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New Options for Affordable Health Insurance

PAP266

Healthy Measures


Provider Administrative Policy

Section
General Information
Policy Date
September 2011
Status/Date
New/September 2011
Provider Type(s)
Physician  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

Healthy Measures

Healthy Measures encourages a healthier community by rewarding participating employees and eligible dependents for actively pursuing healthy lifestyles and working with their healthcare providers to control risk factors.

With Healthy Measures, participants may qualify for incentives such as a lower deductible or lower premium contribution by meeting program requirements. We encourage our members to lead healthy lifestyles, and now we are offering cost-saving incentives to employees to become more health conscious. This is the first Blue Cross of Idaho incentive-based package where participation translates into lower out-of-pocket costs for our members.

Healthy Measuressm supports the goals of keeping your patients healthy and encourages them to follow your advice and achieve evidence-based health outcomes.

How does it work?

To qualify for the incentive, employees and/or eligible spouses, if applicable, must complete an online personal health assessment (PHA) and, with the help of their physician or nurse practitioner, complete a health qualification form (HQF). A copy of the HQF is attached to give you an idea of the program requirements and the information participants will need to collect to qualify for Healthy Measures.

The HQF focuses on six important health factors including:

  • Tobacco use
  • Cholesterol management
  • Alcohol use
  • Blood pressure Control
  • Weight management
  • Blood sugar control

We believe people can improve their quality of life and prevent the risk of long-term, chronic diseases by monitoring and controlling these health factors.

What does this process mean for the healthcare providers?

Employer groups throughout Idaho offer Healthy Measures to their employees. Healthy Measures participants may contact you for assistance in completing the HQF. These patients have preventive health benefits for which we reimburse you when you submit the appropriate preventive codes.

As always, we encourage you to ask your patients for their ID card to determine their eligibility and benefit structure. If you have questions about their benefits, go to bcidaho.com/providers for information about patient eligibility and benefits. If you need further assistance or have questions about the HQF, please call the Blue Cross of Idaho Provider Contact Center toll free at 866-482-2250.

Health Qualification Form Sample


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