Superhero
What is Compassion?
This core value of Plan Advisor emphasizes caring, empathy, and understanding toward others.
This term refers to a specialized advocate assigned to support members with ongoing and complex needs.
Dedicated Plan Advisor (DPA)
On UMR provider directories, this symbol identifies physicians who meet UnitedHealth Premium quality care standards
Two Blue Hearts
This pre-tax account requires enrollment in a High Deductible Health Plan (HDHP) and allows funds to roll over from year to year.
Health Savings Account (HSA)
This packaged rewards program allows employers to choose from pre-customized wellness incentive options for their employees.
Live Well Reward$
What is Cognitive Reframing?
This is the process of consciously shifting your mental perspective to view a situation in a more helpful way.
This weight loss and lifestyle intervention program helps members build healthier habits.
Real Appeal
UnitedHealth Premium quality care providers are recognized for meeting these four care standards.
Safe, Timely, Effective, and Efficient Care
This account is funded through payroll deductions and is used to pay for dependent care expenses.
Dependent Care Account (DCA)
When searching for a Premium Designated provider on umr.com, this icon identifies a Tier 1 provider.
Blue Dot Tier 1 Provider Icon
What is Ownership?
This principle involves accepting responsibility for your actions, whether the outcomes are positive or negative.
Advocates use this system to identify the Plan Advisor model for a group.
Health Plan Database (HPDB)
To qualify as this type of provider, a physician must meet both quality care and cost-efficiency metrics, potentially resulting in lower member costs.
Premium Designated (Tier 1) Provider
This additional 2½-month (75-day) period allows members to incur eligible expenses using remaining funds from the prior plan year.
Grace Period
This Centers of Excellence program helps reduce medical costs by 10%-15% through care management, clinical support, and lifestyle change programs for obesity treatment.
Bariatric Resource Services (BRS)
What is "The advocate owns the understanding"?
When a caller is difficult to understand, the advocate should maintain professionalism, confidence, control, and take responsibility for understanding the conversation.
When reviewing a member's account, you may find information about a Dedicated Plan Advisor in this field on the Claim Info (450) screen.
CSR Note
This UMR program provides access to high-quality, cost-effective care for complex conditions such as cancer, transplants, bariatric services, and spine and joint procedures.
UMR Centers of Excellence (COE)
This feature automatically pays eligible deductible and coinsurance expenses from a member's consumer-driven account after the insurance carrier processes the claim.
Automatic Reimbursement (A/R)
Members using Spine and Joint Centers of Excellence may receive dedicated care navigators, travel and lodging arrangements, warranty coverage, and priority scheduling.
Spine and Joint Services
What is slow the call down and ask for clarification?
If something is unclear during a call, an advocate should do this rather than pushing through or making assumptions.
These are the three most common types of calls handled by Plan Advisors.
Level of Benefits, Claim Status, and Other Insurance
Members using Spine and Joint Centers of Excellence may receive dedicated care navigation, travel assistance, warranty coverage for complications, priority scheduling, and savings of up to this percentage on procedure costs.
25% lower cost savings
An employer must choose between offering this option or a grace period but cannot offer both.
Carryover
This Spine and Joint COE feature provides predictable bundled pricing that includes consultations, admission, surgery, discharge, and follow-up coverage.
Cost Transparency