You make a health appointment and are unaware that the care provider is out of network. Then, you get a bill you weren’t expecting. It can be an unwelcome surprise.
But what if your health plan could intervene before the appointment and steer you in the right direction to avoid unexpected charges?
It’s already happening for some people with advocacy support called active member intercept, which helps eligible UnitedHealthcare members avoid surprise medical bills.
“We are helping members avoid unnecessary costs through near real-time guidance that may lead to more cost-effective choices,” said Rebecca Madsen, chief consumer officer at UnitedHealthcare. “Before and after appointments, we have ways to provide guidance to members and encourage future decisions that may help them save on costs.”
Active member intercept is a part of a broader advocacy initiative at UnitedHealthcare helping to avoid these surprises and make access to health care easier and more efficient. As the name suggests, it’s a proactive outreach to members when an action may trigger an unexpected bill.
This may include a heads-up in a text message or phone call if a member is approaching their benefit limit or when a pre-appointment eligibility check reveals an issue.
“When we receive an eligibility check from a provider, we know who's about to go out of network, and we reach out to help guide the member,” Rebecca said.
That warning gives a member the chance to learn about ways to stay in the network and potentially lower their costs by making a more optimal decision.
Rebecca says similar advocacy can happen before and after appointments.
“Using analytics and modeling, we can predict who may go out of network and encourage members to make more optimal choices,” she said. “After appointments, through analytics and digital targeting, we can help educate members and encourage future decisions that may help them save on costs.
Active member intercept is part of a multi-pronged advocacy program at UnitedHealthcare, which also includes:
- Digital tools that help make health care more personal
- Connections to resources for dealing with social barriers to health, such as housing, food or childcare issues
- Point-of-care assistance to help members and their doctors with decision-making
- Personalized support for high-need cases in children and adults
“Advocacy, at its most basic level, is about helping people — and helping them make smarter decisions,” Rebecca said. “These services are key in that effort.”
For more information on this advocacy support, visit uhc.com.