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07/27/17

  03:20:00 pm, by MedBen5   , 261 words,  
Categories: Wellness, Compliance

When Using Wellness Technology, Follow the Rules

wearable fitness tracker

FitBits and other wearable fitness trackers are popular incentives for worksite wellness programs, but employers need to exercise caution about how data from these devices is used, according to new rules from the Equal Employment Opportunity Commission (EEOC).

A recent International Foundation survey found that the promotion of wellness-related technology in the workplace is expected to increase in the next two years. But when an employer integrates such technology into a wellness program, it must be sure that any information collected through such devices is being used for legal purposes.

At issue for wearable fitness trackers is not the number of steps recorded but rather personal data collected, such as heart rate, activity levels, and sleep patterns. Additionally, care must be taken to ensure that applicable rules under the Americans with Disabilities Act, Affordable Care Act, and other laws are being followed.

MedBen's internal wellness efforts include a walking program in which employees can use wearable fitness trackers or use their smartphones to monitor their progress. However, rather than download data from these devices, participants simply provide our Human Resources department with a printout or screen capture of their daily steps. In this manner, we can be certain that we respect the participants' privacy, while still rewarding them for achieving the minimum number of steps.

MedBen takes wellness seriously, and our expertise extends to helping clients comply with wellness laws. MedBen WellLiving clients who have questions about wellness-related technology or any other aspect of their employee wellness program are welcome to contact Vice President of Compliance Caroline Fraker at 800-851-0907 or cfraker@medben.com.

07/25/17

  04:34:00 pm, by MedBen5   , 245 words,  
Categories: Client Services

Before Helping Clients, MedBen GSRs Get Educated

Megan MIller and Heidi Smith

Your MedBen group service representatives (GSRs) know your plan, your employee population, and your health care goals. But GSRs don’t become experts in serving clients and consultants overnight – it requires the right people getting the proper training.

MedBen always first looks to hire from within, and the GSR team is certainly no exception. Most of our current GSRs started in our Customer Service department, while others have worked in Administration, Specialty Services, and various other areas of the company.

For those GSRs who are new to MedBen when they're hired, prior experience in health benefits is encouraged... and even then, they first undergo several months of customer service training, learning how to use our systems while honing their service skills.

Whether a GSR is a MedBen veteran or a newcomer, before they can "fly solo," they first receive additional instruction from our Client Services Supervisor. This includes reviewing and responding to client voice mails, then finally taking live calls while the Supervisor monitors the conversation.

Following this extensive education, there's still one more piece of initiation: A GSR doesn't become a full-fledged team member until they've successfully helped a new group through enrollment, or a current group with their renewal.

Finally, regardless of how many years of experience our GSRs have, the training never really ends. New processes, services, and client matters are discussed at weekly team meetings, to ensure that the people who work directly with our clients can provide accurate and up-to-date information.

07/24/17

  08:07:00 pm, by MedBen5   , 350 words,  
Categories: Wellness

The Sunny Side of Vitamin D

beachcomber

Ahh – sweet summertime. The warmth, outdoor activities, sunshine and… vitamins? That’s right! The sun is a great source of vitamin D.

Just thirty minutes of sun exposure to the face, legs, or back, without sunscreen, at least twice a week should give you plenty of vitamin D. Wait a minute… no sunscreen? No, thank you!

The American Academy of Dermatology recommends against getting vitamin D from unprotected exposure to sunlight. With good reason, too... that much direct sun exposure might expose you to dangerous levels of cancer-causing UV radiation, which also causes wrinkles and age spots. Even so, the once well-known thought of “getting a base tan so I don’t burn” has been debunked and deemed as providing minimal protection.

If you can’t get your fill of vitamin D safely from the sun, where can you get it? Unfortunately, the body is designed to absorb vitamin D through the skin and not by mouth. So although foods like tuna and cheese contain some vitamin D, it’s hard to find foods that provide adequate amounts. Therefore, a good alternate source of the vitamin can be found in supplements.

Be mindful however, of how much you are taking. Too much vitamin D can cause high blood calcium level, which could result in nausea, constipation, confusion, abnormal heart rhythm, and even kidney stones. Always consult your physician before adding any supplement to your diet.

Full story »

07/21/17

  05:36:00 pm, by MedBen5   , 327 words,  
Categories: News, Health Care Reform, Taxes, IRS

Reminder: PCORI Filing and Fee Deadline Approaching

IRS Building

As in years past, it's time for all self-funded employer health plan sponsors to file and pay the required Patient-Centered Outcomes Research Institute (PCORI) fee. While hope continues that payment of this fee may be suspended as part of the current Administration’s efforts to reduce the burden of Affordable Care Act (ACA) regulation on plan sponsors, to date that has not happened. This means that PCORI fees must be reported and paid to the Internal Revenue Service (IRS) no later than July 31, 2017.

All self-funded plan sponsors are required to pay a fee based on the average number of covered lives under their eligible plans – including employees, retirees, spouses and dependents. Plans subject to the requirements include self-funded medical benefit plans, such as ERISA and non-ERISA self-funded plans as well as retiree-only plans. Other self-funded plans subject to the fee include self-funded HRAs and FSAs which are not integrated with a plan sponsor’s self-funded major medical plan. Dental-only, vision-only, EAP, disease management, and wellness plans are exempt from the fee requirement.

All plan sponsors must use the IRS Form 720 dated April, 2017 to record and remit the amount due. This year, the form has again been modified to include the payment amounts due under the schedule shown below. Make sure to complete the correct section of Part II for “Applicable self-insured health plans” (line 133) and select the correct payment amount based on your plan’s year end date (line 133 (a) or (b)).

This year’s payment schedule is below. If your plan year ended on October 31, 2016, November 30, 2016 or December 31, 2016 you will owe $2.26 per covered life. All other plan years owe $2.17 per covered life. Remember, a “covered life” means each and every individual you have covered under an applicable plan (i.e., employee, retiree, spouse, and dependents).

MedBen clients who need more information about how to count covered lives under their plan or how to prepare and remit your payment, don’t hesitate to contact Vice President of Compliance Caroline Fraker at 800-851-0907 or cfraker@medben.com.

07/16/17

  10:01:00 pm, by MedBen5   , 331 words,  
Categories: Announcements, News, ISO

Following Successful Audit, MedBen Recommended for ISO Recertification

ISO 9001 Certified

MedBen has successfully completed its latest re-assessment audit of its ISO 9001 procedures and has been recommended for recertification, according to the company’s Chairman and CEO Doug Freeman.

In its written recommendation, auditors from SAI Global stated that MedBen's performance demonstrates "an overall well run, constantly evolving system" with regular input from top management. The audit report also says the company has "an effective process for the continual improvement of the management system" ‒ something Freeman says is crucial to client satisfaction and long-term success.

"Having improvement processes in place enables MedBen to move forward with a clear direction for our future, while making sure that customer needs are always being met," Freeman said. "These re-assessment audits serve as a way to confirm that we're maintaining quality, and help us to integrate new approaches that further benefit our clients."

MedBen first achieved ISO Certification in 2005, and has been recertified every three years since then. To earn recertification, the company must undergo an extensive, multi-day re-assessment audit that reviews every detail of its documented ISO standards.
Following the successful re-assessment, MedBen was awarded ISO9001:2015 Certification. The 2015 standard places a greater emphasis on risk management and organizational knowledge than earlier certification standards.

Freeman noted that having proven processes in place benefits MedBen as well as its clients. "ISO Certification demonstrates that we put our customer first, but it also give our employees the security that processes have been tested and documented, which enable them to perform their job successfully," he said.

ISO 9001 is a general quality management system standard that consists of principles that help ensure standardized levels of quality are applied throughout an organization. With the implementation of a quality management system using ISO 9001, a company can implement a process for continual improvement, as well as reduce inefficiencies and waste, thereby experiencing a significant cost savings, while maintaining a focus on client satisfaction.

SAI Global provides organizations around the world with information services and solutions for managing risk, achieving compliance and driving business improvement.

  09:46:00 pm, by MedBen5   , 251 words,  
Categories: Wellness, Cost savings, Preventive care

"Physician First" Wellness Takes a Long-Term View

doctor and patient

A common excuse for not getting an annual wellness exam: "I feel fine, so why waste my time and money seeing a doctor?" But by taking this narrow view of regular check-ups, many people fail to understand that their benefits go well beyond current health considerations.

Meirelys Castro, M.D. recently commented to the Orlando Sentinel:

"To me, physical exams are a special time with the patient to focus on self-awareness, preventive monitoring, CDC-recommended immunizations, potential emotional problems, appropriate weight and nutrition, cardiovascular risk factor screening and modification, and healthy lifestyle recommendations. You can see it’s a lot to cover and can’t be squeezed into a sick visit - which are sometimes the only time your doctor may see you."

MedBen WellLiving espouses a "physician first" approach to employee wellness, in the knowledge that preventive care is most effective when it is built on a sustained doctor-patient relationship.

Even for a healthy person, wellness exams set an important foundation. The annual visit helps your family doctor to detect subtle differences from year to year that the patient may otherwise overlook, such as weight fluctuations or elevated blood pressure. Even slight changes could be an indication of a potential health issue, and the sooner it's detected, the better the chances of a positive outcome ‒ physically and financially.

By integrating MedBen WellLiving into your health plan, you invest in the long-term health of your employees... and save money in the process. Contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com to learn more.

07/14/17

  03:11:00 pm, by MedBen5   , 191 words,  
Categories: Prescription, Cost savings

For Real Rx Savings, Generics (and MedBen) Deliver

pills and mortar

When promoting pharmacy plans, third party administrators sometimes play up their brand-name drug discounts... conveniently overlooking the fact that most doctors prescribe generic medications when available. That's why MedBen focuses on the real savings, by offering a highly competitive discount on generics.

In 2016, MedBen's discount rate on retail generic drugs (based on average wholesale price) was 76.9%. Plan members who utilized our mail order service saw an 82.3% discount.

A MedBen client learned firsthand the importance of generic discounts when they switched to a competitor's pharmacy benefits manager (PBM), only to find that the promised savings weren't delivered. We compared their plan-year pharmacy costs under the new PBM with our projected costs for the same period. While the competitor had a slightly better discount on brand drugs, MedBen’s generics discount was significantly greater... so much so, the difference in their annual savings would have exceeded $111,000, or 17% of pharmacy costs.

Nearly 90% of the pharmacy claims MedBen processes are for generic drugs, so it just makes smart financial sense to direct client discounts to maximum pharmacy savings. Learn more about our Rx Advantage by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

07/05/17

  04:51:00 pm, by MedBen5   , 180 words,  
Categories: MedBen Analytics, Bundled Payments, Value-based care

Data Insight Key to Bundled Payment Efficiency, Say Harden at Summit

Kurt Harden

"If the data is there, we can rebuild it," said MedBen President & COO Kurt Harden at the Seventh National Bundled Payment Summit in Arlington, Virginia on June 27.

Speaking on the topic of how health systems and hospitals can make bundled payments work to their best medical and financial advantage, Harden said that these value-based programs "have given providers critical data to improve care and cost, if the data is properly deployed."

By taking disparate Medicaid data and transforming it into practical insights, MedBen Analytics is designed to give health care providers clear information that helps them to uncover inefficiencies and make improvements to the delivery of patient care, from surgery through post-acute.

Harden also demonstrated MedBen Analytics' drill-down functionality that enables users to review care from the system level all the way to individual services. "And there is no additional charge for extra users," Harden noted.

Harden attended the summit with Wendell Crain, Director of Security, Infrastructure and Web Development for MedBen Analytics.

Organizations interested in discussing MedBen Analytics' services can call Harden at 888-633-2364 or email him at kharden@medben.com.

07/02/17

  10:40:00 pm, by MedBen5   , 223 words,  
Categories: Announcements, Online Services

We're Closed July 4, but MedBen Access Stays Open 24/7

Independence Day

Happy Independence Day from MedBen! In observance of the holiday, our home office will be closed on Tuesday, July 4 and reopen at 8:00 a.m. EST on Wednesday, July 5.

Hopefully, you'll spend your holiday relaxing with family and friends... but if you should need to take care of your health plan while our office is closed, remember that both employers and plan members can take advantage of the online services offered at MedBen Access. To visit the site, simply go to MedBen.com, click on the "MedBen Access" link on the top right corner of the home page, and log in.

For employers, MedBen Access enables designated administrators to enroll new plan members, view claims data, make changes to participation status, and even order ID cards. Group-specific drop-down menus help you find what you're looking for fast.

MedBen Access is equally useful for plan members. The site makes it easy to determine the status of a claim, check current deductible and out-of-pocket accumulators, or review benefit coverage for a health service, just to name a few of the features available. And MedBen WellLiving members and FSA/HRA participants can get even more questions answered!

In addition to offering a variety of services, MedBen Access is a secure, password-protected site, so your private information stays protected.

The entire MedBen team wishes you a safe and relaxing Independence Day!

06/30/17

  10:46:00 pm, by MedBen5   , 242 words,  
Categories: Wellness, Diabetes, Preventive care

Diabetes, WellLiving and "An Ounce of Prevention"

diabetes

With nearly 10 million Americans diagnosed with diabetes, it's imperative that the individuals take the proper steps to control the disease if they have it, and prevent it if they don't. By introducing MedBen WellLiving to a group health care program, employers can better address the diabetes epidemic.

Between 1996 and 2013, diabetes spending grew 36 times faster than spending on heart disease, the nation's leading cause of death. Moreover, 86 million adults have prediabetes ‒ and 30% of them will develop diabetes within five years without intervention.

MedBen WellLiving enables employers to follow the adage "an ounce of prevention is worth a pound of cure." The primary prevention program encourages annual wellness exams, which allows the employee's family doctor to detect possible symptoms of prediabetes as early as possible. In the initial year of the program, claims activity may reflect this rise in doctor visits... but our experience shows that short-term spending increases are typically offset by a reduction in high-cost care for complications associated with diabetes, such as heart attack and stroke.

For those at higher risk of developing diabetes, WellLiving also offers specialty care. RN Health Consultants can offer customized counseling and confidential disease monitoring to plan members who wish to take sensible measures to better control their health.

In addition to diabetes, WellLiving offers preventive and specialty care programs for a variety of chronic conditions, including hypertension, high cholesterol, and asthma. Contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com to learn more.

06/28/17

  02:44:00 pm, by MedBen5   , 235 words,  
Categories: American Health Care Act

Saving Solutions for "Combination" Drugs

prescription

The popularity of specialty drugs is a major factor in health care spending growth, and while there may be no simple solution for controlling their costs, there are steps that employers can take. At our MedBen University roundtables, President & COO Kurt Harden has provided multiple examples of high-cost brand-name medications that are typically nothing more than a combination of two low-cost generics.

On The Atlantic website, author Marshall Allen shared his own experience of getting a prescription for a drug named Vimovo:

"Vimovo was created using two readily and cheaply available generic, or over-the-counter, medicines: naproxen, also known by the brand Aleve, and esomeprazole magnesium, also known as Nexium. The Aleve handles your pain and the Nexium helps with the upset stomach that’s sometimes caused by the pain reliever. The key selling point of this new 'convenience drug'? It’s easier to take one pill than two."

And the bill to the insurance company for this "convenience"? $3,252. That compares to about $40 for a month’s supply of Aleve and Nexium.

Based on a review of “combination” medications and other specialty drugs, MedBen offers a discretionary drug formulary to help clients control the effect of high-cost drugs with low-cost generics available. To receive an updated copy, just contact your group service representative.

Non-MedBen clients interested in learning more about our prescription cost-saving strategies are welcome to contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

06/20/17

  05:17:00 pm, by MedBen5   , 382 words,  
Categories: Wellness, Preventive care

Cholesterol: The Waxy Substance that Blocks Arteries

picking produce

Imagine pouring candle wax into a straw, letting it dry, and then trying to drink from that straw. Depending on how much candle wax you used, you’d probably agree that you’d be lucky to get a drop of liquid from your cup to your mouth, if any at all. Not to mention, the amount of extra effort it would take! This example is similar to what happens when the body has chronically high cholesterol or, as your doctor may call it, hyperlipidemia.

Cholesterol is a type of fat your body makes. There are two types, HDL (good) and LDL (bad). LDL cholesterol is waxy in texture and can build up in your arteries (much like the wax in the straw), making it hard for blood to circulate throughout your body and adding extra stress on the heart. This can translate into high blood pressure and even blood clots. On the other hand, HDL cholesterol acts as a scavenger, carrying LDL cholesterol away from the arteries.

Hyperlipidemia is nearly unnoticeable at first and left untreated can lead to heart attack, heart disease, and even a stroke. MedBen WellLiving encourages cholesterol checks by your family physician every five years. This test, called a lipoprotein panel, analyzes your blood to gage your HDL, LDL, and triglyceride (another fat found in the blood) levels.

Some causes are unavoidable (age and genetics). However, there are ways to help manage the condition. Diet and exercise are a great place to start. You can read more about diet choices to improve your cholesterol below.

Full story »

06/16/17

  08:15:00 pm, by MedBen5   , 210 words,  
Categories: News, Wellness, Reporting, Cost savings, Hypertension, Population health management

MedBen WellLiving Clients See Lower 3-Year Cost Trend

Mike Ketron

By promoting employee wellness, MedBen WellLiving clients are realizing significantly lower health care costs. From 2014 to 2016, employers that integrated WellLiving into their health care package experienced just a 1.6% trend, compared to 8.5% trend for non-WellLiving clients.

Reported at a recent MedBen University roundtable, MedBen noted that even though medical utilization is higher for WellLiving clients (due mainly to a higher volume of wellness exams and preventive care-related doctor visits), clients keep overall spending lower through diagnoses of diseases at their earliest stages.

MedBen employers that offer WellLiving also benefit their bottom line by reducing incidences of chronic conditions that require ongoing and costlier care. A new report from health advocacy organization The Partnership to Fight Chronic Disease (PFCD) says that hypertension, high cholesterol, and other common conditions will cost the U.S. $42 trillion between 2016 and 2030. Americans with five or more chronic conditions make up 12% of the population but account for 41% of total health care spending.

By complementing preventive care with individualized treatment for those at higher risk of developing chronic conditions, MedBen WellLiving focuses on ways to help your entire employee population realize better health and lower costs. Take the first step to promoting a healthier, more productive workplace by contacting MedBen Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

06/09/17

  03:57:00 pm, by MedBen5   , 158 words,  
Categories: Announcements, MedBen Analytics, Bundled Payments, Value-based care

MedBen Analytics Appearing at National Bundled Payment Summit

Kurt Harden & Wendell Crain

MedBen Analytics will be represented at this year's Seventh National Bundled Payment Summit. Kurt Harden, MedBen President and COO, and Wendell Crain, Director of Security, Infrastructure and Web Development for MedBen Analytics, will be present to demonstrate the features of our proprietary analytics software and answer your questions.

The Summit begins with a preconference on Monday, June 26, and runs through Wednesday, June 28. MedBen Analytics also serves as a sponsor for the event, which will be held at the Hyatt Regency Crystal City in Arlington, Virginia.

If you plan to attend, we encourage you to stop by our booth - we'd be happy to talk with you and show how MedBen Analytics takes disparate Medicare files and creates insights for success with bundled payments.

For more information about the Bundled Payment Summit, please visit the event's website. And health system providers who can't attend are always welcome to request a system demo... just call Kurt Harden at 888-633-2364 or email medbenanalytics@medben.com.

06/07/17

  03:09:00 pm, by MedBen5   , 210 words,  
Categories: News, Cost savings, Third party administration, Self-funding

Rise in Multi-Million Dollar Claims Stresses Need for Cost Management Solutions

magnified dollar sign

The elimination of lifetime maximums on self-funded health plans has led to a spike in multi-million dollar claims... and an even greater need for the claims management solutions provided through MedBen.

According to the 2017 Sun Life Stop-Loss Report, the number of multi-million dollar claimants increased by 68% from 2013 to 2016. While this group represents only 2.2% of claimants, they accounted for 23% of all stop-loss claims reimbursements in 2016.

Even before the Affordable Care Act phased out lifetime limits, MedBen had in place an advanced surveillance system that thoroughly analyzed claims to ensure that they met medical necessity or billing standards. Now, as multi-million dollar claims become more common, this system ‒ which uses over 125 certified medical specialists to review flagged claims and look for possible solutions ‒ is even more valuable for employers looking to control health care costs.

MedBen also helps clients to reduce the impact of high-dollar claims through customized plan language. Through the use of carve-outs for specific diseases and other focused strategies, employers can better manage their spending without sacrificing needed care.

With nearly 80 years of experience in group benefits management, MedBen specializes in saving clients money on even the costliest claims. Learn more about the ways we do it by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

06/04/17

  03:29:00 pm, by MedBen5   , 170 words,  
Categories: Research, Third party administration, Vision, Self-funding

Vision Coverage Looks Good, Employees Say

eyeglasses

Adding vision benefits to a group health care plan sends a positive message to employees and serves as a useful retention tool, a recent survey reveals.

According to the Employee Perceptions of Vision Benefits survey (via BenefitsPRO), an overwhelming 98% of respondents agreed that including vision benefits as part of an overall health package shows companies care about their employees’ well-being. Moreover, 87% said that they're more likely to stay with an employer that provides coverage for eye exams, frames and other vision materials.

With MedBen VisionPlus, employers can provide the kind of benefits that attract and retain employees. Our plan promotes preventive care through fully-covered exams, and offers high-quality glasses and contact lenses at reduced prices.

Best of all, VisionPlus is an extremely affordable employer benefit for self-funded employers... and MedBen clients who add vision coverage to their health care plan receive a discount on VisionPlus administrative fees.

To learn how MedBen VisionPlus can complement your group's health care plan, contact Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

06/02/17

  10:01:00 pm, by MedBen5   , 172 words,  
Categories: Announcements, News, Wellness, Cost savings, Third party administration, Self-funding

MedBen Cost Trend Remains Low... Especially for WellLiving Clients

Caduceus and bills

Through effective claims management and intelligent plan design, cost trend for MedBen clients in 2016 was only 3.9%. And from 2012 to 2016, client cost trend averaged just 3.5% over the five-year period.

But there's more to the story. MedBen clients who utilized our WellLiving personal wellness program saw even smaller trend: just a 1.6% bump in costs from 2014 to 2016. (Nearly 40% of our clients currently provide WellLiving to their employees.) Comparatively, national health care cost trend has averaged about 6-7% in the past several years.

The MedBen WellLiving approach of uncovering and closing gaps in care helps employer health plans to improve outcomes, better coordinate treatment, and optimize efficiency and revenue. For our WellLiving clients, that translates to even lower long-term costs, in addition to gaining a healthier workforce.

For MedBen, finding ways to help clients save money and improve population health is important to us, because we know just how important it is to them. Learn more about the many ways we can benefit your business by contacting Vice President of Sales & Marketing Brian Fargus at bfargus@medben.com.

05/30/17

IRS Announces 2018 HDHP Deductible, Out-of-Pocket Limits

IRS building

As is the case every spring, the Internal Revenue Service (IRS) has released its guidance regarding the limitations for high deductible health plans (HDHP) for the coming calendar year. Rev. Proc. 2017-37 announces the limits that will apply to any HDHP used with a health savings account (HSA) in connection with any plan year beginning in 2018.

To qualify as a HDHP in 2018, the deductible for an individual who has self-only coverage cannot be less than $1,350 (increased from last year’s limit of $1,300) or, for someone with family coverage, the deductible cannot be less than $2,700 (up from last year’s limit of $2,600).

Many plan sponsors have preferred not to use the "self-only/family-only" deductible structure for their HDHP, and instead have adopted an “embedded deductible” in accordance with IRS guidance. This allows for an individual deductible that applies to each family member, with an overall accumulative family limit, such as those used by more traditional health plans. In order to do this in an HDHP, the individual deductible must not be less than the minimum family deductible ($2,700) allowed for that plan year. Any health plan currently using the $2,600 individual embedded deductible must be amended by the beginning of the new plan year to reflect this new limit.

If a plan is using the self-only/family-only deductible structure, the deductibles may also need to increase to reflect the new limits. If you have a non-calendar year plan year, but run your deductible and out-of-pocket limits on the calendar year, you may want to consider making this change to be effective January 1st so that the deductible increase will not occur mid-year.

Full story »

05/26/17

MedBen Closed Memorial Day... But We're Open Online!

MedBen Building

The staff of MedBen want to wish you and your family a happy and safe Memorial Day weekend!

Our home office will be closed on Monday, May 29 in observance of the holiday. We will reopen at 8:00 a.m. on Tuesday, May 30.

Should you need claims and benefits information during the holiday weekend (or any other time), MedBen Access is available to help you 365 days a year. Simply go to MedBen.com and select "MedBen Access".

For those who use Pharmacy Data Management (PDM) as their pharmacy benefits manager, you can check on prescription claims and find lower cost drug options through MedBen Access by clicking on the "Rx" button located in the "My Claims" section of the MedBen Access website.

Additionally, if you're a MedBen Flexible Spending Account (FSA) or Health Reimbursement Arrangement (HRA) participant, you also can use MedBen Access to see your FSA/HRA balances, claims submissions and payments. When you log in to MedBen Access, you'll find an "FSA/HRA Online Inquiry" option (visible only to groups offering MedBen FSAs/HRAs) under the "My Plan" section located on the left sidebar. By selecting this option, users are automatically taken to the MedBen FSA/HRA Online System.

Once again, have a good holiday... and thanks for your continued relationship with MedBen!

05/25/17

  08:28:00 pm, by MedBen5   , 212 words,  
Categories: American Health Care Act

June Deadlines for CJR Participants

MedBen Analytics

MedBen Analytics clients should note that several important deadlines are approaching for hospitals participating in comprehensive care for joint replacement (CJR):

June 8, 2017 -- Last day to submit Calculation Error Form
Clients who have received a finding in their CJR Reconciliation: Performance Year 1 (PY1) report may wish to voluntarily respond to the Centers for Medicare and Medicaid Services (CMS). The completed form must be accompanied by eligibility findings or other relevant information. MedBen Analytics clients who have questions about submitting the form may contact Manager of Operations Cari Coventry at 800-423-3151, ext. 405 or ccoventry@medben.com.

June 30, 2017 - Last day to collect pre-operative patient-reported outcomes (PRO) data on eligible total hip arthroplasty/total knee arthroplasty (THA/TKA) procedures
Pre-operative data should be collected between 0 to 90 days prior to the eligible elective, primary THA/TKA procedure. The hospital will then need to collect this patient's post-operative data 270 to 365 days (9-12 months) after the patient's procedure.

June 30, 2017 - Performance Year 2's eligible THA/TKA procedure window closes
Hospitals should collect data for Medicare patients who are aged 65 and older, and undergoing elective, primary THA/TKA procedures. A hospital will need to assess a patient's eligibility for inclusion in the voluntary data collection on the day of or prior to the THA/TKA procedure (before billing codes are submitted). Therefore, hospitals will primarily use clinical criteria to exclude patients.

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