Effective January 1, 2015, Independence will implement a new benefit as part of our commercial benefit programs for small groups and individuals called Preventive Plus.

How the Preventive Plus benefit works

The Preventive Plus benefit incorporates a site-of-service differential with no member cost-sharing ($0 cost-sharing; i.e., no copayment, deductible, or coinsurance) when a colon cancer preventive screening colonoscopy is performed at a freestanding ambulatory surgery center (Freestanding ASC).

When a colon cancer preventive screening colonoscopy is performed at a hospital outpatient facility or hospital-based ASC, the member will incur cost-sharing of up to $750.

Checking patient eligibility

To verify if a patient has the Preventive Plus benefit, use the Eligibility and Benefits Inquiry transaction on the NaviNet^® web portal. In early 2015, updates will be made to the Referrals transaction to assist physicians when referring patients for colon cancer preventive screening colonoscopies. Additional information about these enhancements will be communicated in future editions of Partners in Health Update^SM.

Cost-effective site-of-service

Although the Preventive Plus benefit only applies to commercial members enrolled in small group and individual plans, Freestanding ASCs are a cost-effective site-of-service for all colon cancer preventive screening colonoscopies. Therefore, we encourage you to refer all Independence members in need of this service to a Freestanding ASC when medically appropriate.

Learn more

If you have any questions regarding the Preventive Plus benefit, call 1-800-ASK-BLUE or contact your Network Coordinator.

Updated Find a Doctor tool

Later this month, the Find a Doctor tool will be updated to include a Preventive Plus indicator for Freestanding ASCs and associated gastroenterologists and colon and rectal surgeons.

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