Introduction:

 

Hi, I’m <presenter name>, from Imagine Health, with some important information to share with you regarding your health plan.

 

Your company selected Imagine Health to give you more control over the cost and quality of the healthcare services you receive.

 

In this presentation, I’ll quickly discuss all the benefits available to you through Imagine Health… including everything from direct access to carefully selected Imagine provider partners, the ability to see the provider of your choice, with built-in price protection…

 

and additional support that Imagine makes available to members like you.

Imagine Provider Partners

With Imagine Health, you can see any medical provider you’d like… but…  when you seek care from an Imagine provider, you’ll know you are getting the most from your health plan’s benefits.

 

You have direct access to affordable care from all Imagine providers. You do not need referrals, and you won’t pay more than your plan’s copayment or coinsurance amount.

 

You’ll find providers to cover all your healthcare needs: from primary care physicians and pediatricians, to laboratory and diagnostic services. You can also find other services like surgical and urgent care centers.

 

It’s easy to find an Imagine provider in your area – simply visit providers.imaginehealth.com for the most up to date listings.

Non-Imagine Providers

Your plan also gives you the ability to see any provider outside of Imagine Health, with built-in price protection to make sure you overpay for the healthcare you receive.

 

Claims from Non-Imagine providers are reviewed to find any billing errors or charges that exceed your plan’s allowable limits.  We’re here to make sure you pay a fair price for care –no matter where you go.

 

Your health plan’s partner, ELAP Services, conducts the review and provides assistance in the event a provider disputes your plan’s payment.

 

After the claim is reviewed, a fair and reasonable payment is to the provider. Most of the time, this process works without you needing to do anything.

 

If a provider doesn’t accept the payment, they may bill you directly for the difference between the amount that’s been paid and what they charged. 

 

We call this a balance bill. If you receive one, you need to contact ELAP Services right away.

 

You can quickly identify a balance bill by comparing the bill from your provider to your Explanation of Benefits, or EOB. If the amount you owe from the provider is higher than the amount listed on your EOB, submit the bill to ELAP Services.

 

Once ELAP receives your balance bill, and you sign a few forms, their advocacy team can start working on your behalf. This includes a dedicated Member Services Advocate, who will answer your questions and proactively update you on the status of your claim.

 

Just be sure to tell ELAP Services if you receive a balance bill so you can get the help you need!

Member Support

 

We are here to help you find the right care for your needs –whether you see Imagine Providers or not. Just call the member services number on your benefits ID card and we’ll help you compare doctors based on quality scores, convenience and cost. Let us help you get the care!

 

 

Recap

With Imagine Health, you are in control of your healthcare.

 

Enjoy the direct access and quality care you’ll receive from our Imagine providers. Find one near you today at providers.imaginehealth.com.

 

Or, see any other provider with the confidence that our built-in price protection means you won’t overpay for care.

 

Need help before or after you receive medical care? Call the member number on your benefits ID card for guidance.  

 

Outro

 

We’re excited to welcome you as a member of Imagine Health, and look forward to serving you in the future. Thank you for watching.

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