Benefits
These are the benefits that ilumed offers
$0 copay at PCP office
Transportation Services to and from PCP, Specialist or Pharmacy
Patient advocate team
HEIA (to assess Needs)
Case Management and Chronic Care Management Services.
When you answer an incoming call, and a patient asks "Who are you? And what do you have to do with my doctor?"
ilumed is an extension of your Primary care Physician's office. We have partnered with your PCP to offer additional benefits to improve your health care. I can let you know specifically why we called if you can provide me your name and date of birth?
How many ways can a person align to their doctor?
3
ACO REACH
Accountable Care Organization Realizing Equity Access Community Health
Qualifications for Medicare
65 or older
Disability
End Stage Renal Disease
what are the requirements for ilumed's transportation benefit
3-day notice
20-mile max limit one way
8 round trips or 16 one-way trips per calendar year
Available Monday - Friday 8am to 8pm EST
"Well, what is this costing me?"
Ilumed services cost you absolutely nothing and is 100% free.
This form of alignment involves a person going to Medicare.gov and choosing their doctor from the website
MVA- Medicare Voluntary Alignment
SVA
Signed Voluntary Attestation
This part of Medicare pays for hospital visits
Part A
What are the companies that ilumed has contracted with to provide transportation services.
Uber (Not Wheelchair accessible)
Ride Health (New Jersey – Uber, Lyft, Wheelchair accessible)
Sandy Valley (Kentucky-Wheelchair accessible))
Maruti (Texas -Wheelchair accessible)
Little Kanawha (Roane County, WV - Wheelchair accessible)
Tri River Transit (Lincoln, Logan, Boone, Mason, and Wayne counties, WV – Wheelchair accessible )
"Nothing is just FREE! Someone has to be paying for this."
This is a free program covered by Medicare.
This form of alignment is when a patient signs a form in the PCP office
SVA - Signed Voluntary attestation Form
MVA
Medicare Voluntary Alignment
This part pays for prescriptions
Part D
Give some Examples of Chronic Diseases that may qualify patients for our CM services.
Diabetes
Chronic Obstructive Pulmonary Disease
Congestive Heart Failure
Kidney Disease
"I need a ride scheduled and have to use a walker. Will the driver assist me in putting my walker away?"
Unfortunately, uber drivers cannot help with your walker, but you are more than welcome to bring a companion that can assist you.
This type of alignment is claims based and will occur after a patient has seen their doctor regularly.
Auto Alignment
MBI
Medicare Beneficiary Identifier
This part pays for outpatient services and clinical services
Part B
The patient will be responsible for this when going to a doctor other than their PCP.
Their copay
"I don't even go to that doctor anymore."
Oh, okay! Medicare currently has Dr.______ listed as your PCP. We recommend you go to Medicare.gov and create an account if you don't already have one with them and select your new provider so that they know where you are continuing your care.
A patient must see their PCP this percentage for them to be auto aligned
33%
CMS
Centers for Medicare and Medicaid Services
What is a Medicare Advantage plan?
Private health insurance that contracts with the government to bring patients medicare benefits. Medicare advantage replaces traditional Medicare