Insurance Updates
New Directions Behavioral Health Student Assistance Plan
When Life Gets in the Way
The goal is for every student to succeed. The reality is that students face challenges that have nothing to do with the classroom. Sometimes, these challenges disrupt a student’s ability to study, concentrate, and learn.
But what if your students could have a trustworthy friend to guide them when they face these other questions? That’s what New Directions offers.
Assistance is available 24 hours a day, 7 days a week by calling 1-800-624-5544. You can also visit their website at www.ndbh.com for more information.
SAP Flyer – New Directions Behavioral Health
A representative from Paradigm Group was on campus today and presented at the Student Life Committee Meeting at Noon. We also recently added a student insurance concerns form to that page that is shared with the Paradigm Group (the College’s insurance broker) claims specialist, Rachel Love.
United Healthcare Student Resources Additional Contact Information
We encourage you to set up an account online by following this link: Create Your Account.
There’s an App for the medical plan once you set up an online account: Google Play, iTunes
Customer Service: 1-800-767-0700
Online Plan Information: www.uhcsr.com/mmc (create an account to access your card)
Search for a Provider: UHC Choice Plus
For those of you who have questions or concerns about bills you’ve received or claims that were denied or partially paid, we encourage you to review your plan details FIRST, then contact the insurance provider. If you are still confused or not satisfied with the answer(s) you’ve received, please complete a Personal Representative Authorization (PRA) request form so that Ms. Rachel Love of Paradigm Group can work on your behalf for resolution of the claim/bill.
Please go online and complete a PRA form so that representatives from our Broker’s firm can request more information on your behalf from United Healthcare.
- Go to www.uhcsr.com/mmc and create an account (or login to your account),
- Under MyAccount there is a link there where you can submit a (Personal Representative Authorization) PRA form.
- Please list Rachel Love (rachellove@paradigmgroup.net) as the PRA.
- (this address is required on the form)
Paradigm Group for Meharry Medical College
1600 Division St., Suite 220
Nashville, TN 37203
- (this address is required on the form)
- Once you’ve completed the online form, please email Rachel to let her know you’ve completed the form.
How Healthcare Reform Affects Preventive Care
New Preventive Care Guidelines
There are new government guidelines for preventive care. The guidelines vary based on age, gender, and family history. The guidelines are defined by the US Preventive Care Task Force (USPCTF).
Services defined as preventive (and covered at 100%) will vary for each patient’s preventive or well care visit. This means that services covered at 100% for you may be different from services covered for a relative or other student – based on age, gender, and family history.
Plan Your Preventive (Well Care) visits
During annual physical or other preventive visits, you must be clear that you are there for a preventive visit only. Be certain the providers know that you expect the services performed to be covered 100% with no patient responsibility.
During a preventive visit, be aware that a single illness complaint can change the nature of the visit from preventive to diagnostic. If the nature of the visit changes, your provider may code a service as nonpreventive. You may be charged for that service.
Though many providers are implementing the new US preventive A&B Guidelines, some still have not. It is your responsibility as a healthcare consumer to tell your provider that you expect all services to be covered at 100%.
IF you have services that are not covered under preventive care, you can request your provider resend them for appropriate supporting documentation.
Please review the UHC guidelines prior to your preventive visit:
UnitedHealthcare Preventive Care Guidelines
Healthcare Reform Background
Due to the new healthcare reform and ICD-10 coding requirements, providers must now submit all items performed in a preventive or sick visit. Insurance companies now follow healthcare reform’s US Preventive Care Task Force (USPCTF) guidelines for patient age, gender, family, history, etc. This new payment structure will allow providers to continue billing for services that the guidelines deem nonessential according to age, gender, family, history etc.
- Because not all providers have adjusted the way they submit claims to insurance carriers, patients have begun to complain. Providers are hearing concerns from patients and insurers and starting to adjust.
Information provided by Paradigm Group