HEALTHCARE ADVOCACYTELEMEDICINE WELLNESS RX MANAGEMENT

NAVIGATING HEALTHCARE

PROCEED WITH CAUTION

You and Your Team Face Increased Responsibilities all while trying toDeliver Significant Value

• Time tracking for variable hour employees• Full-time employees and equivalents calculation• Plan affordability analysis

ACA Reporting

• Data gathered automatically from payroll• End-of-year printing and mailing to employees• Completed employer forms filed with the IRS

Forms 1094 and 1095

• Penalty exposure warning• What-if simulations• Checklist to keep you on track

ACA Compliance

Today’s Consumers have grown accustomed to:

• Instant access to every piece of information.• Expecting more services to be available 24/7.• More comfortable connecting with people and

businesses through technology instead of in person.

The Insurance Consumer has Changed. Have you?

Move from Broker to Trusted Advisor

Stay on Top of Legislation and Industry Trends

Managing Healthcare

Timelines and Enrollment Process

ACA and Compliance

Checklist

Plan Members find Navigating Healthcare to be Very Confusing

What’s Covered in My Plan?

Mandatory Second

Opinions

Scheduling Appointments

Locating Care

ProvidersBrand or Generic Drugs?

In orOut of

Network?

Finding Convenient

Facilities

Supporting a Consumer requires a New Dimension of Information and Solutions

Whatshould I do?

Whereshould I go?

How muchwill it cost?

Cost Transparency and Medical Bill

Review

Provider Search and Scheduling

Evaluate and CompareTreatment Options

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We help with answers and get results.

• Help in understanding your health plan• Find the Right Doctor, Hospital• Schedule Tests, Appointments, Second Opinions• Get cost estimates for procedures• Resolve billing issues• Perform medical record transfers

How does Healthcare Advocacy Help Members?

Assist your Clients with Cloud Based Collaboration of Subject Matter Experts (SMEs)

Clinician, RNsand Medical Advocates

Insuranceand Benefit

Professionals

Pharmacyand

Treatment Specialists

Provider Relations and

Claims Coordinators

Meet Our Subject Matter Experts

• Dedicated Toll Free Numbers• Advocate Resources• Transparency Tools• Chat Box Options• Responsive Website

High Tech, High Touch

General Plan Questions • Assistance with Copayments, •

Deductible & Out-of-Pocket Costs Clarify Covered Services •

Understanding Pharmacy •Benefits & Formularies

PLAN BASICS: Explanation &

Understanding Of Benefits

• Finding In-Network Providers, Treatments & Facilities• Get Second Opinions & Alternative

Care Options• Schedule Appointments & Transfer

Medical Records• Compare Cost & Quality

FINDING CARE: Transparency & Access

• Claims Explanation & Support•Medical Bill Reviews & Audits• Fee & Payment Negotiation• Appeals & Approvals

PROBLEM SOLVING: Hands-On Support & Solutions

Rx Medication Review •Cost Savings Options •

Case Management Support •One-to-One Preventative Care Planning •

PERSONAL CARE: Individual Solutions

Rx Medication Review •Cost Savings Options •

Case Management Support •One-to-One Preventative Care Planning •

PERSONAL CARE: Individual Solutions

• Finding In-Network Providers, Treatments & Facilities• Get Second Opinions & Alternative

Care Options• Schedule Appointments & Transfer

Medical Records• Compare Cost & Quality

FINDING CARE: Transparency & Access

• Claims Explanation & Support•Medical Bill Reviews & Audits• Fee & Payment Negotiation• Appeals & Approvals

PROBLEM SOLVING: Hands-On Support & Solutions

General Plan Questions • Assistance with Copayments, •

Deductible & Out-of-Pocket Costs Clarify Covered Services •

Understanding Pharmacy •Benefits & Formularies

PLAN BASICS: Explanation &

Understanding Of Benefits

General Plan Questions • Assistance with Copayments, •

Deductible & Out-of-Pocket Costs Clarify Covered Services •

Understanding Pharmacy •Benefits & Formularies

PLAN BASICS: Explanation &

Understanding Of Benefits

• Finding In-Network Providers, Treatments & Facilities• Get Second Opinions & Alternative

Care Options• Schedule Appointments & Transfer

Medical Records• Compare Cost & Quality

FINDING CARE: Transparency & Access

• Claims Explanation & Support•Medical Bill Reviews & Audits• Fee & Payment Negotiation• Appeals & Approvals

PROBLEM SOLVING: Hands-On Support & Solutions

Rx Medication Review •Cost Savings Options •

Case Management Support •One-to-One Preventative Care Planning •

PERSONAL CARE: Individual Solutions

• Claims Explanation & Support•Medical Bill Reviews & Audits• Fee & Payment Negotiation• Appeals & Approvals

PROBLEM SOLVING: Hands-On Support & Solutions

• Finding In-Network Providers, Treatments & Facilities• Get Second Opinions & Alternative

Care Options• Schedule Appointments & Transfer

Medical Records• Compare Cost & Quality

FINDING CARE: Transparency & Access

Rx Medication Review •Cost Savings Options •

Case Management Support •One-to-One Preventative Care Planning •

PERSONAL CARE: Individual Solutions

General Plan Questions • Assistance with Copayments, •

Deductible & Out-of-Pocket Costs Clarify Covered Services •

Understanding Pharmacy •Benefits & Formularies

PLAN BASICS: Explanation &

Understanding Of Benefits

Rx Medication Review •Cost Savings Options •

Case Management Support •One-to-One Preventative Care Planning •

PERSONAL CARE: Individual Solutions

• Finding In-Network Providers, Treatments & Facilities• Get Second Opinions & Alternative

Care Options• Schedule Appointments & Transfer

Medical Records• Compare Cost & Quality

FINDING CARE: Transparency & Access

• Claims Explanation & Support•Medical Bill Reviews & Audits• Fee & Payment Negotiation• Appeals & Approvals

PROBLEM SOLVING: Hands-On Support & Solutions

General Plan Questions • Assistance with Copayments, •

Deductible & Out-of-Pocket Costs Clarify Covered Services •

Understanding Pharmacy •Benefits & Formularies

PLAN BASICS: Explanation &

Understanding Of Benefits

Activity Summary Reports

• Employee / Member Count• Number of Interactions• Distribution of Call Categories• Easy to Understand Usage Chart

Activity Reports Include

We answer the phone 24/7 with

your agency name and greeting.

We free up agency staff to focus on growing the

business.

We customize

our materials to promote

your company and

brand.

We bringvalue and improve

client retention and relationships.

We provide customized reports that

reinforce program value.

Create a Differentiator

Become a Trusted Advisor

• Add Value and Enhance Client Relationships• Improve Productivity and Retention• Provide Expertise• Stand Out in the Market

Healthcare. Confusion. Simplified.

HEALTHCARE ADVOCACYTELEMEDICINE WELLNESS RX MANAGEMENT

THANK YOU