Page 6 - Synergy Private Health Membership Packet

ENHANCEMENTS 1 8. In-Office Business Center. Access to a business center
that includes access to faxing, copying and document
scanning equipment, a private area where you can
hold conference calls, as well as internet access for your
A. HEALTHCARE DELIVERY EXPERIENCE personal use while you are visiting your Physician’s office.
The Company will work with the Practice and your
Physician to make available the following, to enhance 9. Dedicated Office Personnel/Expedited Check-
your healthcare delivery experience: in and Check-out. Availability of personnel at your
Physician’s office to provide you with dedicated
1. Panel Limits. A limited membership panel in order to administrative service, including expedited check-in
enable your Physician to provide you with personalized and check-out, in order to minimize your waiting time
care and attention to your individual needs. The Company whenever possible and to provide you with outstanding
will also arrange for your Physician to agree to be service.
available to provide the Professional Services described
in this Handbook on the Schedule titled, “Professional 10. Personalized Member Services. Availability of a
Services.” dedicated Member Services representative to provide
assistance addressing and coordinating the administrative
2. Communications Access. Telephone, cellular phone, aspects of Members’ health needs, and to act as your
facsimile, secure text messaging and e-mail service, for advocate for all Member-related issues.
your Physician, coupled with information on how you can
contact your Physician through those means (collectively, 11. Hospital Personal Assistant Services. Should
the “Communications Enhancements”). Your Physician has you require admission to Newton Wellesley Hospital,
agreed to be generally available to communicate with you availability of a personal assistant to facilitate
(or your authorized representatives) 24 hours a day, seven communication between hospital staff, family members
days a week through one or more of the Communications and/or your personal representative and you in a
Enhancements, including to consult with healthcare personalized manner at Newton Wellesley Hospital.
providers attending to you out of state, overseas or
otherwise outside of the Company’s usual service area. 12. Telemedicine Services Availability. Opportunities
Telephone and email communications will be responded for telemedicine or “virtual” visits in appropriate
to as quickly as reasonably feasible. In the event that your circumstances.
Physician is not available due to vacation or other reasons,
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alternative communication with another practitioner at 13. Connectivity to Castle Connolly Top Doctors .
the Practice or with another covering physician will be Use of Member Services representatives to facilitate
arranged. Additional charges may apply for international connectivity for you or your Physician to over 50,000
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or unusual communication expenses. Castle Connolly Top Doctors nationwide, upon request.
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3. Same-day/Next-day Appointments. Use of the B. SENS SOLUTION WELLNESS PROGRAM
Communications Enhancements to make appointments,
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including same-day (or, where appropriate, next business- The SENS Solution Wellness Program is a comprehensive
day) appointments to see your Physician (or if your and integrative approach to enhancing Members’
Physician is unavailable due to vacation or other reason, wellbeing, focusing on four lifestyle pillars: Sleep,
to see another covering physician or other healthcare Exercise, Nutrition and Stress Management. As part of
provider), including appointments for non-urgent care, that Program, the Company has arranged to provide you
regardless of medical necessity. with the following:

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4. Extended Appointments. Appointments with your 14. SENS Solution Health Assessment. The
Physician for routine visits of such length as will enable opportunity to receive a personalized assessment of
you to discuss your health-related concerns, regardless of your overall wellness status and needs through the SENS
medical necessity. Solution Risk Assessment, which takes a close look at the
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four lifestyle pillars by having you fill out an electronic
5. Extended Patient Hours. Office visits Monday self-assessment tool, the results of which are reviewed by
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through Friday during normal office hours. Under special a SENS Solution Health Coach, and which can help your
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circumstances, if medically appropriate and mutually Physician and SENS Solution Health Coach work together
agreed, weekday evening appointments may be provided. to create and monitor a customized wellness plan. Note
that this assessment is not a clinical assessment, and the
6. Limited Wait Time. Minimal waiting time for your assessment and plan are not intended to be, and should
physician when you are scheduled for appointments, not be construed as, a Welcome to Medicare exam or an
unless your Physician is attending to a medical urgency or annual covered wellness visit, exam or clinical service.
emergency, or is delayed for other good reason.
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15. SENS Solution Health Coaching Program. Access
7. Comfortable Waiting Area. Access to a comfortable to a SENS Solution Health Coach, who, utilizing the
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reception area, with internet access and educational SENS Solution Risk Assessment, will provide you with
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materials for the occasional brief wait for your Physician. customized support and education, to help you identify