In the April edition of Partners in Health UpdateSM
, we announced new outreach initiatives for our high-risk Medicare Advantage HMO and PPO members. We are excited to announce an enhanced member outreach program that may include member telephone calls, letters, and face-to-face member visits, as appropriate. Through Inovalon, Inc. (formerly MedAssurant), an independent company, our Medicare Advantage HMO and PPO members may be contacted in an attempt to close gaps in care that have been identified through a review of our claims data. The purpose of this program is to partner with providers to ensure their patients, our members, are visiting their personal physician or primary care physician (PCP) on a routine basis and are receiving recommended preventive services to close these identified gaps.
As part of this outreach program, members may be sent a letter that informs them of their identified gaps in care and encourages them to contact their personal physician or PCP to schedule an appointment. Members may also receive follow-up telephone calls to confirm visits to their doctor or to set up a face-to-face meeting to review the information the member received. Although not obligated to participate, members are highly encouraged to take advantage of these outreach programs.
Physicians may also receive letters regarding patients who have been contacted by Inovalon and will be provided a packet of information. Physicians are encouraged to contact these members to schedule an office visit, if an appointment has not already been scheduled, and place the packet of information in the patient's chart so the information can be reviewed and updated during the patient's office visit.
We hope that you find this information useful in delivering care to your patients, our members.
Please call Customer Service at 1-800-ASK-BLUE if you would like more information about this initiative or if you have further questions.