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Pick
Your Own Physician
The family doctor/patient relationship is the cornerstone of Primary Select. Employees
are asked to chose a family physician and see that physician for all his or
her medical needs. If specialty care is required, you work with your family
doctor to select the best course of care for you or your family. There are
generally no restrictions on what specialist and facilities are utilized as
long as the member works with the family doctor to seek specialty care.
Family
Doctor
All members of Primary Select are asked to choose a family doctor and communicate
with that doctor whenever they have healthcare needs. Employees can use any
family doctor as long as they are:
- A Family Practitioner
- A General Pediatrician
- An Internist
- A General Practitioner
Employees consult their family doctor before seeking specialty care. Once
the family doctor is consulted, the appropriate specialist can be seen.
Care
Management
Primary Selects sophisticated care management system, administered by Future
Health, is integrated into the plan. It concentrates resources on the five
percent of plan members that generate 60 percent of healthcare costs. By identifying
these high risk members in the early stages of an illness Primary Select can help
contain the severity of health care costs and deliver optimum outcomes. Integrated
components make up Primary Selects Care Management System. These typically
include:
- Future Health's RiskScreen®
- Future Health's HealthModels
- Traditional Utilization Review
- Proactive Health Risk Assessments
- Nurse Advice Line
Hospital
Access
Primary Select has access to discounted pricing arrangements which help
to manage the cost of health care. These arrangements do not impact the
decisions that you and your physician make about your specialty care selections.
Management
and Reporting
Primary Select provides detailed management and reporting for all employers. This
reporting is available through a secure website via a data warehouse. Some
sample reports include:
- Claims and Enrollment tracking
- Budget Projections vs. Actual Costs
- Stoploss
- Provider Listing
- Plan Utilization Detail
Banking
and Underwriting Services
Primary Selects underwriting department handles cost projections, prices out
benefit options, places stop loss insurance and provides quarterly and annual
reports.
Banking services include the funding of claims payments, monthly bank reconciliations
benefit statements and the payment of premiums and claims. |