Health Advocacy

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

Addresses the Entire Family’s Needs Employee Spouse/Domestic Partner Dependent Children Parents and Parents-in-law

What is a Personal Health Advocate? Registered Nurses with 10+ years experience in clinical care, case management, nursing education, supervision and administration Benefits Experts with 5+ years experience in benefits administration, claims management, provider group administration Supported by full-time Medical Directors

What is a Personal Health Advocate? Trained clinical professionals – social workers, behavior change counselors, nutritionists, dieticians, dental care and pharmacy management Single, ongoing contact person – direct dial phone number, email address Chosen for medical expertise, commitment to service excellence, communication skills and strong problem resolution approach

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 specialized 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 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

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 65 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 Reduces grievances and appeals Improves health outcomes Reduces medical costs Improves administrative efficiencies Eases burden on HR staff Maximizes benefits utilization Reduces grievances and appeals Supports consumer-driven health plans Professional, non-adversarial approach to finding the right answers Increases employee productivity, satisfaction and retention Easy to install