Concierge, Navigation & Copay Clarity
FiveStar Health: Concierge Program
When customers enhance their benefits with our FiveStar Health concierge program, members have a single point of contact for every aspect of their benefits plan. Members call a dedicated 800 phone number to speak with their FiveStar Health Navigator who simplifies the healthcare process, works with their Prairie States team, and provides guidance on making informed decisions.
- Answer questions on benefits, coverage, eligibility, and claims
- Hand-off to Prairie States’ in-house nurses
- Help members find in-network providers
- Connect members with external partner programs, staying on the phone through a warm call transfer
Navigation: Guiding Members to the Best Care at the Best Cost
With our Navigation service, members get the guidance they need to make smart healthcare choices. It all starts with your Direct Primary Care (DPC) clinic that drives affordable access to preventive and diagnostic care. When health concerns arise, the DPC is in the best position to guide members to high quality, low cost provider options outside the clinic’s scope of services. Prairie States’ Navigation service streamlines this steerage between the clinic, Tier 1 and Tier 2 providers, and packaged bundles. Our FiveStar Health Nurse Coordinator works with your clinic’s staff, providing navigation support for members that the clinic may see and refer.
The results? Members choose top-rated, low-cost care, and employers reduce health plan costs!
Copay Clarity: Upfront Prices for All of Your Care
Employers typically address rising health plan costs by increasing employee cost share, decreasing the quality of benefits, or implementing complex plan strategies. The alternative, simplified solution? Copay Clarity, our variable copay plan design! Copay Clarity uses cost and quality data to set copays for any covered service or procedure, simplifying – and improving – the member experience. Members spend less out of pocket on high value care, and employers reduce claims costs.
- No deductibles or coinsurance. Just upfront copay pricing so members know their full cost share prior to receiving care.
- Easy-to-use online search that incentivizes members to use high quality, low cost care.
- FiveStar Health Concierge provides benefits guidance and searches for high value care options on behalf of members.
With easy-to-use coverage and high touch member support services, both employers and employees experience significant cost savings.
