Regence AdviCare^SM program frequently asked questions

Patient Benefits Questions:

Q:

Can the Regence AdviCare Program team answer health coverage or benefits questions?

A:

No. Please call Regence at the number on the patient's member ID card for patient benefits or questions about patient coverage.

Q:

Will educational materials be mailed to program participants?

A:

Yes. Participants will receive materials to support their specific goals. The materials we use follow the guidelines of nationally recognized organizations.

Q:

Will participants’ benefits be affected?

A:

No. Participation is voluntary and will not affect current coverage or eligibility.

Participation Questions:

Q:

What if a provider does not want a patient to participate?

A:

The program is strictly voluntary, and the decision to participate is left up to the patient. However, by electing not to participate, patients could be missing the opportunity to be in a program that is designed to help them take better care of their condition.

Q:

If someone chooses not to participate now, can he or she join later?

A:

Yes. Eligible health plan members can join the program anytime.

Q:

Does this program require a provider referral or authorization?

A:

No referral or authorization is required.  Only participant consent is necessary for participation.

Outcomes Questions:

Q:

What types of reports will be requested of providers with participating patients?

A:

There are no standard reports we will need from providers. Occasionally our staff may request a copy of the latest lab report or report from a specialist.

Confidentiality Questions:

Q:

Who sees participants’ health information?

A:

The health plan and Healthways will have access to participant information.

Q:

Will participant information be kept confidential?

Q:

Yes. All information will be kept confidential by the health plan and Healthways.

Medical Management Questions:

Q:

If a participant has a medical problem or emergency, whom is he or she instructed to call?

A:

All patients calling with medical questions will be referred to their physician. If a participant calls with an emergency, they will be directed to call 911 or to contact his or her physician.  In either event, the provider’s office will be notified of any instructions given to the participant.

Q:

How does program impact the provider’s medical management plan?

A:

This program is an educational program only with a goal of reinforcing the provider’s treatment plan. The provider will continue to be responsible for the medical management of participants.