CLAIMS ........
MEDICAL........PRESCRIPTION BENEFIT MEDICARE PART D PRESCRIPTION........ CREDITABLE COVERAGE LETTER
HEALTH ADVOCATE SERVICE..........
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CLAIMS ........
MEDICAL........PRESCRIPTION BENEFIT MEDICARE PART D PRESCRIPTION........ CREDITABLE COVERAGE LETTER
HEALTH ADVOCATE SERVICE..........
November 2006
Dear Sisters & Brothers:
We are proud to offer you a new service to assist you in navigating through the healthcare system. Effective December 1, 2006 all members, and their families, have access to a unique new service offered by Health Advocate. This service is available to you, your spouse, your dependents, parents and in-laws regardless of whether or not they are covered by the Local 28 plan of benefits.
Health Advocate is an independent company that is made up of professional individuals such as nurses, doctors, psychologists, etc. These professionals are now available to our members and families to help you navigate the healthcare system. Health Advocate is designed to help handle healthcare and insurance related issues by cutting through the red tape and barriers that can create frustration and problems. Please read the brochure provided for all the details of this service and how it might be of use to you or to learn more, please visit http://www.healthadvocate.com where you can view an introductory video located on the home page of the website (bottom left titled "Video Guide")
Health Advocate does not replace the customer service line of our health plan, nor is it a nurse hot-line for emergencies. It is an organization of qualified individuals who will use their expertise in the health field and knowledge of providers across the country. It is a service to obtain confidential, unbiased, objective information and to help you make choices concerning your health situation. Too many times patients are uncertain that they are getting all of the information or the correct information. Health Advocate is here to remove that uncertainty for our members and their families.
Some examples of the reasons to call Health Advocate are:
1) To identify and make appointments to see the best physician or hospital for an illness.
2) For help understanding an illness when you have been unable to get the time with your provider to ask all your questions.
3) For help with insurance claims and billing issues.
4) For help with medical issues and healthcare needs that your parents or in-laws might have (they are also eligible for the service).
5) Assistance with understanding any issues with your prescription drugs.
Health Advocate does not deliver medical care nor do they tell the members what to do. Instead they help you make more informed decisions about your healthcare. A Health Advocate nurse will answer your questions, do the research, provide you the options and follow up with you. There are no enrollment forms; you simply call Health Advocate at 1-866-695-8622. When you call Health Advocate and require service, they will ask you to complete a Medical Information Release Form. Please be assured that all of your information will be kept strictly confidential by Health Advocate and your privacy will be protected.
Our decision to offer Health Advocate clearly relates to our interest in making certain that our members have the best possible healthcare. We believe that you and your family will greatly benefit from this valuable service.
November, 2006
Dear Sisters & Brothers:
At the direction of President & Business Manager Michael V. Belluzzi, the Funds & Plans have made every effort to have claims adjudicated and paid within ten (10) days. The obvious problems we are still seeing are with lab claims (please see enclosed lab hotline letter) and claims with diagnosis codes that indicate the possibility of an accident where other insurance might have been used or a workers compensation claim should have been filed. In these cases, the claims are taken out of the system and the member is asked to send a letter indicating the cause of injury. Once the letter has been received, the claim is put back into the system and adjudicated. In an effort to serve the membership better and pay claims in a timely manner, we would like to suggest that you call the helpline at 877/347-7225 and give them the information. When you make that call, kindly get the name of the person you are dealing with for the future. After contacting the Dickinson Group, if you still have a problem, then you would call the Funds office. We thank you in advance for your cooperation.
MagnaCare is aware that at times Laboratories may send invoices when in fact a claim has been resolved. As we work with the laboratories to improve the process and exchange information more efficiently, we would like to provide you with a resource to address your laboratory-related issues.
MagnaCare has established a dedicated Laboratory Hot Line for members. This toll-free number, exclusively for members, allows you to contact a MagnaCare Customer Service Representative who will resolve any laboratory-related billing issues that you may have.
• When visiting a laboratory, please make sure that you present your MagnaCare card. This will help to ensure that you are identified as a MagnaCare member so that you are not billed by the laboratory.
• If the laboratory does not require you to provide any insurance information at the time of your visit, remember to ask them if they have your health insurance information on file in order to have the claim submitted to MagnaCare.
• If your doctor draws blood or collects a specimen from you during an office visit, please make sure that he or she indicates on the laboratory requisition form that you are a MagnaCare member.
• If you receive a bill directly from the laboratory and they have not submitted a claim MagnaCare because they do not have your health insurance information, you should complete the insurance information section located on the back of the bill and return it to the lab.
