September 2012

In This Issue

 

NCMS Plan Website Redesign Launched

The NCMS Plan (http://www.ncmsplan.com/) has had a web presence for many years, but had not refreshed the look and feel of the site in quite a while. The redesign was about giving the NCMS Plan a more current look and highlighting features of the NCMS Plan more visibly. One of the best new features is right on the front page…the rotating “billboard” that allows us the flexibility to promote new programming in an eye-catching way. Visitors will also find more personal elements spotlighting George Fanelli (Account Service Representative) and Jason Horay (Health Promotion Coordinator). One of the strengths of the NCMS Plan is that practices get to know our staff on a personal level and develop relationships based on trust and mutual respect. The new site also highlights practices that have earned Practice Wellness grants and shares their success stories.

There are plans for further enhancements to the website to reinforce our sales and marketing efforts and to distribute NCMS Plan related materials in an efficient and secure manner.

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Dedicated NCMS Plan Service Representative

The NCMS Plan's dedicated service representative for enrollment and billing issues at BCBSNC (the health plan administrator) has added a new member to the team over the summer, Dawn Burwell. Dawn can assist you with adding employees or dependents, cancellations, address changes, or other routine maintenance and billing issues.

Dawn has many years of experience, including familiarity with the NCMS Plan assisting with renewal processing. Please make a note of Dawn's name and her phone number, 919-765-7759. The e-mail address and fax number will not change (ncms@bcbsnc.com and 919-765-3564, respectively).

Dawn is a contact for practice administrators only, not individual employees or dependents. Of course, George Fanelli (Account Service Representative, MMIC Agency) will continue to assist you with any other concerns you may have.

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Mellon HSA Product Enhancement

Over the summer, ACS|BNY Mellon HSA Solution, the NCMS Plan's Health Savings Account administrator, announced the following new features and service enhancements:

  • Direct Pay HSA fund transfers. This enhancement went live on July 1st and provides individual account holders the ability to directly transfer funds from their HSA account to a personal checking or savings account online. In addition, new account-to-account transfer capabilities allow funds to be deposited into HSAs from personal accounts. Direct Pay continues to be a popular feature for account holders.
  • Investment threshold reduced from $1500 to $1000. Beginning October 1, 2012, account holders can start investing into a wide selection of mutual funds when their HSA checking account balance reaches $1,000. Reducing the investment balance from $1,500 to $1,000 enables account holders to begin investing sooner. Click here to view investment options.
  • Mobile access. Account holders can access HSA account balances and transaction information from their mobile or smart phones. They can check HSA account balance on- the- go as well as make changes to the account profiles (for example mailing addresses and phone numbers). Note that a security code will be needed for first time mobile device logon (as it is a new and as of yet untrusted device) but the account password remains the same. Click here to view the FAQs available on the mobile browser.

These enhancements were shared directly with your employees who are HSA account holders by e-mail and in account statements.

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Ask George

Question: One of my employees recently received an Explanation of Benefits (EOB) for medical services and their claim was denied. The employee believes this was an error. How can they appeal this decision?

Answer: The NCMS Plan is administered by BCBSNC. This administration includes claims adjudication and management of the appeals process. When an employee disagrees with the way a claim has been processed, their first step is to call BCBSNC Member Services, 1-877-248-3334. A BCBSNC representative can review the claim with them, explain the EOB, and discuss the specific reasons for the denial.

If the employee is not satisfied with the explanation and continues to believe the claim was processed in error, there is an appeals procedure (including a First & Second Level Appeal) for resolution by a BCBSNC review panel. A First Level appeal can be initiated via phone with BCBS Member Services at the number referenced above, or by mail at BCBSNC Customer Service P.O. Box 2291 Durham, NC 27702. The first level appeal must be submitted within 180 days of claim denial. Requests for review should always include your name & id number, the name of the patient, the nature of the appeal and any information or clinical data that may be helpful for the review. BCBSNC's Member Services website provides more information about the appeals process and a Member Appeal Form.

If the employee is dissatisfied with the outcome of the First Level Appeal, they have the right to initiate a Second Level Appeal. The appeal data will again be reviewed and findings mailed to the employee. Employees can appeal to the North Carolina Department of Insurance if the First and Second Level Appeals do not result in the outcome they believe is correct. Instruction for NC DOI appeals are included in Benefit Booklets available on BCBSNC's Member Services website.

If you have questions about the appeals process, call me at (919) 878-7561 or e-mail george.fanelli@mmicnc.com.

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CEENTA Receives the First NCMS Plan Practice Wellness Grant

Charlotte Eye Ear Nose & Throat Associates, P.A. (CEENTA) has been awarded a $15,000 grant from the North Carolina Medical Society Employee Benefit Plan (NCMS Plan) for encouraging wellness and good health practices among its employees.

CEENTA was the first group to receive a Practice Wellness grant and in its full amount of $15,000 from the NCMS Plan. To qualify for the grant, CEENTA pledged to create an environment that supported healthy lifestyles; had 75 percent of its enrolled employees complete a health assessment; and had 50 percent of its employees attend a 30-minute educational seminar. On July 4 of this year, CEENTA made all of its locations tobacco-free environments.

“We’re so appreciative of the NCMS Plan for making the Practice Wellness grant program available to its participating practices,” said Annette Potts, the director of human resources at CEENTA. “We have had an employee wellness program for several years. When we were offered the opportunity to enhance our wellness program even more, we were excited to take the challenge. Of course, we were also excited to be the first to receive a grant and have funds to continue our wellness initiatives.”

To learn more about the Practice Wellness Grant Program and to apply, please contact mailto:Jason.Horay@mmicnc.com?Subject=Practice Wellness Grant Program or call (919) 878-7530.

NCMS Staff Embraces Wellness

Over the past two years, the NCMS Plan has made dedicated efforts to improve the health and wellness of its members with resources and consultation for member practices. The Plan’s Board of Trustees, comprised of physicians, believes that employers can play a role in helping practice employees make healthy living decisions and lifestyle changes that make a difference in their lives and improve their utilization of the healthcare system.

The North Carolina Medical Society (NCMS), as Plan Sponsor, is leading by example. NCMS EVP, CEO Robert W. Seligson, embraces wellness initiatives and has put in place opportunities for employees to improve their health. Two years ago, a personal fitness trainer leased space in the NCMS headquarters building. Seligson established an arrangement for employees to attend fitness classes and personal training sessions at a significant discount.

The benefits have been realized in several ways. NCMS employees have lost weight ranging from 5 to 100 pounds. Feedback from employees is that they are more fit, feel better about themselves, are more productive, and have reduced sick leave. Even for employees who exercise on their own and do not access the facility in the NCMS building, there is a prevailing atmosphere of healthier living and support for their fitness endeavors. From a company view, Seligson considers the benefits to be a significant return on investment.

Other wellness efforts by the NCMS include eliminating soda and snack vending machines; establishing a smoke-free property; and providing health and wellness resources through the NCMS Plan.

Upcoming Practice Wellness Webinars

Don’t miss the last webinar in 2012...

November 13, 2012

Creating Practice Wellness Cultures

Wellness holds great promise for each of us. Unfortunately, unsupportive cultures frequently undermine positive practices and our efforts to adopt healthier lifestyles.

Join Dr. Judd Allen for a review of the importance of having a wellness culture. He will also defines culture and explore the impact of five cultural dimensions: shared values, norms, peer support, cultural touch points and the overall social climate.

About Dr. Judd Allen

Dr. Allen is President of the Human Resources Institute, LLC, a research, publishing and consulting firm that focuses on the creation of supportive cultural environments. He earned his Ph.D. in Community Psychology from New York University. Dr. Allen serves on the editorial board of the American Journal of Health Promotion and is a member of the Board of Directors of the National Wellness Institute. Dr. Allen has assisted several hundred government, business, and community settings to bring about lasting and positive culture change. He has authored more than 50 books, journal articles, training manuals and software titles. His most recent books are Kitchen Table Talks for Wellness, Bringing Wellness Home, A Family Guide to Wellness, Wellness Leadership and Healthy Habits, Helpful Friends.

All attendees will receive a complimentary copy of Dr. Allen's book, Wellness Leadership.

Click here to register.

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About the North Carolina Medical Society

As the largest physician organization in the state, the North Carolina Medical Society (NCMS) is devoted to representing the interests of physicians and protecting the quality of patient care. The NCMS Plan, sponsored by the NCMS, is the only statewide employee benefits plan designed specifically for North Carolina physicians.

For more information about many other benefits of NCMS membership, visit http://www.ncmedsoc.org/.