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Q: Does Teladoc replace my doctor?
A: No. Teladoc physicians use electronic health records, telephone consultations and online video consultations to diagnose, recommend treatment and write short-term, non-DEA controlled prescriptions, when appropriate.
Q: How do I request a consultation with a physician?
A: Log on to your account at www.MyMemberPortal.com and request a consult or simply call the number located on the back of your membership card any time day or night and a representative will request your medical consult.
Q: How quickly may I speak with a Teladoc physician?
A: The average call back time is 16 minutes, but all calls are guaranteed within three hours. Note: If a member misses the call from the consulting physician (away from phone), he is returned to the waiting list and his three hour guaranteed time period starts over. After three missed calls, the consult request is cancelled.
Q: What is a Medical History Disclosure (MHD) and electronic health record (EHR)?
A: Your MHD contains information similar to the forms you complete when you visit a physician’s office. Your EHR is a combination of your MHD and your Teladoc physician consult information. Your EHR is portable and free!
Medical Health Advisor
Q: What is Medical Health Advisor?
A: Medical Health Advisor is the nation’s leading health advocacy and assistance company. They serve as a liaison for members with healthcare providers, insurance plans and other health-related community resources. Medical Health Advisor offers a broad menu of services including providing assistance when finding primary care, specialist physicians and medical institutions and resolving claims, billing and related administrative problems. Medical Health Advisor also helps members access community resources, including senior care services that fall outside traditional healthcare coverage.
Q: How do members use Medical Health Advisor?
A: Medical Health Advisor is simple to use. All members have to do is call a designated toll-free number and explain their needs. When members call about an issue, a trained Personal Medical Health Advisor will review the problem, determine the member’s needs and ask questions about the member’s overall healthcare situation. The goal is to help members and their family with their healthcare related issues or problems.
During the first call to Medical Health Advisor, members will be assigned to a Personal Medical Health Advisor or PHA, typically a highly trained registered nurse, who will take responsibility for helping the member. Personal Medical Health Advisors are backed by a staff of medical directors and administrative experts.
The member’s Medical Health Advisor can help with numerous related medical and administrative issues. For example, members are provided assistance in finding qualified doctors and hospitals for complex needs. Members also receive assistance with administrative, billing and claims issues, and information and resource support for members and their family.
Medical Health Advisor is available to assist members, the member’s spouse, dependent children, parents and parents-in-law.
Q: Why would a healthy person want to join?
A: Medical Health Advisor provides a highly personalized service; this service is available to members who use the healthcare and insurance systems—healthy or ill. If a member moves to a new area, she or he may want help finding a physician or dentist, and even a “well visit” may result in an unexpected claims problem. Additional scenarios may include members who are unsure of exactly what their health plan covers or a parent or parent-in-law who may want help finding senior care. Medical Health Advisor’s sole priority is to help members with any issues or questions they may have about their healthcare or health insurance.
Q: How can members be assured of the security of their information?
A: Medical Health Advisor has designed information systems and processes to protect the confidentiality of all member health related information. Medical Health Advisor fully complies with all appropriate provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which addresses the privacy and confidentiality of all members’ information.
Q: How can members be assured of the privacy and confidentiality of their information?
A: We fully recognize the importance of protecting and respecting members’ privacy. Medical Health Advisor’s staff is specially trained to handle each case with the utmost confidentiality. Additionally, they follow careful protocols that comply with all governmental privacy standards to ensure that members’ medical and personal information is fully protected and held confidential.
During the first call, members will be asked to complete and sign a Medical Authorization Form giving Medical Health Advisor permission to begin working on the member’s behalf. If a member calls on behalf of a dependent minor, the member must complete this form for them.
Q: How do members change the information on their Card?
A: For additional or replacement cards, members can call Member Services at the toll-free number listed in their benefit packet. Medical Health Advisor is not responsible for changing, renewing or canceling memberships.
Dental Care
Q: How does the dental plan work?
A: Participating dental providers are listed in the membership packet; members may also call the toll-free number located on the back of the membership card Monday through Friday, 7 a.m. to 7 p.m. andSaturday, 8 a.m. to 5 p.m. Central Time. When calling to schedule an appointment the member should identify him/herself as a member of the Aetna Dental Access® program. To receive the discount the member must present the membership card and pay the total bill at the time of service.
Q: Is there a limit to the number of times the card can be used?
A: No. Members and their families may take advantage of the savings any time throughout the year. Members may also change dentists within the network whenever they choose.
Q: May this discount be combined with dental insurance?
A: In some cases, members may use both. If your insurance company allows you to submit claims after service, simply visit a participating dental provider, pay the discounted bill and submit the bill and claim to the insurance company. The net out-of-pocket cost will be lower because the insurance company would reimburse the member the percentage of the reduced bill as defined in their insured plan. If your insurance company does not allow the policyholder to submit claims, the discount dental can only be used for services not paid for by the insurance such as cosmetic dentistry or services after your annual maximum has been met.
Q: Is there someone that can answer questions about the card and services offered?
A: Yes. Simply call the toll-free number located on the back of the membership card Monday through Friday, between 7 a.m. and 7 p.m. Central and Saturday between 8 a.m. and 5 p.m. Central. A member services representative is standing by to answer any questions.
Q: What if a member’s dentist is not a participating provider?
A: Simply call the toll-free number on the membership card and give the member services representative the doctor’s name, address, phone number and specialty. We then contact the doctor about becoming a provider.