2019 Qualified Health Plan (QHP) transparency reporting for Individual HMO
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- Loraine Lynch
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1 2019 Qualified Health Plan (QHP) transparency reporting for Individual HMO Information on Explanation of Benefits (EOB) Your EOB is a statement that shows what health services you received, what bills your health plan paid, and what you may still owe to a healthcare provider. You will receive an Explanation of Benefits (EOB) after each claim is paid, explaining what was covered for that claim. How to read your Explanation of Benefits (EOB) Your EOB has three sections: Summary of charges A summary of the bills your healthcare providers sent to Geisinger Health Plan for health services provided to you and other family members on the plan. Plan accumulations: This section shows you: The amount of money you have paid to date for healthcare services The amount you are expected to pay for each member and family as a whole The amount remaining until you meet your annual limit Claim detail: Specific information for each claim that is submitted to Geisinger Health Plan. It includes: The date the service was received The procedures performed The charges for that claim
2 Information on Coordination of Benefits (COB) Plans that provide health and/or prescription coverage for a policy holder with more than one insurance policy can determine their payment responsibilities (i.e., determine which insurance plan has the primary payment responsibility and the extent to which the other plans will contribute when an individual is covered by more than one plan). This is why GHP asks you for information on other health insurance coverage you have. Retroactive denials Claims can be denied retroactively when processed for payment in error. Geisinger Health Plan reserves the right to retroactively deny claim payment, if services do not fall within policies consistent with the policy holder s coverage. Ensuring the proper required prior authorizations for out of network services can prevent denials from occurring. Out of network liability and balance billing It is important to know which providers are part of our network because cost sharing may be higher for services provided by out of network providers. If there are no criteria to pay claims to out of network providers, you may be responsible for the entire bill. Out of network providers may balance bill. Exceptions to out-of-network liability include emergency service, out-of-network claims sent to repricing vendor for provider discount pricing, and Letter of Agreement with out-of-network provider for discount rate. Balance billing, sometimes also called extra billing, is the practice of a healthcare provider billing a patient for the difference between what the patient s health insurance chooses to reimburse and what the provider chooses to charge. Staying with in-network providers can reduce out of pocket costs. Enrollee Claims Submission If a provider fails to submit a claim, you can submit for reimbursement. Download the form by signing in to your account at GeisingerHealthPlan.com. Not a registered user? Visit GeisingerHealthPlan.com/register to create your account. You have one year to submit. Send forms to PO Box 8200, Danville PA, with ATTN: Claims. Customer service can be reached at Enrollee recoupment of overpayments If Geisinger Health Plan overbills you, a credit in the amount of the overbilled premium will be applied to your subsequent month s premium invoice, reducing the following month s premium owed. If you would like a refund rather than a credit, the refund can be requested through the Accounts Receivable and Billing department by calling A refund will be issued via the same method the original payment was made. In some circumstances, a check in the amount of the overpayment will be sent.
3 Drug exceptions timeframes and enrollee responsibilities You can obtain access to any non-excluded, non-formulary drug by meeting criteria set forth by Geisinger Health Plan for that specific drug. You can call to initiate an exception request or your prescriber can submit a request in writing by filling out a prior authorization request form, which can be found at GeisingerHealthPlan.com, or electronically at Your prescriber can also have a form faxed to their office upon request if he/she contacts Regardless of how the exception request is initiated, verbally or via fax, the prescriber must include all relevant medical record documentation and then fax or mail the completed form and documents to Geisinger Health Plan. Once the information is received by Geisinger Health Plan, it will be reviewed, a decision will be made, and verbal and written notifications will be completed as expeditiously as possible. Notifications will be completed no more than 24 hours after receipt for expedited requests and 72 hours after receipt for standard requests. Your request for a formulary exception can also be reviewed by an Independent Review Organization (IRO). This process is called the formulary external exception review process. You or your prescriber can make this request by calling (TTY: PA Relay: 711). There are two types of external exception requests: standard and expedited. If your original exception request was standard, we will notify you of the external exception review decision within 72 hours of our receipt of the request. If your original exception request was expedited, we will notify you of the external exception review decision within 24 hours of our receipt of the request. If your request is approved by the IRO, coverage of the excepted medication will be provided for the duration of the prescription, subject to the terms of your contract. Grace periods and claims pending policies during the grace period Under the Affordable Care Act, a 90-day grace period is provided. This grace period is a 90-day window during which coverage cannot be cancelled due to missed or late premiums. This applies only to those who have received an advance premium tax credit to purchase health insurance through the Marketplace, and have previously paid at least one month s full premium in that benefit year. Claims will pend and payment will not go out during this period, awaiting premium payment. Once payment is received, all claims will be paid. If payment is not received and the policy is cancelled, claims submitted during the second and third months of the grace period will not be paid. Medical necessity, prior authorization timeframes and enrollee responsibilities Some services may require prior authorization by Geisinger Health Plan (GHP). If your GHP participating provider recommends a service(s) that requires prior authorization, it is that provider s responsibility to request an authorization through GHP prior to providing the service. Requests for services are reviewed by GHP to determine medical necessity, as well as member eligibility and benefit availability at the time the covered services are to be provided. Standard requests for services are completed within 2 business days of receipt, unless an extension is required. If an extension is required, the provider and member are notified in writing within 15 days of receipt of request of the need for an extension and further information needed.
4 If an extension is needed for an expedited request, necessary information must be requested within 24 hours of receipt and the member is given at least 48 hours to provide the information needed. Failure of the participating provider to obtain prior authorization before providing the service will result in denial of payment. The provider will be held financially responsible. When services are denied on the basis of medical necessity, you will be directly notified of the decision, as well as your right to appeal that decision. If you proceed with the denied procedure/service, you become financially responsible. Geisinger Health Plan may refer collectively to Geisinger Health Plan, Geisinger Quality Options, Inc., and Geisinger Indemnity Insurance Company, unless otherwise noted. HPM50 sg qhp transparency hmo rev 9-18
5 Discrimination is against the law Geisinger Health Plan, Geisinger Quality Options, Inc., and Geisinger Indemnity Insurance Company (the Health Plan ) comply with applicable federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. The Health Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. The Health Plan: Provides free aids and services to people with disabilities to communicate effectively with us, such as: Quali ed sign language interpreters Written information in other formats (large print, audio, accessible electronic formats, other formats) Provides free language services to people whose primary language is not English, such as: Quali ed interpreters Information written in other languages If you need these services, call the Health Plan at or TTY: 711. If you believe that the Health Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, sex, gender identity, or sexual orientation, you can le a grievance with: Civil Rights Grievance Coordinator Geisinger Health Plan Appeals Department 100 North Academy Avenue, Danville, PA Phone: , TTY: 711 Fax: GHPCivilRights@thehealthplan.com You can le a grievance in person or by mail, fax, or . If you need help ling a grievance, the Civil Rights Grievance Coordinator is available to help you. You can also le a civil rights complaint with the U.S. Department of Health and Human Services, Offi ce for Civil Rights electronically through the Offi ce for Civil Rights Complaint Portal, available at portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue SW., Room 509F HHH Building, Washington, DC Phone: , (TDD) Complaint forms are available at ce/ le/index.html. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call or TTY: 711. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (TTY: 711) TTY 711 CHÚ Ý: N u b n nói Ti ng Vi t, có các d ch v h tr ngôn ng mi n phí dành cho b n. G i s (TTY: 711) ). ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: (TTY: 711) (TTY: 711) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (TTY: 711) ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le (ATS : 711). ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: (TTY: 711). :, : (TTY: 711) (TTY: 711). ang ki disponib gratis pou ou. Rele (TTY: 711)., (TTY: 711) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (TTY: 711). HPM 50 alb: Nondiscrimination dev Y0032_16242_2 File and Use 9/2/16
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NOTIFICATION FROM EMPLOYEE BENEFITS The Open Enrollment period will commence on November 1, 2017 and end on November 21, 2017. All changes made during this period will be effective January 1, 2018. If
Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: All Covered Members Plan Type: HMO This is only a summary. If you want more detail about your coverage and costs, you
Check Plan Type: Check Enrollment Type: Fill Out Sections: q KP/HSA Small Group Employee Enrollment Form q Multi-Choice
Kaiser Foundation Health Plan of Georgia, Inc. Kaiser Permanente Insurance Company (KPIC) Check Plan Type: Check Enrollment Type: Fill Out Sections: q KP/HSA q New Hire A, B, C, D q Added Choice/HSA Added
Evidence Of Coverage
Evidence Of Coverage FLORIDA Broward, Hillsborough, Miami-Dade, Palm Beach, Pinellas, and Polk 2018 Molina Medicare Options Plus HMO SNP Member Services (866) 553-9494, TTY / TDD 711 7 days a week, 8:00
Important Questions Answers Why this Matters:
USA Health &Dental Plan STANDARD PLAN #79873/78380 Coverage Period: Beginning on or after 1/01/2017 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage For: Individual + Family
Evidence Of Coverage
Evidence Of Coverage CALIFORNIA Imperial, Los Angeles, Riverside (partial), San Bernardino (partial), and San Diego 2018 Molina Medicare Options Plus HMO SNP Member Services (800) 665-0898, TTY / TDD 711
rocky mountain monument health ppo plans
rocky mountain monument health ppo plans 2017 Small Employer Group rmhp.org Healthy Employees Build Healthy Business Rocky Mountain Health Plans is Colorado-based and Colorado-focused. We are committed
2017 Individual Enrollment Form
2017 Individual Enrollment Form Easy ways to enroll Enroll online at BasicBlueRx.com Call 1-844-469-2920, 8 a.m. to 8 p.m., daily, local time (TTY hearing impaired users call 711) Contact your licensed
CommunityCare: CC 80/500 A Lg
CommunityCare: CC 80/500 A Lg Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: Beginning on or after 01/01/2017 Coverage for: Family Plan Type: HMO This is only
Errata Sheet to the Imperial Health Plan of California (HMO) Traditional LA (006) & Traditional SFO (007) 2018 Evidence of Coverage
Errata Sheet to the Imperial Health Plan of California (HMO) Traditional LA (006) & Traditional SFO (007) 2018 Evidence of Coverage [Insert date] This is important information on changes in your Imperial
Annual Notice of Changes for 2018
TexanPlus Classic (HMO) offered by SelectCare Health Plans, Inc. Annual Notice of Changes for 2018 You are currently enrolled as a member of TexanPlus Classic (HMO). Next year, there will be some changes
Annual Notice of Changes for 2018
Simply More (HMO) Offered by Simply Healthcare Plans Annual Notice of Changes for 2018 Next year, there will be some changes to the plan s costs and benefits. This booklet tells about the changes. 1-877-577-0115,
Please contact Sharp Health Plan if you need information in another language or format (Braille).
2019 Sharp Direct Advantage SM Basic (HMO) & Sharp Direct Advantage SM Premium (HMO) Enrollment Form Completing your enrollment is your first step to becoming a Sharp Direct Advantage Medicare member.
Annual Notice of Changes for 2018
Simply Complete (HMO SNP) Offered by Simply Healthcare Plans Annual Notice of Changes for 2018 Next year, there will be some changes to the plan s costs and benefits. This booklet tells about the changes.
Annual Notice of Changes for 2018
City of Houston Group Retirees (HMO) offered by SelectCare of Texas, Inc. Annual Notice of Changes for 2018 You are currently enrolled as a member of City of Houston Group Retirees (HMO). Next year, there
: McKesson Corporation- Northwest
: McKesson Corporation- Northwest All plans offered and underwritten by Kaiser Foundation Health Plan of the Northwest Coverage Period: 01/01/2017-12/31/2017 Summary of Benefits and Coverage: What this