aetna presentation

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Published on January 15, 2008

Author: Ubert


Aetna HMO for State of Delaware Employees and Pre-65 Pensioners:  Aetna HMO for State of Delaware Employees and Pre-65 Pensioners Highlights:  Highlights Outstanding customer service located in the Blue Hen Corporate Center - Dover, DE Dedicated Customer Service # : 877-54-AETNA (877-542-3862) Large local and national network Tools to help members stay healthy and well informed Personal Health Record Aetna Health Connections Aetna Navigator Proven track record The Basics….:  The Basics…. Member chooses primary care physician (PCP) from our large network of participating providers Member visits PCP for routine care, injury or illness PCP referral generally required for specialist care, except for direct access benefits Member pays copay at time of service Coverage for dependents living away from home Direct Access Benefits:  Direct Access Benefits No referral needed for: Routine and preventive care Routine well-baby care OB/GYN care Routine eye exams Value Add Programs & Services:  Value Add Programs & Services Aetna Health Connections Aetna Navigator Personal Health Record DocFind Moms-to-Babies Informed Health® Line Aetna Natural Products & Services National Medical Excellence Program® Slide6:  Aetna Health Connections In house disease management monitors 30+ diseases/conditions Single Aetna nurse manages all member’s conditions State-of-the-art predictive modeling tools Patient safety is an integral part of the program Care considerations Slide7:  Vascular Peripheral Artery Disease (PAD) Cerebrovascular Disease (CVA)/Stroke Congestive Heart Failure (CHF) Coronary Artery Disease CAD) Diabetes – Adult and Pediatric Hypertension (high blood pressure) Hyperlipidemia (high cholesterol) Pulmonary Asthma – Adult and Pediatric Chronic Obstructive Pulmonary Disease (COPD) Gastrointestinal Gastro Esophageal Reflux Disease (GERD) Chronic Hepatitis Peptic Ulcer Disease Inflammatory Bowel Disease (Crohn’s Disease and Ulcerative Colitis) Neuro-Geriatric Seizure Disorder Migraine Parkinsonism Geriatrics Orthopedic Rheumatoid Arthritis (RA) Osteoporosis Osteoarthritis (OA)* Cancer General Cancer Breast Cancer Lung Cancer Lymphoma/Leukemia Prostate Cancer Colorectal Cancer Renal Chronic Kidney Disease End Stage Renal Disease Other Cystic Fibrosis HIV Hypercoagulable State Chronic Low Back Pain Sickle Cell Disease - Adult and Pediatric Weight Management Program Conditions/ Clinical Content Slide8:  Navigator™ Engaging Consumers Through Aetna Slide9:  Links to Related Resources Personal Health Record Find Health Care in DocFind Order a Member ID Card Contact Member Services Take Action On Your HealthSM Member- Centered Design Slide10:  DRAFT What Is DocFind?:  What Is DocFind? Aetna’s premier online directory of doctors and hospitals Supports searches for network participating: PCPs Specialists Dentists Urgent Care Facilities Pharmacies Data refreshed three times per week Hospitals Institutes of Excellence™ Transplant Facilities Behavioral Health Specialists Vision One® locations Other Facilities (e.g., Labs) Slide12:  Members: Identified for participation by multiple means and encouraged to register and complete pregnancy risk survey Risk stratified based on responses to pregnancy risk survey At normal risk receive educational intervention and telephonic support when necessary With high risk stratification assigned to OB nurse case managers to receive targeted outreach calls Slide13:  Informed Health® Line 24/7, toll-free access to registered nurses for health information Access to Audio Health Library Access to Healthwise Knowledgebase Ongoing communications Personal follow-up Consistent, coordinated service Slide14:  Natural Aetna Products and Services ProgramSM Slide15:  Health-Related Products Purchase online for InterNatural and WebVitamins, Inc. InterNatural Minimum 20% discount off retail prices for: Over-the-counter vitamins Herbal and nutritional supplements Health-related products WebVitamins, Inc. 12% discount off retail prices for: Over-the-counter vitamins Herbal and nutritional supplements Slide16:  National Medical Excellence Out-of-country care program Supports members who need emergency medical care while temporarily traveling outside the United States National special case program Assists members with rare or complex conditions requiring specialized treatment in evaluating their options and obtaining appropriate care National transplant program Case management, centralized claims/member service, Institutes of ExcellenceTM (IOE) transplant network Slide17:  Our Customer Service Center Dover, DE Our Customers Our Site Our People Serving 700,000 members Focused exclusively on National Accounts customers and members Over 195 service staff Average 7.9 years Aetna experience 76% at Aetna over 5 years High Quality Service Since 1987 Full Spectrum of Products Dedicated Customer Service #: 877 54-AETNA (877-542-3862) Slide18:  Our Customers Are at the Center of Everything We Do We deliver results for you We organize our people around you We focus our service and technology on you

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