MAKING
SHOPPING
FOR CARE
EASIER

When you shop, you consider both quality and price. Why should health care be any different? Our engagement and transparency tools help members make quality health care decisions with an easy and convenient shopping experience.

• Provider Finder^®: An integral part of our transparency suite, Provider Finder supplements the search experience to help members make more informed health care decisions. This web-based digital tool applies a specific member’s current health plan benefits to the estimated episode-of-care costs for up to 1,600 procedures and diagnostic tests.
• Benefits Value Advisor: Our personalized benefits navigation program provides more than customer service. Our team of advisors helps members better understand their benefits. Advisors provide live, real-time access to cost and quality information; they shop on the member’s behalf for increased engagement and savings; and, when appropriate, they provide warm transfers to clinicians.
• Member Rewards: Prices for medical services of the same quality can differ by thousands of dollars within the same region and network, but with Member Rewards members are encouraged to shop for the most cost-effective option without sacrificing the quality of care. Members can earn as much as $500 in rewards per episode when they select the most cost-effective option.
• Virtual visits: A health care solution, powered by MDLIVE^®, that gives members access to board-certified doctors and mental health providers via phone, computer or mobile device for non-emergency care anytime and from virtually anywhere. The average wait time is less than 20 minutes—considerably less than most trips to an urgent care provider or emergency room.
• Imaging Solutions: This innovative program ensures that imaging tests performed on your employees are medically necessary and are done in the appropriate sequence of care. Imaging Solutions provide medical peer-to-peer review of imaging tests that can potentially eliminate unnecessary tests and could lower a member’s cost. Plus, the program’s health benefits may even include reduced exposure to radiation for members.
• Reference Based Pricing: Reference Based Pricing (RBP) is a flexible, member-friendly, web-based transparency tool that demonstrates the incredible potential of empowering people to make cost-effective health care decisions. RBP motivates members to learn the cost of certain procedures so they can maximize their benefits. A sophisticated algorithm compares nearby provider quality and cost in their network to set a maximum coverage amount for up to 1,600 procedures and tests. With the support of easy-to-navigate prompts and a Customer Advocate, when needed, members are able to choose high-quality, lower-cost care options.
• Value-Based Insurance Design: Value-Based Insurance Design (VBID) removes barriers to essential, high-value health services and helps members manage chronic conditions. Members are encouraged to enroll in a coaching program related to their chronic conditions in order to maximize their benefits. VBID can reduce costs by giving members the knowledge to take more control of their health.
• Blue Access for Members^SM: The online platform allows members to access all their health care information through a secured website. Members can find information about their coverage: location of network providers, claim status, explanation of benefits, product information, pharmacy information, health and wellness tools, and member ID card replacement.
• ConsumerMedical: Empowering employees and their families to make intelligent health care decisions. By collaborating with employers to help members find quality providers and effective care for all medical conditions.