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Important Entries From blog.swdhc.com

  • An important component of the Deluxe Plus plan is Ancillary Services.

    Ancillary care includes those services that support the work of primary health care providers such as family doctors, nurse practitioners, physician assistants and specialists such as cardiologists, surgeons, dermatologists and so on. Ancillary care can be broken down into 3 categories. They are diagnostic, therapeutic, and custodial services.

    First, we have Diagnostic services – These are services that help a physician reach a diagnosis or guide him in the treatment of his patients. These are services that provide the physician insight to a patient’s problems that can’t be discovered simply by a physical examination. This includes imaging such as x-rays, mammograms, and MRIs. It also includes sleep diagnostics and laboratory tests. Every time you have blood drawn and sent to a lab or you provide a urine sample for urinalysis, ancillary services are being used. There is much more that could be included under diagnostic services, but these are some of the most common.

    The second category that falls under ancillary services is Therapeutic – After a patient has been diagnosed there may be a need for therapeutic services. Therapeutic refers to those services that may help regulate or improve the health of patients over time. Physical Therapy is a common example of this. But there is so much more. Dieticians, acupuncturists, mental health counselors, speech therapists, massage therapists. These are all included under Therapeutic ancillary care. And it includes other needs such as durable medical equipment, prosthetics, and orthopedic shoes. And the list goes on.

    The final category is Custodial Services – This is personal care for those who need assistance with the activities of daily living. This includes everything from skilled nursing facilities like retirement homes to in home care. A good example of one of the companies that AmeriPlan has contracted that offers custodial services is BrightStar Care. BrightStar Care is available in many locations now and is growing. They offer companionship and sitter services, transportation services, meal preparation, in-home blood draws and injections and a great deal more.

    This is a brief overview of the types of Ancillary Services that may be available to you. Not all services are available in all areas. So once again I would like to invite you to send us contact information for any providers in your area that you would like to see listed in the AmeriPlan network. Referrals should be sent by email to referral@ameriplanusa.com.

    If you have questions about Ancillary Services or any other aspects of AmeriPlan products please let us know by sending email to customersupport@ameriplanusa.com.


    Contact Your Benefit Consultant
    Have more questions? Contact Us @ 1-800-647-8421

  • We receive questions every day about the Hospital Advocacy Program and we know that being able to offer this program to a prospective member can be a huge selling point for you.  We want to make it easier for you to sell, so our goal here is to make the basics clear.

    THE BASICS

    No case can be started until a member has been active for at least 3 full business days and the member must remain active throughout the entire advocacy process.

    Hospital advocacy can be used when a member has already or will be experiencing a hospital or surgical center event.  And yes, an ER visit is a hospital event and an ambulance ride can be included.

    Every advocacy case starts with a call to AmeriPlan.  Although the Hospital Advocacy Program is administered by The Karis Group the case cannot be started without first calling AmeriPlan.  AmeriPlan facilitates the Karis group.

    We cannot begin an advocacy case by email or by chat.  A phone call from the patient or their guardian is required.

    It’s important to know what the definition of a case is.  A case is a single incident with expenses totaling at least $1500 that you must pay out of your own pocket.

    The minimum out of pocket expense of $1500 must result from bills from the hospital or surgical center.  This may include the cost of the anesthesiologist, x-rays, lab work and more.  The cost of visits to the doctor’s office is NOT included in the $1500 minimum.  However, those doctor bills can be submitted along with the hospital bills for negotiation.  We cannot begin a case based on doctor bills.

    Medical bills should never be sent to AmeriPlan.

    BEFORE A CASE IS SUBMITTED REMEMBER THESE 5 THINGS

    1.  You must be a member for 3 full business days and must stay active

    2.  Bills must be from the hospital or surgical center

    3.  Every advocacy case starts with a call to AmeriPlan

    4.  Each case must total at least $1500 out of your own pocket

    5.  The doctor office visits cannot be included in the $1500 minimum

    PRE-MEMBERSHIP BILLS

    If a current or prospective member has hospital bills that were incurred prior to becoming a member we can still help.  The only difference for these cases is that a $250 non-refundable fee must be paid prior to beginning the negotiations.

    INSURANCE DEDUCTIBLES

    We often get asked about is if we can negotiate insurance deductibles.  The short answer is NO.  But there is more to the answer.  Here is an example of how it works.  If the hospital bill is $5000 and your deductible is $5000 we will still negotiate the bill.  If the result of the negotiation leaves you with $2000 to pay the hospital, that $2000 will go towards your deductible.  Your deductible was not reduced.  So, if you have another hospital incident you will still have a $3000 remaining deductible that has not yet been met.

    EXCLUSIONS

    We cannot advocate for mental health services.  And, we cannot advocate for kidney dialysis.  This is because they are typically ongoing situations that have no definite end to treatment.  There may be other situations that fall into this category.

    SUBMIT QUESTIONS

    We welcome your questions.  Please send your questions to us by email at customersupport@ameriplanusa.com and we will try to answer as many as we can.

  • Here are the truths that need to be better understood:

    • We only have to brush twice daily to reduce the risk of decay. Brushing more frequently does not help any more.
    • If we brush after breakfast, we have to wait 20 to 30 minutes after eating to allow remineralization to occur and the pH of the oral cavity to return to normal otherwise we will be brushing away demineralized enamel that will be lost forever
    • We are not trying to remove all dental plaque or kill all dental bacteria. We are simply disrupting its growth and maturation.
    • If our toothpaste does not have fluoride in it, it is not proven by the preponderance of evidence to be beneficial in lowering our risk of decay. Fluoridated toothpaste is proven. Over and over.
    • We only need to brush for two minutes. That’s it.

    ‘The harder you brush, the cleaner your teeth become!’ …. False!

    Gum disease

    This is a common misconception. Teeth are living biological tissue. And unlike any soft tissue in the body, teeth cannot regrow/repair themselves once they wear out. Below is an image.

     

    These wear facets near the gum line in turn increase sensitivity.


    Contact Your Benefit Consultant
    Have more questions? Contact Us @ 1-800-647-8421

  • AmeriPlan Keeps On Growing Adding New Providers To Its Network!

    In the month of April, AmeriPlan added 63 new provider locations to the AmeriPlan network. These offices are scattered through 19 states and consist of dental, chiropractic and ancillary care service providers.

    And, many of these offices have multiple healthcare professionals practicing at the location!

    Adding new providers to our network provides better services and convenience to our members. If you would like a certain provider possibly added to the AmeriPlan network, contact us with the providers info; type of service, contact name, office number and city & state.

    Send your info to: referral@ameriplanusa.com


    Contact Your Benefit Consultant
    Have more questions? Contact Us @ 1-800-647-8421

  • Value, Savings And Affordability For The Entire Family

    An AmeriPlan membership saves you time and money with access to affordable healthcare products and services, including dental, prescription drugs, chiropractic, eye care, hearing, laboratory services and more.

    Save with deep discounts on healthcare products and services. We’ve pre-negotiated deeply discounted rates with our nationwide network of quality healthcare providers. Our members can take advantage of these deep discounts and significantly reduce their overall healthcare cost.

    Whether you have no insurance, limited insurance or full health insurance that does not cover all your healthcare needs, you can save money with one of our discount plans.

    Telemedicine is included with the Deluxe Plus membership and offers 24/7 access to US based physicians, including pediatricians. These physicians are available for detail consultations to diagnose common conditions and develop treatment plans, which may include prescription medication. Our members can schedule a consultation with a call back from a physician on average in 23 minutes.

    As a compliment to primary care, Telemedicine reduces the cost and frequency of in-person consultations. Some of the common conditions that may be addressed by Telemedicine are:

    • Allergies
    • Nausea
    • Cold & Flu
    • Ear Infection
    • Stomach Virus
    • Acid Reflux
    • High Blood Pressure
    • Acne
    • Sore Throat
    • Pink Eye
    • Asthma
    • Sinus Conditions
    • Headache
    • Rashes
    • Diabetes
    • Constipation
    • Hemorrhoids
    • Fever
    • Vomiting
    • Urinary Tract Infections

    *Prescriptions will only be issued when indicated and approved by a physician, and as permitted by law in your state.

    Patient Advocacy or Bill Mediation

    AmeriPlan Value

    “Recently I was in the ER, my bill was $3,676.50 and with hospital advocacy my out of pocket was $0. The Karis Group was awesome!”

    Todd M.

    When you incur a major medical expense exceeding $1,500 our AmeriPlan Healthcare plan will provide Patient Advocacy or Bill Mediation services dedicated to finding the best solutions for resolving your outstanding medical bills. Our advocate will work with you on everything from Medicaid and charitable care qualification to discounted settlements and payment plans. We will coordinate communications with each provider in pursuit of mutually acceptable solutions.

    If you are unable to pay your medical bills before or after service by any reasonable means, we will advocate on your behalf, working with providers to find a solution. Highly-trained negotiators will assist you and research the availability of financial assistance programs in an effort to locate alternate sources of funding to satisfy or reduce your bills.

    Telemedicine…It’s like having a doctor in the family.

    AmeriPlan Value

    “I was between doctors from when I had insurance to a transfer to medicare. My doctor would not take medicare. Called in to Telemedicine, told the very helpful lady what I needed. She was pleasant and very professional. The doctor called me back within half an hour. ” more

    Thomas S.

    Contact Your Benefit Consultant
    Have more questions? Contact Us @ 1-800-647-8421

  • Obesity Makes Flu Threat Worse

    By Dr. Mehmet Oz and Dr. Mike Roizen, MDs

    The influenza pandemic of 1918 infected and affected almost everyone in the world. An estimated 50 million people died as a result, making it three times more deadly than World War I, which claimed 16 million lives. As horrible as that was, an unchecked flu pandemic today could have even more devastating results.

    Special: This Toxic Vegetable Is the #1 Danger in Your Diet
    A new study funded by the National Institutes of Health found that “obese adults with flu symptoms and laboratory-confirmed influenza shed influenza A virus for 42 percent longer than adults with flu who were not obese.”

    Meaning that they can infect others for much longer than normal-weight people. The study also notes that people who are obese don’t respond to the flu vaccine as positively as normal-weight folks. And if they do get the flu, they’re far more likely to have complications and die.

    The Centers for Disease Control and Prevention (CDC) recently reported that almost 40 percent of American adults are obese — the highest rates ever recorded for the U.S.

    So it has never been more important to get your flu vaccine, whatever your weight. Also, practice infection control by staying home from work if you get the flu and washing your hands frequently.

    Keep your immune system healthy, and increase the chance the flu vaccine will work by getting enough sleep and taking a multivitamin, especially in the week before your shot; reduce stress with meditation and exercise (10,000 steps daily); and eat healthfully by avoiding trans and saturated fats, added sugars and syrups, and any grain that isn’t 100 percent whole. You should also avoid red meats and highly processed foods.


    Contact Your Benefit Consultant
    Have more questions? Contact Us @ 1-800-647-8421

  • AmeriPlan Deluxe Plus ofrece una variedad de servicios de atención médica a un precio de descuento por una tarifa mensual baja que incluye a toda su familia.

    Acceda a una red nacional de 75,000 dentistas, 12,000 proveedores ópticos, 56,000 ubicaciones de farmacias y más de 7,500 quiroprácticos a precios de descuento prenegociados. Acceso a Telemedicina las 24 horas, los 7 días de la semana, por teléfono o video que proporciona contacto con médicos certificados por la junta. Ahorre en servicios auxiliares y facturas de hospital.


    Contact Your Benefit Consultant
    Have more questions? Contact Us @ 1-800-647-8421

  • With healthcare insurance cost at an all time high and hospital care even higher, we all need an alternative to help pay unexpected hospital bills.

    Below is a real story that has become more common in today’s world.

    Taken from Time Magazine.

    “You Only Think You’re Covered”

    There were so  many sad stories of people needing to go to the hospital. They met their deductible and selected an  in-network hospital AND  they were STILL stuck with hospital bills.

    One poor lady found out she needed to have two surgeries , one on each thumb for arthritis.  She chose a hospital that was in-network and had met her deductible of $3,500.00 She didn’t expect to  have to pay more.   Months later, she was whacked with a $6,300 out of network bill, that she discovered that the anesthesiologist on duty the day of her procedure was an out of network and that the bioengineered implant that her doctor  had used in the procedure was not covered by her insurance.

    Unfortunately by the time that bill arrived, she has already had the same procedure performed on her other thumb, using the same surgeon, anesthesiologist and implant.  She’s now bracing for another $6,300 hit.  If you include her $568 monthly premium, her in-network deductible, plus the $12,600 in surprise bills, she is expected to pay $22,916 for her health care last year alone.  That’s close to half her after -tax-take-home pay.


    Contact Your Benefit Consultant
    Have more questions? Contact Us @ 1-800-647-8421

  • Hello members!

    Welcome to the Save With Discount Healthcare, the membership entity of AmeriPlan USA.

    Is the high cost of quality health care getting you down? Are you one of the 58 million uninsured Americans with no health savings plan? Look no further… it is now possible to access affordable dental, vision, prescription, chiropractic and medical plans for your entire household.

    Plans that range from $24.95 per month for Dental Plus to $39.95 per month for Deluxe Plus.

    For more information visit the Save With Discount Healthcare website »

    AmeriPlan® Corporation…

    The nation’s premier Discount Medical Plan Organization (DMPO). Since 1992, AmeriPlan® members have saved hundreds of millions of dollars receiving discounted health care services using the AmeriPlan® provider network. Our network has tens of thousands of health care professionals across the country with dental care, advocacy, hospital ancillary care, hearing & vision, chiropractic care, wellness and pharmacy.

    AmeriPlan Deluxe Plus PlanThe AmeriPlan® Mission…

    • Provide high quality and affordable medical care, dental care, prescription drugs, vision and chiropractic care to the average American family.
    • Hold the well-being of our members, Benefit Consultants, service providers, staff and our company in equal balance.
    • Foster an environment which promotes a spirit of cooperation, self improvement, leadership and genuine concern for each other.
    • Adhere to the highest standards of professionalism, service and leadership that will earn us the respect and praise of our industry while providing financial stability and independence to those who would earn it.

    We invite you to take care of yourself and your family with AmeriPlan®. Your life is full of precious things: the people you love, the home you live in, plans you need to keep the things you value most in life secure. A good place to start is right here at AmeriPlan®.


    Contact Your Benefit Consultant
    Have more questions? Contact Us @ 1-800-647-8421

  • Article From OnForb.es

    While 87% of Americans now have health insurance, overwhelming co-pays, high deductibles and a lack of primary care doctors still stand in the way of healthcare for many.

    An average GOLD level plan—one of the more expensive, “better” insurance plans—still has a deductible of $2,000 for an individual, which approximately 40% of Americans cannot afford. Thirty-five percent of Americans already struggle with medical debt despite that 70% of those struggling have insurance. And by 2025, the United States faces a potential physician shortage of as many as 52,000.

    For many, new health insurance is not providing access to affordable care, and the ACA will not address the physician shortage. To bridge that gap, we must find innovative ways facilitate hassle free access to a provider that is more cost-effective. Telemedicine is a growing model that is a part of the answer.

    TelemedicineTelemedicine, or “telehealth,” is the provision of remote access to a physician via phone or videoconference to address a health care issue. It’s not a new concept. It’s well-established in rural areas for specialty consultations, and has been widely used in many primary care practices like pediatrics as a practical matter (although most pediatricians do not bill for phone consultations).

    More broadly, telehealth is gaining ground as an alternative to urgent care or the emergency department for more minor concerns like ear infections and colds. This week, Blue Cross Blue Shield of Massachusetts announced that it is offering video visits to patients within two physician groups. BCBSMA Director of Network Innovation Greg LeGrow told MobiHealthNews that video visits have the potential to improve cost, access, quality, efficiency, as well as patient and physician satisfaction.

    Data show that telemedicine can deliver quality outcomes comparable to in person office visits.  A 2011 Center for Disease Control study showed eighty percent of adults discharged from the emergency room-meaning patients who could be treated and sent home-said they sought care at the ER due to lack of access to a primary care provider (PCP). However, the ER is also the most expensive and least efficient way to provide non-emergent care, costing from $1,500 to $3,000 on average compared to $130 to $190 for a PCP visit. A telemedicine visit can cost as little as $40.

    Access to a telemedicine provider can prevent an ER visit on a Saturday night or prevent the need to arrange travel, childcare, or time off from work for an office visit during the week. Telemedicine is not designed to replace the need for a relationship with a PCP, but serves as a convenient and cost-effective alternative.

    There are multiple barriers to the widespread uptake of telemedicine, but the most prohibitive are regulatory policies at the state level. The laws in many states either severely limit or completely ban the practice of telemedicine. But the truth is telemedicine is a tool used to practice medicine, not the practice of medicine itself. This is an important distinction to make in order to craft laws that govern its use.

    As of February 2015, 36 states have introduced 100 varied bills related to telemedicine. We need to see state legislation with the following four elements.

    First, the legislation needs to provide payment parity. This means requiring insurers to reimburse licensed health care providers for services delivered remotely at the same rate they would pay if the visit were in-person. There should be no financial incentive to treat a sore throat in person versus with a telemedicine consult, because the reimbursement to the provider should be the same. Currently only 21 states and D.C. have parity legislation, and of those only 15 do not have provider or technology restrictions.

    Save With Discount HealthcareSecond, the legislation should establish that the same standard of practice applies whether the services are delivered in person or remotely. This means codifying that the questions and “images” a physician uses to adequately diagnose and treat a condition are the same whether they are gathered in person or over the phone and with pictures.  This would clearly distinguish telemedicine as the tool that it is, rather than the practice of medicine.

    Third, the legislation would prevent the creation of more restrictive licensing requirements by the medical licensing entity in the state for delivering services via telemedicine. Specifically, the legislation should prevent the use of additional rules requiring in person visits before or after telemedicine encounters or the presence of care facilitators during an encounter. These types of restrictions make it almost impossible to deliver quality, cost-effective care remotely, or via telemedicine, and prevent the use of many current telemedicine business models in our state. Currently 27 states and D.C. have legislation that is telemedicine friendly. However, Alabama, Arkansas, Missouri, Nebraska and Texas require an initial in-person visit before a telemedicine visit and Alabama, Texas and Georgia require in-person follow up visits.  These laws effectively eliminate the possibility of most telemedicine models from operating in the state.

    Fourth, the state licensure requirements should allow exemptions for telemedicine. All states currently have some restrictions on physicians practicing out of state despite that the Federation of State Medical Boards (FSMB) offers a uniform licensing procedure and guidelines. Each state has a different set of policies and practices and only D.C., Maryland, New York and Virginia have reciprocity agreements with bordering states. Currently, there are 10 states that have conditional licenses for telemedicine for out-of-state physicians.

    As a physician, I understand clinicians can be skeptical of new practice modalities and strategies because that is not how we were trained, and we want to see the evidence. The good news is that we have evidence telemedicine works, is safe, and cost effective. Providing Americans with Accessible, Affordable Care, is going to require a new strategy. Telemedicine can, should, and quite frankly will be a part of that strategy.

    The patient-consumer has spoken, and they want to access primary care on their own terms, not those of the healthcare industry. They want to be able to use their smart phones to find providers, schedule appointments, and view their medical records. With telemedicine they could also see a physician. This issue is picking up steam. But this is only possible if states remove the current regulatory barriers to care.


    Contact Your Benefit Consultant
    Have more questions? Contact Us @ 1-800-647-8421

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