Thank you for being a part of Evergreen Health. If I can ever be of assistance, please don t hesitate to me at

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1 The Pulse MEMBER NEWSLETTER APRIL 2014 Volume 1, Issue 1 TABLE OF CONTENTS A Letter from the CMO 2 Your Health Risk Assessment 2 Evergreen Health Care centers 3 Pledge to Members 3 Picking Your Primary Care Provider 4 Frequently Asked Questions 4 Board Elections Care Coordination Services The Member Portal Staying Connected Important Phone Numbers 6 Evergreen Health s Member newsletter, The Pulse, is published quarterly for members. If you would like to receive updates instead of a printed newsletter, please see page. AM.N Welcome to Evergreen Health! I am proud we have built a new kind of health insurance company from the ground up one that puts you first. From the health care teams at the Evergreen Health Care centers included in our national network, to our 24/7 live call support. Our commitment to our members sets Evergreen Health apart. Not only do we provide our members with affordable and quality health care choices, but as a co-op, our members have a voice in how their Evergreen Health plan is operated. We will be holding elections for our Board of Directors later this year; I hope you will consider nominating yourself or another member to have a seat at the table. Thank you for being a part of Evergreen Health. If I can ever be of assistance, please don t hesitate to me at Sincerely, Peter Beilenson, MD, MPH Founder & CEO, Evergreen Health

2 A LETTER FROM EVERGREEN HEALTH S Chief Medical Officer It pays to assess your risks! We are thrilled you are a member of Evergreen Health. In an effort to inform you of our work and to help you to improve your health, we will send you a quarterly Evergreen Health Bulletin. I am happy to welcome you in our first newsletter. My overall goal as Chief Medical Officer is to support the delivery of high quality health care services to our members. To that end, I d like to highlight two of our efforts to reach our goal of improved health and health care delivery: #1 NETWORK: In a less than a year we have built a robust, comprehensive network of providers in the State of Maryland. With all of our Evergreen Health plans you have the flexibility to choose from our national network of over 70,000 providers that includes over 20,000 doctors and specialists in Maryland alone, plus access to care at one of our new innovative Evergreen Health Care centers. #2 QUALITY: I oversee Clinical Services for Evergreen Health. In that capacity I manage the network of providers who accept our insurance and ensure they are delivering the highest quality of care to you. We have stringent requirements for providers who join our network and the vast majority are Board eligible or certified. We have also built a comprehensive care coordination system that allows us to identify any gaps in your care. We communicate this information to providers so our members receive the appropriate care. As a physician, I love working for Evergreen Health because we have built an insurance company that puts our members first. If you have suggestions about providers you would like to see join our network or ideas about how we might improve the health of our members please send me an at Complete your Health Risk Assessment and get $0 in return! A Health Risk Assessment, sometimes called an HRA is an important way to help you stay healthy by providing you with a better understanding of your current health status and risk of developing diseases. It will take only 10 minutes to complete, and you will get a $0 gift card and a personalized health profile in return for your time and your fully completed HRA. To complete your HRA go to: AT EVERGREEN HEALTH YOUR PRIVACY AND YOUR RIGHTS ARE PARAMOUNT. For details on Evergreen Health s privacy practices and your patient rights go to: Alex Blum, MD, MPH Chief Medical Officer, Evergreen Health Go to members for more information and contact us with questions. If you do not have internet access, contact Member Services at Evergreen Health 3000 Falls Road, Suite 1 Baltimore, Maryland THE PULSE

3 THE HEALTH CARE EXPERIENCE YOU HAVE ALWAYS WANTED Evergreen Health Care Centers Did you know that your first preventive care visit at any of the over 230,000 Primary Care Providers in our network is FREE, even if you have a deductible? Consider getting care at one of our 4 brand new Evergreen Health Care centers, which have appointment slots waiting for you. Have you been frustrated by the long waits at your doctor s office, unfriendly staff, difficulty re-scheduling, and delays in follow-up? This doesn t have to be your health care experience if you join us at the new Evergreen Health Care centers. Joining the centers gives you access to a primary care team unlike any in Maryland. At the health centers, you ll feel the Evergreen Health difference. You can expect twice as much time with your Provider to address all of the health questions or concerns that you ve been wanting time to ask. You ll also have free-of-charge access to a Health Coach who will work with you to break down any barriers to a healthy lifestyle. Not to mention the availability of same day appointments, assistance with referrals, early morning and evening hours, and brand new warm and welcoming facilities! The Evergreen Health Care center at the Rotunda in Baltimore. As a patient at our Greenbelt center recently said, Everyone here is so friendly and inviting. I ve never had this much time with my health care Providers before! But, don t just take this patient s word for it. We invite you to come experience the centers for yourself. Call your nearest center to arrange a tour or stop by the center closest to you. BALTIMORE The Rotunda 733 W. 40 th Street, Suite 200 Baltimore, MD WHITE MARSH 7939 Honeygo Boulevard Building 3, Suite 127 White Marsh, MD COLUMBIA 9710 Patuxent Woods Drive Suite 200 Columbia, MD GREENBELT 701 Greenway Center Drive Suite 600 Greenbelt, MD CENTER HOURS: Monday, Wednesday, Friday: 7am - 3pm Tuesday, Thursday: 11am - 7pm Pledge to Members Evergreen Health continually strives to ensure you receive necessary services at the appropriate time and in the appropriate setting. This is done through our utilization management (UM) processes. UM is our process to make sure all the clinical care you receive is appropriate and matches your benefits. We are never rewarded for rejecting a provider s request for payment for services delivered to our members and we keep a keen eye that providers don t skimp on the care they should provide our members. If you have questions about the review processes, please contact us. We are available to answer your UM questions from 8 AM until 7 PM Monday through Friday. You may leave a message at other times and your call will be returned the following business day. Call our Member Services department toll- free at In addition, language assistance is also available through Member Services. TDD/TTY services for the hearing impaired can be accessed by calling or THE PULSE

4 Have you picked your primary care provider? You have the flexibility to choose from our national provider network that includes over 20,000 doctors and specialists in Maryland alone, plus access to care at one of the new innovative Evergreen Health Care Centers. Visit to search for providers near you. Frequently Asked Questions I HAVEN T RECEIVED MY MEMBER ID CARD. WHAT SHOULD I DO? Your member ID card will be mailed out to you approximately 7-10 days after you enroll and make your first payment. If it has been more than 10 days since you enrolled and paid, call Member Services at so that we can help you. If 2-3 business days have passed since you enrolled and paid, you can get a copy of your ID card until your card arrives in the mail by calling Member Services at or logging into your Member Portal at: WHAT PROVIDERS DO I HAVE ACCESS TO? Whether you are enrolled in an Evergreen Health Care HMO plan or an Evergreen Health Insurance point of service (POS) plan, you have access to a robust national network of providers and specialists, including in network benefits from PHCS/ Multiplan. Included in our network are also the four brand new Evergreen Health Care centers, located in Baltimore, White Marsh, Columbia, and Greenbelt. WHO IS CATAMARAN? WHAT SHOULD I DO IF THE PHARMACY DOESN T RECOGNIZE ME IN THE SYSTEM? We re proud to partner with Catamaran for your pharmacy benefits. Catamaran provides retail, specialty and mail order pharmacy benefits to Evergreen Health members. For any pharmacy benefit questions call Catamaran s Member Services team at For a complete list of pharmacies in the Evergreen Health network, go to: WHO SHOULD I CONTACT IF I CANNOT ACCESS, OR I CAN T SEE ANYTHING IN MY MEMBER PORTAL? We are here to help. Call member services at HOW LONG DO I HAVE TO SUBMIT A CLAIM? In most instances your provider submits your claims. If you need to submit your own claim you have 180 days from the date of service. QUESTIONS? Call member services at , where we have a live person available to take your calls 24/7. You can also contact our Director of Customer Experience at or us at Save time and have your prescriptions delivered in the mail! Evergreen Health has partnered with Catamaran Home Delivery to make getting your prescriptions more convenient. To enroll in the program call or go to mycatamaranrx.com. Click on mail order and complete the form. 4 THE PULSE

5 THE CO-OP DIFFERENCE Your plan. Your say. Evergreen Health is not just another insurance company, we are YOUR company. What makes Evergreen Health different isn t just our commitment to your care it is that we are a nonprofit health co-op. That means that we are governed by a board of Evergreen Health members not outside investors. Beginning early this summer you may nominate members (including yourself) to serve on the Evergreen Health Board of Directors. Stay in touch with us on social media for more details or us at to receive updates when they are available. Prevention is key. EXPLORE YOUR MEMBER PORTAL AT Each Evergreen Health Care center has a Care Coordinator on staff to help you seamlessly navigate the complex healthcare system anytime you need care beyond the walls of the center. Online or in the portal: The Care Coordinator will ensure that your primary care team collaborates with their specialists to maintain good communication and to keep your health care needs and goals at the center of their care. We teach and refer to community resources as needed to maintain wellness. Download a copy of your member ID card See the summary of benefits and coverage for your plan Access your member handbook Find a provider Check the status of claims How do you want to stay connected? Connect with Evergreen Health online so you can stay up to date on the new programs and services we will be launching later this year. Prefer to receive updates instead of a printed newsletter? Visit your member portal to update your communication preferences: facebook.com/ EvergreenHealthCooperative twitter.com/ evergreenmdcoop THE PULSE

6 Important phone numbers EVERGREEN HEALTH CARE CENTERS: If you have questions, comments, or concerns, we want to hear from you! MEMBER SERVICES BALTIMORE COLUMBIA WHITE MARSH GREENBELT OUTREACH & COMMUNITY RELATIONS CATAMARAN Questions regarding prescription coverage 3000 Falls Road, Suite 1 Baltimore, Maryland 21211

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