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There is no charge to the member. The form may also be completed without an office visit by instead having a phone conversation with your primary care physician, physician’s assistant or nurse practitioner.
Yes, the subscriber and covered spouse/domestic partner must have the form completed and returned to Independent Health in order to remain in the Enhanced option within the first three months of enrollment.
Completed Patient Engagement Forms must be returned to Independent Health within the first three months of the group effective date for you – the subscriber (and family) – to remain in the Enhanced option. Forms that are not returned or are returned with incomplete information will result in the subscriber (and family) being moved to the Standard option for the remainder of the plan year.
No, completion of a Health Risk Assessment is not required, however, completion and submission of the Patient Engagement Form is required to remain in the Enhanced option.
Yes. Independent Health plans on working with additional physicians and are hopeful that they can meet the requirements associated with the tailored network.
You must obtain a referral to all specialists from your primary care physician (PCP) of record in order to receive a lower charge. If a referral is not obtained from their PCP of record, you will be responsible for the higher charge.
Members must select a PCP of record. Members may also select an OB/GYN of record if they choose to do so.
No. The in-network deductible and out-of-network deductible are not combined.
No. All referrals need to be written by the primary care physician who participates in the network associated with Prime Access.
After the deductible is satisfied, you would be responsible for the specialist member liability without a referral.
Practice Care Coordinators are nurses employed by Independent Health who work in The Primary Connection offices as extended case managers to help the practices coordinate care. The Practice Care Coordinators find care alternatives, and assist in setting up care plans and support services. Their efforts help The Primary Connection practices provide the right care in the right setting.
Yes. You can contact Member Services by calling (716) 631-8701 or 1-800-501-3439.
Claims received under the Enhanced option after the deductible was satisfied will not be recalculated against the Standard deductible. However, any new claims processed under the Standard option will be subject to the new plan deductible.
Deductible, copayments and coinsurance apply to the Out-of-Pocket Max in Prime Access.