Select News: October 2016
HEDIS® SPOTLIGHT: Member incentives
Many of our First Choice members recently received a letter and form notifying them of their eligibility for a gift card if they complete a needed screening before Dec. 31, 2016. Here is a list of the Healthcare Effectiveness Data and Information Set (HEDIS) member incentives:
- Complete adolescent well visit (including body mass index, counseling for nutrition, and counseling for physical activity): $10 gift card.
- Complete well-child 3 – 6 visit: $10 gift card.
- Complete six well visits by 15 months: one $10 gift card for each visit up to six visits.
- Breast cancer screening: $25 gift card.
- Annual chlamydia screening: $25 gift card.
- Cervical exam (Pap test): $25 gift card.
- Diabetic screenings (members may be eligible for both gift cards depending on care gaps and eligibility):
- Hemoglobin A1C: $25 gift card.
- Retinal vision screening: $10 gift card.
- Postpartum visit: $25 gift card (ongoing).
Members must be on the HEDIS Year-to-Date list to be eligible for these incentives. Members receive gift cards four to six weeks after we receive their forms. Please contact firstname.lastname@example.org for a list of your eligible members.
Mosquito repellent is covered
Select Health added mosquito repellent to the preferred drug list and now covers one bottle of mosquito repellent every 30 days, from March through October, for women of childbearing years (ages 14 – 44). A prescription is required. Covered products include:
|Product name||Ounces||National drug code|
|Cutter Backwoods 25% DEET spray||6 oz.||71121-0962-80|
|OFF! Deep Woods Dry 25% DEET spray||4 oz.||46500-0717-64|
|OFF! Deep Woods 25% DEET spray||6 oz.||46500-0018-42|
|Repel Sportsmen 25% DEET spray||6.5 oz||11423-0941-37|
|Repel Sportsmen Max 40% DEET spray||6.5 oz.||11423-0003-38|
|Natrapel 20% picaridin||5 oz.||44224-0068-78|
|Sawyer Insect Repellent 20% picaridin||4 oz.||50716-0005-44|
Prior authorizations might require a MedWatch form
Effective Nov. 1, 2016, Select Health requires providers to complete a MedWatch form when submitting a prior authorization request for a brand name medication when a generic A-rated equivalent exists.
Reduce patient screening time with the Member Clinical Summary
The Member Clinical Summary (MCS) is a snapshot of a patient’s relevant clinical data and demographic information in a single user-friendly report. It's available through NaviNet to primary care providers (PCPs), specialists, hospitals, and ancillary providers. Your NaviNet security officer must enable access to this report for your office. For access details, visit Select Health’s NaviNet Plan Central or contact your Provider Account Executive.
October is National Breast Cancer Awareness Month
Select Health is reaching out to our First Choice members who are due for a mammogram to remind them to get this important screening. Please talk to our members, your patients, about the importance of getting screened. Discuss any risk factors that may warrant the need to be screened at an earlier age or more frequently. For a list of your members currently due for a mammogram, email us or contact your Provider Account Executive.
“First in Quality, First in Care”: First Choice is South Carolina’s Quality leader
Thanks to your support and help with our efforts, Select Health has again received Commendable Accreditation from the National Committee for Quality Assurance (NCQA). Based on an annual review of HEDIS and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data, our final score was 87.56, more than 4 points over last year’s score! This tremendous accomplishment moves us toward our goal of achieving Excellent Accreditation in 2018. (Note: Plans must achieve a total of 90 points to achieve Excellent.)
First Choice by Select Health successfully maintained a perfect rating in “Access and Service” and “Quality Providers.” We’ve seen continuous improvement across all HEDIS measures for both well visits and comprehensive diabetes care. In addition, the 2016 – 2017 NCQA ratings have been released, and First Choice is once again the top health plan for South Carolina Healthy Connections, a position we’ve held since 2010. Our overall score of 4 out of 5 stars is an increase of .5 stars over last year, with a score of 5 stars in Consumer Satisfaction, 3 stars in Prevention, and 2.5 stars in Treatment.
Select Health would like to thank our providers for your tremendous cooperation and support with our accreditation efforts and improvement of our plan ratings. We could not do it without you!
October is Health Literacy Awareness month
Here’s a reminder: Use plain language to make written and oral information easier to understand and allow patients to be more engaged in their health. Learn more on our website.