Scenarios
MM: How can I be selected for this program?
CSR Response: MM's are usually selected based on claims received by Aetna showing the member has been diagnosed with specific chronic conditions.
In your own words describe how you would describe VBC for the MM's
KA Description: In value-based care, doctors and other health care providers work together to manage a person's overall health, while considering an individual's personal health goals.
Name the 3 Vendors partnered with Aetna.
CVS Healthspire Primary Care, Landmark Health and WellBe Senior Medical
MM: Someone called me from CVS Healthspire Primary Care I don't want anything to do with whatever that is, will I loose my Health Insurance if I don't call them back?
CSR: No you will not loose your health insurance participation is voluntary.
In your own words describe what these programs offer?
KA Description: This program offers in-home and telehealth visits by doctors or advanced practice providers.
What does VBC stand for?
Value-based care
MM: Hi I received a call from someone saying they were partnered with Aetna something about a Landmark, I dont know it sounds like a scam.
CSR Response: I am sorry about the confusion, Landmark Health is a provider partnered with Aetna.
In your own words how can VBC providers improve health care...
NAME the 4 VBC Provider Specialty:
Kidney, Oncology, Diabetes, and Complex Care
MM: When can I schedule with this provider?
CSR Response: You can reach your providers 24 hours a day, 7 days a week including weekends and holidays.
In your own words describe to the member how they were assigned to a specific provider...
KA Description: Assigned to providers based on location and plan
What specialty does Perry Health cover?
Diabetes
MM: I just heard about something called WellBe but I live in Ohio, Columbiana am I eligible? What even is Wellbe?
CSR Response: Wellbe is a provider partnered with Aetna to assist our MMs to receive the care they need with in-home and telehealth visits by doctors or advanced practice providers, unfortunately MM's cannot self-attest to the program but they do service the are of Ohio, Columbiana.
In your own words how would you explain to the mm how this can be beneficial for them...
...
The Kidney Specialty has how many partners? And what are the partners names?
3. Monogram, Strive, & Interwell.