True/False
When a patient uses the Virtual Medical Team, it is billed through insurance
False
No bill generated to insurance or patient for care through VMT
For Aetna/Alignment, how do they pay the AMF?
The membership fee is covered within there plan benefits, once they align with us and list One Medical as PCP on file
What are the three membership options for CMS?
Option 1: Paying the AMF fee of $199
Option 2: Member Financial Assistance Program / Financial Waiver
Option 3: Limited Access
If we are speaking with someone on a plan outside of CMS, Aetna or Alignment, who do we transfer them too?
Member Advisor Team
How do we help align and update PCP for Aetna/Alignment MA members in SFO?
Transfer to PES team for OC call
We accept and help patients on all insurances
FALSE
We only schedule and enroll patients on CMS, Aetna & Alignment and transfer every other new patient to the Member Advisor Team
What is the cost of the AMF?
$199 per person/per year nationally
What code right now in active for new members?
OMAMAZON
$144 membership fee
If we get in touch with a new patient and they are outside of the SFO market (EX) New York, who do we transfer them too?
Member Advisor Team
Do patients need to stay at the office they sign up at and have there first appointment?
No, they can be seen at any office in SFO or nationally
The Virtual Medical Team (VMT) is only available on your smart phone, not within the online portal (via laptop/computer)
True
Why do we have a membership fee?
A One Medical membership makes it faster, easier, and more enjoyable for individuals to look after their health. Our fee supports the organization to create, maintain, and expand services not typically offered at other primary care practices.
What does the Paid Membership option entail?
The membership is paid out of pocket by the individual patient. They have full access to the online portal, mobile app, & all communication tools. As long as a patient's billing details are up-to-date & active in 1Life, their membership will renew automatically unless we are notified otherwise.
If we get in touch with a current patient who is on Medicare, who do we transfer the call to?
Member Support Specialist Team
What insurance plans does our team accept and help enroll?
CMS, Aetna & Alignment
Patients on CMS are responsible for the AMF
True - we will discuss the $199 membership fee with them and talk about options if any concerns
Benefits of membership include access to the app and online portal to:
Self-schedule appointments through a live calendar (including same day visits for urgent issues in offices close by)
Request prescription renewals
Directly communicate with their provider through a secure platform (48 hr typical turn time)
Access the 24/7 Virtual Medical Team (e.g., Treat Me Now, Video Chat [through the mobile app only])
Unlike standard telehealth services, our virtual team can diagnose, treat, prescribe and refer to specialists
Travel health services
What does the Financial Assistance membership option entail?
These patients have applied & been approved for financial assistance; they have full access to One Medical including the online portal, mobile app, & all communication tools. Financial Assistance must be reapplied for each year; it does not carry over automatically & is not guaranteed.
If the Member Advisor Team gets a new patient who is on CMS, Aetna or Alignment, who do they transfer them too?
PEC Team - US!
What type of visit needs to be scheduled for the new patient visit?
Any type of visit
No establish care visit needed, they can come in for urgent need, remote visit, in person visit, annual wellness visit, etc.
We enroll SFO patients through Chirp and they will be added to 1Life
False: They need to register online at onemedical.com
What is it called when we talk about the membership fee and care we provide?
Description of Experience (DOE)
What does the Limited Access membership option entail?
These patients do not pay the annual membership fee. They can read messages & download lab reports from their MyOne portal but do not have access to the mobile app. They cannot book or cancel their own visits & should be scheduled for any visit they need. Limited Access expires each year. Patients must speak with a Membership Advisor to renew this status.
To ensure a great experience for each prospective patient we get in touch with so we can utilize the escalation pathways, what is something we will confirm at the beginning of the call
Insurance plan
True/False: Aetna/Alignment MA plans in SFO need to pay the AMF fee
False.
Because of the way Aetna/Alignment MA pays One Medical for the services One Medical provides to members of Aetna/Alignment MA plans, the membership fee is covered by Aetna/Alignment MA plans. Aetna/Alignment MA members don’t have to pay anything beyond their regular copays.