2013 Practitioner and Provider Manual - Presbyterian Healthcare ...

Presbyterian Customer Service Center505-341-0042, or Customer Service at 505-923-5200 or 1-888-977-2333.Medicare Annual Notification of ChangeMeetingsEach year, before and during the Medicare AnnualEnrollment Period, members and their guests havethe opportunity to attend a Presbyterian MedicarePlans Annual Notification of Change meeting. Themeetings are designed to meet our members’needs by providing information about changes tothe Presbyterian Medicare Advantage plan benefitsand services for the upcoming year. This is also atime when we can address members’ personalquestions regarding the benefit plans. For ourmembers’ convenience, meetings are availablethroughout the Medicare plan service area.Members are encouraged to attend annually.Medicare Advantage Plans New MemberEducation, Verification, and Welcome CallsAn outreach to all new Presbyterian MedicareAdvantage plan members is conducted within 15calendar days of receipt of the member’s requestfor enrollment. The primary purpose of the call is towelcome the new member and to ensure that theyhave an understanding of the product type and planin which they are enrolling. Key plan elements arereviewed and members are provided an opportunityto ask questions about their new PresbyterianMedicare Advantage plans.Medicare Member Appreciation EventsEvery year, Presbyterian invites all PresbyterianMedicare Advantage plan members and theirguests to join us at a Member Appreciation Event.Presbyterian senior leadership takes thisopportunity to thank our members for theirmembership in Presbyterian’s Medicare Advantageplans and to answer members’ questions. Membersare also informed about the latest developments atPresbyterian.Additional Medicare Benefits: My Advocate byAltegra HealthMy Advocate by Altegra Health is a trusted partnerwhose sole service is providing expert coordinatedoutreach services to Presbyterian MedicareAdvantage plan members. My Advocate assistsmembers in learning about and taking advantage ofprograms that provide financial assistance toseniors and disabled individuals with limitedincome. Members appreciate the personal supportMy Advocated provides with enrolling andrecertifying members into the Medicare SavingsPrograms and the Medicare Part D “Extra Help”program, as well as other federal and state financialassistance programs or services.Through these efforts, My Advocate helps toimprove the quality of life for our members who aremost financially at risk. Participation is entirelyvoluntary and provided at no cost to our members.SilverSneakers ® Fitness ProgramPresbyterian Medicare Advantage plan membersare offered the SilverSneakers ® Fitness Program orSilverSneakers ® Steps benefit at no additional cost.With the SilverSneakers ® Fitness Program,members have access to basic fitness centermembership at no additional cost. This membershipincludes access to amenities such as treadmills,19-42014 Practitioner and Provider Manual - Ver. 3