Health Care ID Card Enhancements

Transcription

1 State of California Health Care Enhancements Incorporating National WEDI Indstry Card Standards and the UnitedHealthcare Branding Transition UnitedHealthcare is the first health company to se the national Workgrop for Electronic Data Interchange (WEDI) indstry card standards to proide niformity of information, appearance, and technology for commercial and Medicare health care ID cards for all bsiness. Ne data standards mean physicians and care proiders can read any carrier s ID card sing a single card reader. We beliee this is an important step in simplifying the administration of health care. We condcted research ith physician offices/practice managers, pharmacists, hospitals and consmers; and e responded to comments and improements sggested by employers to ensre that e proide the optimal health care ID card. Why Are We Becoming One, Unified Master Brand? We are transitioning to a single UnitedHealthcare brand for or benefits bsinesses. Or goal is to bild a brand that consmers and bsinesses can trn to for health care benefits no matter here they lie, no matter hat their age, and no matter hat type of prodct they need. We feel a single UnitedHealthcare brand ill make it easier to do bsiness ith or company. Key Featres of the Health Care Some of the important WEDI health care ID card standards inclde: Consistency layot based on WEDI standards for data fields, placement and size; personalization and ariable information ith labels printed on front of card and instrctions on back of card Readability limited information on the card, machine readable formatting, and se of large font size Copying/Scanning ability to clearly copy or scan for patient health records ith hite backgrond Inclsie meets national health care ID card gidelines set by the National Concil for Prescription Drg Programs (NCPDP) What does Medicare Soltions Mean? Medicare Soltions is the family of Medicare plans that inclde Part D Prescription Drg Plans, Medicare Spplement Insrance Plans and Medicare Adantage Plans featring the UnitedHealthcare, AARP, SecreHorizons or Eercare brand names. As part of or rebranding for 2012, all of the Medicare Soltions prodcts ill either be UnitedHealthcare branded, or in the case of the AARP Medicare Plans, insred throgh UnitedHealthcare.

2 What s Changing on the Health Care s? Or health care ID cards ill display the ne UnitedHealthcare logo in the top left corner of the ID card and there ill be an additional name modification to the right of the logo for or PacifiCare and Medicare plans: PacifiCare ill transition to the ne UnitedHealthcare logo ith the prodct name, sch as Signatre Vale HMO appearing to the right of the logo SecreHorizons Medicare plan in 2012 ill be: UnitedHealthcare Medicare Soltions Cobranded AARP Medicare plans ill contine to hae the AARP logo bt the sb-brand ill change from SecreHorizons to UnitedHealthcare Additionally, the cards inclde an indstry-standard bar code for machine readability of the information printed on the card. What s NOT Changing on the Health Care s? Or claims process, claim addresses and cstomer serice nmbers are not changing. What Do the Ne Cards Look Like Compared To the Old Cards? See belo to see ho the cards ill look for each line of bsiness. Highlights are inclded for changes to the cards. Samples of Commercial and Medicare Health Care ID cards Commercial Plans Sample Cards Former 2

3 Pacificare Commercial Sample Cards Former Former 3 NEW Logo ith Prodct Identifier NEW ebsite address NEW legal entity name NEW WEST indicator

4 Medicare Plans Sample Cards Crrent y NEW Logo NEW Prodct Name NEW Medicare Indicator y NEW Proider Web site URL NEW WEST Indicator Crrent 4 NEW Logo NEW Prodct Name NEW Medicare Indicator y NEW Proider Web site URL NEW WEST Indicator y

5 Medicare Plans Sample Cards Crrent NEW Logo NEW Medicare Indicator Crrent 5 NEW Logo NEW Prodct Name NEW Medicare Indicator

6 Medicare Plans Sample Cards Crrent y NEW Logo NEW Prodct Name NEW Medicare Indicator NEW Proider Web site URL y NEW WEST Indicator 6

7 Q. Ho do I identify a member s prodct coerage (Commercial s Medicare)? A. Yo ill be able to identify the correct prodct coerage by looking at the logo on the top of yor patient s health care ID card here it references UnitedHealthcare, UnitedHealthcare Signatre Vale (or other PacifiCare prodct names) or UnitedHealthcare Medicare Soltions. If a member calls in to set an appointment, yo can erify the prodct by asking the member to tell yo the name on the front of the card as ell as the address for claims on the back of the ID card. This ill allo yo to identify the prodct line. * Please note, that the branding transition ill take place oer more than a year. Therefore, depending pon that timing, it is likely that yo ill enconter members ith a non-branded ID card. Q. Where shold I call if I hae qestions? A. Yo shold call the phone nmber as noted on the back of the health care ID card. Q. Which ebsite URL shold I se in order to check eligibility or claim stats? UnitedHealthcare Commercial Contine to se UnitedHealthcareOnline.com PacifiCare Commercial: Use hcest.com. Medicare: Use hcest.com. Q. No that eerything is referred to as UnitedHealthcare can I find information on UnitedHealthcareOnline.com for all my patients? A. Althogh most of or member information can be accessed on UnitedHealthcareOnline.com, yo may need to tilize other URL s de to the fact that UnitedHealthcare spports mltiple claim platforms for or arios lines of bsiness. Please reference the URL on the back of yor patient s health care ID to select the correct eb portal. Q. When Will the Branding Changes Occr? A. UnitedHealthcare Commercial Branding changed at the end of PacifiCare Commercial changed brand beteen May 1, 2011 and Jly 1, All Medicare prodcts inclding PacifiCare Medicare ill change brand in early Q. Ho does this rebranding affect my contracts ith UnitedHealthcare? A. The branding initiatie does NOT affect yor contractal agreement ith UnitedHealthcare and its lines of bsiness. This incldes or family of prodcts in PacifiCare and Medicare. Key Tips When schedling a patient, reference the P.O. Bo on the back of the health care ID card to confirm the member s prodct When calling the cstomer serice nmber enter the member s crrent ID# into the Interactie Voice Response system to ensre proper roting When sbmitting claims enter the Payer ID hich is noted on the cards Alays se the member s ID card as the sorce of trth. Check it each time that yo see or talk to the member. 7

8 Q. Ho ill rebranding affect the reports, letters and other docments I receie for UnitedHealthcare bsiness? A. On reports or letters crrently displaying the PacifiCare logo, the logo ill be replaced ith the UnitedHealthcare logo. Additionally, the headers in all system-generated reports (sch as capitation, eligibility or enconter reports), ill be labeled as UnitedHealthcare instead of PacifiCare. Also, if yo se Capitation Flat File data in yor daily operations, the ale for the Health Plan field ill change from PHS to UHC. Crrent Flat File HEALTH PLAN RECORD BUSINESS CONTRACT PLAN PLAN COMPANY NUMBER CAP PROCESS MONTH CAP PERIOD PHS 4S CO CO PO PHS 4S CO CO PO PHS 4S CO CO PO PHS 4S CO CO PI File HEALTH PLAN RECORD BUSINESS CONTRACT PLAN PLAN COMPANY NUMBER CAP PROCESS MONTH CAP PERIOD UHC 4S CO CO PO UHC 4S CO CO PO UHC 4S CO CO PO UHC 4S CO CO PI M47500CA 10/11 Doc #: UHC United HealthCare Serices, Inc.