UA Health plan partners assist with life, health care and wellness decisions
The second of a three-day November 2015 Joint Health Care Committee meeting in Anchorage featured a round robin report by representatives from all of the auxiliary services provided as a part of the UA Choice health plan. They included Best Doctors, Patient Care, ComPsych, Healthyroads and VSP. Premera also gave an overview of the health care climate in Alaska.
The PowerPoint presentations from each auxiliary service will be posted when available on the UA Benefits site under the Joint Health Care Committee’s Nov. 11, 2015 meeting link.
Here are some highlights from their reports.
Best Doctors are who to call if you aren’t certain about the diagnosis or treatment plan you receive from your primary care provider, if you are concerned about prescribed surgery or treatment, or if you are looking for a new doctor or specialist.
Of those utilizing Best Doctors, most want to confirm the need for surgery OR they are not improving and want more information. Their services include:
- Second opinion (called an InterConsultation)
- Critical Care Support (help with catastrophic events)
- Ask the Expert (no medical records required)
- eSummary (all your medical records pulled together for you)
- Find Best MD (finds physicians in-network accepting new patients)
Best Doctors will collect your medical records, images and test samples and send them to an expert specialist for review. After the review, you will receive a detailed and confidential report summarizing the Best Doctors expert's findings so that you and your treating physician can take the right next steps. Once Best Doctors has your medical records, you should receive their evaluation within 7-10 days. To start your case, or get more information, call 1-866-904-0910, or visit members.bestdoctors.com
This service is not for mental health issues or substance abuse, chronic pain or depression. For those instances they will refer you to the Employee Assistance Program (EAP) with ComPsych. They also do not handle Workers’ Compensation cases.
Employee Assistance Program with ComPsych Guidance Resources
ComPsych has served UA since 2007. Most often you’ll hear about them for their counseling service. They offer up to six counseling sessions per person, per issue, per year, at no out-of-pocket cost to the member. This service is 100% paid for by the university and is 100% confidential. If you need additional services after using the EAP, you can continue seeing the same provider under the UA Choice health plan, or be referred to another in-network provider. But their comprehensive employee assistance program covers far more services.
Legal services are available, though only free for the initial consultation, and are available at a discounted rate afterward. There are some free online legal tools available such as a will development template and estate planning tools.
Other online resources include information on bullying, overcoming empty nesters issues, stress management, dating and family advice, developing healthy habits and much, much more. Online resources are completely free. Quarterly communication campaign plans for 2016 include more information on managing personal finances, improving wellbeing, legal and financial resources and building resilience.
You or your eligible family members may contact ComPsych® directly 24 hours a day, seven days a week, at (866) 465-8934 or use the TDD at (800) 697-0353. Telephone or in-person consultations will be set up for program participants at their convenience, depending on the type of need or problem. You can also go online to GuidanceResources® Online, which provides in-depth information with help sheets on a variety of topics. The "company ID" required to sign in is GC5901Q. ComPsych is also working on a new mobile app so that they “can meet the client where they are.”
Patient Care is a patient advocacy service designed to help health plan users better navigate the health care system. They are not affiliated with any insurance company. The service is free and confidential and takes a lot of the stress out of health care decisions. They can help make sense of the confusing world of medical billing and assist in shopping around for the best deals.
Patient Care will help members with:
- solving billing and claims issues
- answering questions on what’s covered
- assisting with follow up questions
- clarifying prescription drugs
- finding in-network specialists
- locating providers for a second opinion
They are focused on health care costs and transparency. Through research they have identified varying rates for care and can help guide consumer decisions.
Examples of the range of Alaska rates:
- Colonoscopy can vary from $920-$8,750
- Mammogram can vary from $110-$2,900
If you need a health care advocate call Patient Care at (866) 253-2273 or visit http://www.patientcare4u.com/university_of_alaska/ to get started.
Healthyroads manages UA’s Wellness plan. They provided an assessment report for the UA cohort from January 2014 through June 2015. The cohort is the group of employees and spouses who have completed the program both years. In the cohort, 1,839 completed the personal health assessment and 1,706 completed the biometric screenings. Those two tests, plus point-earning activities, are required to earn a $600 rebate on UA Choice health plans. More information on Healthyroads wellness program and eligibility will be highlighted in the next Statewide Voice.
The vendor summit included a brainstorming session between JHCC and vendors on how auxiliary service providers could better serve UA Choice health plan members. All agreed that UA Choice plan users would benefit by being more consumer-savvy in their healthcare choices. But how do we get there?
Ideas to induce this included:
- Develop a decision tree for scenarios (How do I…or I’ve got this, now what?)
- Offer wellness plan incentive points for using vendor programs
- Provide auxiliary vendor cards with contact numbers
- Patient Care could share its transparency report (on service costs) with Best Doctors
- If Prior Authorization is denied, refer patient to Best Doctors to find alternative treatment or diagnosis confirmation
- Have vendor links available on more websites
- Send health care information from UA Benefits with a different sender name, such as UA BENEFITS UPDATE
- Consider creating a Consumer Healthcare 101 course; if plan users take it, they could earn incentive points for wellness plan.
The Joint Health Care Committee will discuss these ideas and others at its January 2016 meeting.