvoCare Group, Inc. suggests eight crucial steps to building and maintaining a successful workplace wellness program for the new year. Presentation tips include information on compliance guidelines, building a wellness committee and identifying key risk factors based on workplace environments.
Discover the top Medicare Advantage plans available in California, Florida, and Texas for the year 2023. Explore the process of effectively comparing these plans to ensure you can make well-informed healthcare choices. Delve into our blog for comprehensive insights on how to navigate these options and select the most suitable plan for your needs.
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Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
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share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
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3. great ways to save
3
[ plan news ]
on health care costs
Shopping smart and improving your well-being can
really pay off. Here’s how. New
(www.questdiagnostics.com) typically Medicare
1 Stay in the network, and more
dollars will stay in your pocket costs less than a hospital setting. SuppleMeNt
hmo plans — If you need medi-
cal care when you’re traveling, your medical procedures — These costs plaN
Harvard Pilgrim introduced
Harvard Pilgrim HMO plan provides also vary by location, and higher costs
a new Medicare Supplement
coverage in a medical emergency or don’t necessarily mean higher quality.
plan, effective January 1,
when you get sick or injured. However, For outpatient surgery, talk to your doctor
for Medicare beneficiaries
it’s important to keep in mind that no about using an independent outpatient
without access to retiree
coverage is provided for routine care or surgical center instead of a hospital.
coverage through a former
care you knew you needed before you And, for in-hospital procedures, Har- employer. Our new Medicare
left on your trip. vard Pilgrim’s online WebMD Health Supplement Plan is easy to
Manager, available via HPHConnect for use and helps protect against
ppo and pos plans — While Members, can help you find a hospi- the gaps in coverage that
these plans provide coverage for out- tal based on quality, cost and other exist with Original Medicare.
of-network care, this flexibility comes criteria. Members will still have the
with a price. In addition to higher pre- benefits, savings and service
miums in comparison to a traditional
HMO, receiving out-of-network PPO
3 Only use the ER when it’s an
emergency
they’ve come to expect as
Harvard Pilgrim members,
and POS plan services typically means Going to an emergency room for a non- including:
higher out-of-pocket costs, including emergency problem will cost you • The choice to go to any
a separate out-of-network deductible. a lot more than a visit to a doctor’s Medicare-participating
To verify coverage provisions of your office, and you’ll probably spend a lot physician or hospital
particular plan, see your Schedule more waiting time in an emergency • No copayments for
of Benefits. room. Keep in mind that many physician services (Part B
doctors have after-hours and weekend deductible may apply)
• A new fitness benefit —
2 Use lower-cost providers for
procedures, tests and services
coverage. And while you may need a
referral from your doctor, urgent care $150 yearly reimbursement
centers and convenience care clinics (in Massachusetts only)
Here’s where comparison shoppers,
especially those in deductible plans, can also offer a cost-effective alternative
Additionally, as a member
reap big dividends. While all Harvard to the emergency room. For example,
of Harvard Pilgrim you are eli-
Pilgrim providers meet our strict qual- a convenience care clinic such as
gible for our Member Savings
ity standards, costs for some provider MinuteClinic, which serves Eastern
Program, which includes dis-
and facility services can vary widely — Massachusetts, offers low cost options
counts on eyewear, hearing
by thousands of dollars in some cases. for minor injuries and common ill-
aids and other health-related
nesses when your doctor’s office can’t
products and services.
lab and radiology services — see you (www.minuteclinic.com). Of
Because costs can differ quite a bit, course, if you think you are having a LEaRn mORE by calling
using certain labs and radiology medical emergency, don’t hesitate to 1-877-909-4742 or visit
centers may subject you to higher call 911 or go to the emergency room. our Web site at
out-of-pocket expenses. Ask your Otherwise, call your doctor’s office first. www.harvardpilgrim.org.
doctor about options that include If it turns out you are having a true
independent, non-hospital providers. medical emergency, your doctor will
For instance, an independent lab send you to the emergency room.
such as Quest Diagnostics Look for more ways to save at
www.harvardpilgrim.org/savings!
w w w. h a r va r d p i l g r i m . o r g [3 ]
4. [ cover story ]
Growing up, we heard the saying,
“An apple a day keeps the doctor away.” As
adults we know that sometimes we need
stronger medicine than an apple. Getting the
health care you need requires you to be
involved, prepared and proactive. But you’re
not alone. Harvard Pilgrim is here to help. On
the following pages, discover useful tools for
a healthy lifestyle.
6
8
10
Continued on page 6
[ 4 ] y o u r h e a lt h winter 2011
5. [ cover story ]
w w w. h a r va r d p i l g r i m . o r g [5 ]
6. [ cover story ]
from health Care advocate
ellen menard
ellen menard is a registered nurse,
former health care executive and
“when faced with a successful business consultant. But it was
health problem or a her experience as a frightened patient that gave
newly diagnosed her the insight and inspiration to write The Not So
Patient Advocate, a guide for health care consumers.
condition,” says menard,
In the 1980s Menard learned she had an “acoustic
“we are often the least neuroma,” a little-known type of tumor found in the inner
prepared to ask the ear. Since further growth of the tumor could cause problems for her
right questions and brain, she was advised to have the tumor surgically removed.
communicate Her future uncertain, Menard needed to make a number of serious
decisions in a short amount of time. She felt not only overwhelmed but
effectively.”
vulnerable. Her usual self-confidence gave way to feelings of fear and
helplessness. “When faced with a health problem
or a newly diagnosed condition,” says
Menard, “we are often the least
prepared to ask the right ques-
tions, listen well and make
are my
What ourselves heard.”
health estions? This personal health
qu
crisis caused Menard to
Get a rethink everything she
nsw
from m ers thought she already
y doct
or knew about health
care. “Even routine
I'm in charge
of my health!!!
[ 6 ] y o u r h e a lt h winter 2011
7. [ cover story ]
as menard learned through personal experience, there is tremendous potential
within each of us to heal ourselves. getting the care you need — without fear and
frustration — requires you to be involved, prepared and proactive as a patient.
office visits can create stress and undermine your confi- ask, listen, discuss. Ask to see your chart.
dence. Yet these are the very moments when you need to Request your medical records. Question your clinician
be self-assured and fully engaged so you can listen well, about instructions you don’t fully understand. Discuss
make sense of new information and make wise decisions treatment options and how you can get more information
about your care.” about them. If you’re having a procedure, learn whom
to call for help and who will be covering for your clini-
it starts with you cian if he or she is not available. Your medical records,
Now Menard spends a lot of time making sure others your health history and your care options are all yours.
are better prepared to get the best health care possible. Own them and you are truly in charge of your own health
“You are the most powerful player in pursuit of your own future.
health and wellness,” says Menard.
She offers these tips to help patients take a more now, act on it
active role and responsibility for their own health care: Knowledge is only power when we act on it. Heed
be mindful of your medications. “Be mindful your doctor’s advice. Take advantage of the additional
of drugs,” advises Menard. “Medications are such a huge resources offered by your practitioner and health insurer.
part of our health care system; they should never be con- Everyone benefits when you take better care of yourself.
sidered routine, even though they seem so for many of Health plans offer incredible resources to their members
us. You should always know why your doctor chooses a because everyone benefits when you take charge of your
particular drug for you, what other options are out there, health. So take advantage of all the information out there
what you should expect and who to call for more infor- and make the recommended changes to your lifestyle.
mation.” This kind of close attention is even more critical No one is going to stop you, and you’ll have trouble stop-
if you have had past drug interaction or addiction issues. ping yourself once you experience the immense power
and pride of setting your own health course.
additioNal reSourceS
ELLEn mEnaRd: www.ellenmenard.com
cREatinG a HEaLtH jOURnaL:
http://familydoctor.org/online/famdocen/home/pat-advocacy/
healthcare/838.printerview.html
amERican HEaLtH infORmatiOn manaGEmEnt aSSOciatiOn:
www.myphr.com
w w w. h a r va r d p i l g r i m . o r g [ 7 ]
8. [ cover story ]
getting the most out of therapy
PSycHOtHERaPy (OftEn jUSt caLLEd “tHERaPy”) can
be a very effective way to treat and even overcome a number
of mental health and substance abuse problems. While treat-
ment approaches vary, all involve talking with a licensed and
trained behavioral health professional. With support from a
skilled clinician, patients can successfully work through life
problems, gain new perspectives and the necessary coping
skills to regain a sense of control and pleasure in life.
connection is key
1 Successful therapy begins with a good
“connection.” You’ll want to find someone
who specializes in treating the problems you
face and can help you create a plan to best
address these problems. Besides matching the
appropriate clinical skills for your needs, you
need to feel comfortable with the provider’s
approach to treatment. (See sidebar on how
we can help you get started.)
the first session
2 At the first session the clinician will gather information about your behavioral and
medical health history. Your clinician will ask you for permission to talk with other
health care providers to coordinate with them on your treatment plan. Just as impor-
tant, this is also your opportunity to see if the clinician’s treatment approach feels
right for you.
Talking about what made you look for help and what you hope to achieve in therapy
can give the therapist a good understanding of your health needs. If you do not feel
connected and comfortable, you should look into other providers for a better fit in
addressing the problems you are facing.
[ 8 ] y o u r h e a lt h winter 2011
9. [ cover story ]
Getting to work
3 Success also depends on an honest relationship with your
therapist and understanding your personal responsibility. You Support
will need to participate fully in treatment for the recommended
times and duration. There will be “homework,” in applying what StartS here
you are learning to real-life situations. With your clinician as Harvard Pilgrim Health Care
has contracted with United
your personal coach, consultant and “sounding board,” you can
Behavioral Health (UBH) to
practice strategies and skills that will help make a
manage the mental health and
positive difference.
substance abuse services for our
members. Our partnership helps
clinicians and their patients
benefit from the most current
How do you know if it’s working?
4 Therapy can be challenging. It takes practice to break pat-
scientific research and latest
treatment options. Members
terns and incorporate new behaviors into your day-to-day life. can choose from a vast
So it’s important to discuss this with your therapist and to network of thoroughly
periodically evaluate your progress in treatment. Improvements reviewed, routinely
in mood, behavior, relationships and daily interactions are credentialed professionals.
all helpful ways to tell if there’s progress.
There may be times, • At www.harvardpilgrim.org/
for example, when you members you can look for
Need a referral feel overwhelmed by the a clinician using our online
or help finding a process. Or you may want to provider directory.
therapist? switch gears and try different • Or call our Behavioral
strategies. Be sure to share your Health Access Center* at
For confidential
concerns and fears, discuss what is 888-777-4742 for
referrals to a
and isn’t working, new circumstances confidential referrals.
behavioral health
that may have come up and so forth.
provider, call our Either way, you’ll be able to
Tweaking and making changes to
Behavioral health your treatment is all part of getting choose a therapist based on
access Center* at closer to meeting the goals you set at whatever is most important to
888-777-4742. the beginning of treatment. you: areas of expertise, gender,
Treatment for mental health prob- language capabilities,
lems focuses on behavioral change convenience to home and
and typically lasts only for a set period of time. When you and your work, and more.
clinician are comfortable with the improvements, it may be time to
*Please note that some
change gears and focus on strategies for maintaining the changes employers do not offer
outside of treatment and concluding therapy. If other problems arise behavioral health coverage
that affect your function, it may be appropriate to return to treatment. through Harvard Pilgrim.
REady tO tRy mindfULnESS mEditatiOn?
www.harvardpilgrim.org/mindfulness gives you step-by-step
instructions and free mP3s to get you started.
cURiOUS abOUt yOGa?
Visit www.harvardpilgrim.org/wellness to find a schedule of classes.
this ancient practice can help your body and mind.
w w w. h a r va r d p i l g r i m . o r g [ 9 ]
10. [ cover story ]
we want to make it as easy as possible for you to understand
your benefits and how to get the care you need, when you need it. That’s
why there’s HPHConnect, a secure online feature at www.harvardpilgrim.org
that makes it easier than ever to find the right doctors, specialists and behavioral
health providers.* Not only that, you can evaluate your care options, look up your
records and find out how to get hospital services and emergency care so you’re
prepared.
for more information, visit our Web site at
www.harvardpilgrim.org/members and select “HPHConnect.”
access information on
doctors and hospitals
• Know how and where to get your
primary care services.
• Evaluate providers by location,
background, training and language
capability.
• Learn how to get hospital services,
after-hours care or emergency care
(including when to directly access
emergency care or use 911 services).
• Find specialists and behavioral health
providers* and obtain their services.
• Compare hospitals and prepare for
procedures.
*Some employers do not offer behavioral health coverage through Harvard Pilgrim.
[ 10 ] y o u r h e a lt h winter 2011
11. [ cover story ]
manage your health
• Access tools to improve your health and help
manage chronic conditions.
• Order your medications through mail service and
learn more about our pharmacy program.
• Learn specific things you can do to prevent illness.
find your benefit
information
• Know what is covered and
what isn’t under your plan.
• Know what copayments and other
charges you may be responsible for.
• Know how to get care outside of the
service area and what restrictions
apply, based on your plan’s coverage.
• Review your medication and claims
history.
• Change your primary care physician
and request an ID card.
• Learn how to submit a claim.
• Get information on how to voice a
complaint or appeal a decision.
• Learn how Harvard Pilgrim evaluates
new technology for inclusion in
covered benefits.
need language assistance?
Harvard Pilgrim offers interpretation services in more than 150 languages.
So if you have questions about your care and coverage, we most likely can
answer them in your preferred language. The services of these qualified
translators are readily available through our Member Services department
at 888-333-4742 (TTY service: 800-637-8257).
w w w. h a r va r d p i l g r i m . o r g [ 11 ]
12. [ health notes ]
the good news is that you can take steps to prevent
high blood pressure or to treat it if it is already high.
high blood pressure, or hypertension, is a Know the facts!
common condition that affects one in three adults in the
United States. If your blood pressure stays high, it can What is high blood pressure?
lead to serious health problems such as heart disease, High blood pressure occurs when your blood moves
kidney disease and stroke. Because high blood pressure through your blood vessels with a stronger force than
has no warning signs or symptoms, many people don’t normal. This causes the walls of your blood vessels to
even realize they have it. That’s why it’s important to get stretch. Over time, this can lead to damage to your blood
your blood pressure checked at every doctor’s visit. vessels and your heart. >>
diabEtES cOnnEctiOn
did you know that having diabetes
increases your chance of getting high
blood pressure? in addition to reducing
your risk of heart problems, controlling your
blood pressure can help prevent complica-
tions of diabetes such as eye disease and
kidney disease. make sure that you get your
blood pressure checked on a regular basis
and talk with your doctor about setting a
blood pressure goal.
[ 12 ] y o u r h e a lt h winter 2011
13. [ health notes ]
Blood pressure Systolic mm hg diastolic mm hg
Category (upper #) (lower #)
Normal less than 120 and less than 80
Prehypertension 120–139 or 80–89
High Blood Pressure 140–159 or 90–99
As defined by the American Heart Association
What do the numbers mean? • limit sodium to 1,500 mg a day. Check the
Blood pressure is made up of two numbers — for label on your favorite can of soup. You may be
example, 120/80. The first number is the systolic blood surprised at how much sodium it contains.
pressure. It measures the force of blood moving through • limit alcohol. If you drink alcohol, limit it to no
your vessels when your heart beats. The second number more than one drink a day for women or two drinks a
is the diastolic blood pressure. It measures the force of day for men.
blood moving through your blood vessels between beats. • if you smoke, quit. Nicotine can raise your blood
If your first number (systolic blood pressure) is 140 or pressure for up to an hour after you smoke. Smoking
higher or if your second number (diastolic blood pressure) throughout the day means your blood pressure may
is over 90, you may have high blood pressure. remain high all day long.
• limit caffeine. Two to three cups of coffee a day may
How do i know if i have high blood pressure? cause a short but major rise in your blood pressure.
High blood pressure usually has no warning signs. The • reduce stress. Stress or anxiety can cause a
only way to know that you have it is to have your blood temporary rise in blood pressure.
pressure checked. At your doctor’s office, they will use • take your medicine. If your doctor has given you
a blood pressure cuff and will listen for the flow of blood. medicine for your high blood pressure, make sure you
Blood pressure can change if you are excited, nervous or take it as instructed. If you are having trouble with
active. To see if you have high blood pressure, your your medicine, talk to your doctor or pharmacist about
doctor will need to check your blood pressure at more your options.
than one visit.
WHERE can i GEt mORE infORmatiOn?
What can i do to lower my blood pressure?
Visit www.harvardpilgrim.org/bloodpressure to:
• lose weight, if you are overweight. Losing just • Calculate your risk
10 pounds can make a real difference. • Track your blood pressure
• change the way you eat. Try whole grains, fruits, • Test your salt IQ
vegetables and low-fat dairy, and limit saturated fat • Get tips for reducing salt in your diet
and cholesterol. • Learn about reading food labels
• increase your physical activity. Just 30 minutes • Find out about Your Member Savings on DASH for
a day most days of the week can lower your blood Health online program
pressure within a few weeks. • Learn about Harvard Pilgrim’s Heart Program
w w w. h a r va r d p i l g r i m . o r g [ 13 ]
14. [ plan news ]
your new activity Summary
an easy-to-understand breakdown of your health care
benefits and costs
a new activity summary is
replacing your current Harvard Pilgrim
Explanation of Benefits.
For the past several years, you received
an Explanation of Benefits notice for each
claim we processed related to your care.
Now, instead of getting this information
on a claim-by-claim basis, you’ll receive a
summary* of all of your health care claims
and costs within a given month.
The new, easy-to-review format shows:
• What services you’ve received and
their costs
• Recently filled prescriptions and
their costs
• What is covered under your
plan benefits
• What you may owe the provider
You’ll receive a summary in the mail when
we process medical claims that result in
you being responsible for a deductible,
coinsurance or denied amount during a
particular month. Like the statements you
may receive for your bank or credit card
accounts, your Harvard Pilgrim Activity
Summary lets you keep track of your “ac-
count” — your health care benefits, costs
and coverage.
View your activity Summary anytime online through your HPHConnect personal member account.
*by midyear, all members will receive an activity Summary instead of an Explanation of benefits.
HaRVaRd PiLGRim HEaLtH caRE HaS a WidE RanGE Of intERactiVE tOOLS
to help you stay healthy. you can find them on our Web site at www.harvardpilgrim.org.
if you do not have access to the internet, you can call 1-866-750-2068 and request
written information on the following topics: maintaining a healthy weight, quitting
smoking, encouraging healthy activity, healthy eating, managing stress, avoiding risky
drinking and identifying depressive symptoms.
Log on or call us today to start on your own way to better.
[ 14 ] y o u r h e a lt h win mer
S u m t e r 22001110
15. [ plan news ]
C 3
H E A L T H
4 1 1 1 1 4
protectiNg
R 1
your privacy
Harvard Pilgrim is commit-
ted to ensuring the privacy
and confidentiality of your
R E F O R M
1 1 4 1 1 3
protected health information
(PHI). To provide your health
care benefits and services
effectively, it is necessary to
collect and disclose certain
get your Free, updated BeNeFit PHI. We do this in accor-
dance with our own strict
haNdBook today oN hphconnect confidentiality policies and
in response to recent legislation at the federal and state level, those federal and state laws
your Benefit Handbook and Schedule of Benefits may have been updated. designed to maintain the
Your Benefit Handbook and Schedule of Benefits explain the services privacy of your PHI, including
and benefits to which you are entitled under your plan. Please log in to the Health Insurance Porta-
HPHConnect at www.harvardpilgrim.org to view these materials. You bility and Accountability Act
can get a copy of the Benefit Handbook and Schedule of Benefits or any of 1996 (HIPAA) Privacy Rule.
part of your Evidence of Coverage mailed to you at no cost. Just call To review our Notice of
888-333-4742 (TTY service 800-637-8257). Privacy Practices, visit
www.harvardpilgrim.org
(keyword: privacy) or call
888-333-4742 for a
printed copy.
acHiEVEmEntS
In QuALITY
We are committed to promoting care and customer
service that continue to meet or exceed the highest
standards of excellence, and we invite you to check our
progress. for a summary report of our quality improve-
ment activities and results, please visit our member Web
site at www.harvardpilgrim.org and click on “Understand
Quality” (select “Achievements in Quality”). Also, you
can call the Quality Program office at 617-509-7564 for a
printed copy.
w w w . h a r v a r d p iil g r i m . o r g
w w w. h a r va r d p l g r [ 15 ]
16. your health NoNPRofIT oRg
u.s. PosTAge
paid
Volume 15, Number 1 | Winter 2011 HARVARd PIlgRIm
harvard pilgriM health care HeAlTH CARe
1600 Crown Colony drive
cliNical adviSorS Quincy, ma 02169
Judith Frampton, RN
Joel Rubinstein, MD
Linda D. Winslow, RN, MEd
editor
Melanie Juran
Your_Health@harvardpilgrim.org
harvard pilgriM
MeMBer ServiceS
Phone: 888-333-4742
(TTY service: 800-637-8257)
Please Recycle 529MA www.harvardpilgrim.org Health or wellness or prevention information
important 1099-hC update: Remember to file
File under “easy” 1099-HC!
as you know, massachusetts ing health insurance, so if you were a
health care reform law requires state First Seniority Freedom or Medicare
residents to report on their health care Enhance member, you will not receive
Need help?
do you want to:
coverage when they file their Massa- a 1099-HC form.
chusetts income tax return. Most • know more about why you
Massachusetts residents ages 18 and 2) Look for your Schedule Hc. must file a schedule hc?
older are subject to a tax penalty for Along with the tax forms you receive in Contact your tax advisor or refer
any month in 2010 in which they did the mail this time of year from the Mas- to the department of Revenue’s
not have a plan meeting minimum sachusetts Department of Revenue, Web site: www.mass.gov/dor.
creditable coverage (MCC) standards. you should get one called Schedule HC. • get another copy of your
So it’s important that you include the Be sure to save it along with your other 1099-hc form? Visit the
proper forms with your 2010 tax filing tax documents as you prepare to file 1099-HC Info Center at
to show you were covered last year. your taxes. www.harvardpilgrim.org/1099.
You’ll find lots of helpful infor-
Here’s what to do: 3) file your taxes. mation about your 1099-HC, and
(As a helpful reminder, tear out this When you file your income tax return, you can securely print out an
page and put it in your tax file.) just be sure to include your completed additional copy of your most
Schedule HC. Also include your recent 1099-HC form.
1) Look for your 1099-Hc form from 1099-HC form if you’re filing a hard • talk to harvard pilgrim
Harvard Pilgrim. copy. about the details on your
We mailed this form to Massachusetts 1099-hc form? Call the
subscribers in January. The 1099-HC What else you should know Member Services department at
form provides proof of MCC health Employers generally have up to 60 days 888-333-4742. Representatives
insurance coverage for you and any to notify us of enrollment changes. As a are available 8:00 a.m. to
dependents in 2010 and includes the result, we may not have current enroll- 7:30 p.m. esT mondays and
information you’ll need to fill out and ment information on members enrolled Wednesdays; 8:00 a.m. to
file the Schedule HC form with your through employer groups. If a change 5:30 p.m. esT Tuesdays,
Massachusetts income tax return. affects your coverage as it appeared on Thursdays and fridays. for TTY
Note: Medicare recipients automati- your 1099-HC form, we will send you a service, call 800-637-8257.
cally meet the requirements for qualify- corrected form.