Company Name Here Table of Contents Company Overview
Company Name Here
Table of Contents Company Overview…. . . . . 02 Program Overview…. . . 04 Health Advocacy…. ……. . . . . 08 Benefits Gateway. . . 17 Health Cost Estimator+. . . . . 19 Communications Support…. . . . 22 Member Experience…. . . . . 25 How to Reach Us…. . . 29 1
Company Overview 2
Company Overview • Nation’s leader in healthcare advocacy and assistance • Distinguished roster of 11, 500 nationwide clients • Serving over 50 million eligible lives • Broad product spectrum • Outstanding, experienced management team 3 • Expert staff of healthcare and insurance professionals • Powerful and proprietary infrastructure • Strong brand recognized as objective and well-respected • A subsidiary of West Corporation
Program Overview 4
METRICS Welcome to Health Advocate Your Health Advocate benefit provides: • Health Advocacy • Benefits Gateway™ • Unlimited access for employees and eligible family members • Provided by <insert company name> at no cost to you • A single number connects employees 24/7 5
METRICS Important Note About Our Service Health Advocate • Does not replace health insurance coverage • Does not provide medical care or recommend treatment Health Advocate • Helps resolve healthcare and insurance-related issues • Interacts with healthcare professionals and insurance companies 6
METRICS Private and Confidential • We protect employees’ privacy • All healthcare information is kept strictly confidential • We fully comply with the federal Health Insurance Portability and Accountability Act (HIPAA) 7
Health Advocacy 8
Health Advocacy Solution Close-up • Highly personalized • We do the work for the member • Helps members navigate healthcare and insurance-related issues • Experts who know the ins and outs of the healthcare system • Saves time and money • HIPAA compliant * Based upon receipt of group’s utilization data 9 * *
How does the Health Advocacy service work? Call the single, toll-free number Member is assigned to a Personal Health Advocate Same Personal Health Advocate works with the employee until the issue is resolved; available for follow-up 10
What is a Personal Health Advocate? • Registered Nurses professionals – with 10+ years experience in clinical care, case management, nursing education, supervision and administration social workers, behavior change counselors, nutritionists, dieticians, dental care and pharmacy management • Benefits Experts • Single, ongoing 11
Addresses the Entire Family’s Needs • • 12 Employee Spouse/Domestic Partner Dependent Children Parents and Parents-in-law
METRICS Medical Authorization Release Form • Authorizes Health Advocate to interact with the employee’s doctors, other providers and health insurance companies on their behalf • One-page form can be downloaded from member website or emailed, mailed or faxed to employee to complete and return • Ensures complete confidentiality and privacy 13
How We Help • Find the right doctors, hospitals and other healthcare providers; expedite appointments • Explain complex medical conditions; research and locate the latest treatments • Coordinate care and schedule follow-up visits; facilitate second opinions; transfer X-rays and medical records • Arrange treatments and tests; answer questions about results, treatment options and prescribed medications • Clarify benefits including copays; help facilitate access to appropriate care • Provide one-on-one coaching to help close gaps in care* • Provide personalized information through Member and Client Dashboards* • Offer personal contact with Registered Nurses to support treatment decisions • Resolve insurance claims; negotiate billing arrangements • Help locate eldercare services including assisted living and adult day care; address other issues facing parents and parents-in-law * Based upon receipt of group’s claims and utilization data 14
Special Help for Seniors • Retirees transitioning to a new health plan • How to enroll in Medicare • Clarify Medicare Parts A, B, D and supplemental plans • Inform about pre-existing conditions; dependents under age 65 15 • Locate eldercare services that fall outside traditional healthcare coverage • Assist with the transition from traditional insurance to Medicare HMO • Facilitate early care management intervention
Key Benefits • • Independent and objective Improves health outcomes Reduces medical costs Improves administrative efficiencies • Eases burden on HR staff and employees • Supports consumer-driven health plans • Professional, non-adversarial approach to finding the right answers • Increases employee productivity, satisfaction and retention • Easy to use • Maximizes benefits utilization • Reduces grievances and appeals 16
Benefits Gateway 17
A Single Phone Call § Benefits experts connect employees to all health-related benefits through a single 800# (e. g. , medical, dental, EAP, pharmacy) § Smooth transition to Health Advocacy service for help resolving healthcare and insurance -related issues § Unlimited support available 24/7 18
Health Cost Estimator+ 19
Key Features • Helps employees shop around for medical procedures and services in their area • Estimated costs for doctors, hospitals and other facilities nationwide • Quality indicators, safety scores and patient reviews • Complete mobile functionality (smartphone, tablet, PC) 20
Drives More Informed Decisions • Detailed cost breakdown for each estimate • Powerful filter to narrow search results • Compare hospitals and doctors side by side • Contact a Personal Health Advocate for added support 21
Communications Support 22
Member Communications • Year-round electronic, print and online materials introduce the program, raise awareness and drive participation • Multi-leveled: brochures, newsletters, posters, health tip sheets, table tents • Strategic and comprehensive Communication may be different from samples above. 23
Member Website What’s included? • • Features of the program Access to communication materials Health information Member videos www. healthadvocate. com/members 24
Member Experience 25
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“ This is a great service. As a HR professional at my company, I have encouraged others to use Health Advocate but had not had the opportunity to call for myself until now. I was getting nowhere with my issue on my own, so I decided to give it a try. I greatly appreciated the help, and the representative helped me save a considerable amount of money. ” 27
“ The nurse who helped me is worth her weight in gold. She clearly saved me at least four hours of work time. This may be the best benefit we have! Shout it from the rooftops! ” 28
How to Reach Health Advocate Telephone: 866. 799. 2731 Email: answers@Health. Advocate. com Website: Health. Advocate. com/members Hours of Operation Normal hours of operation are Monday - Friday from 8 am to 12 am (midnight), Eastern Time. Health Advocate can be accessed 24/7. Staff is available for assistance after hours and on weekends. 29
Thank You Any questions? 30
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