What is Tandem Health Advantage and Why Should I Care?

What is Tandem Health Advantage and Why Should I Care?

Wednesday, October 24, 2012

What Is Tandem Health Advantage?
Tandem Health Advantage is a personal healthcare shopping service.
Tandem Health Advantage offers you information and incentives for making smart healthcare decisions.  When your doctor recommends an outpatient test or procedure, just call Tandem toll free and our nurses will tell you who the low cost facilities are and how much you can earn as a reward for using a low cost facility.
 
Why Do I Need Tandem Health Advantage If My Health Plan Covers My Service?
Your health plan has negotiated discounts with doctors, hospitals, and outpatient facilities in your network.  The price paid for a particular healthcare service varies from one location to the next.  The difference in price can be significant.  Tandem's nurses will help you find a lower cost provider and, if you choose, we can help you schedule your appointment so that there is no delay in receiving the care you need. 
When you call Tandem Health Advantage and use a lower cost facility, your employer will save money which will help to keep future health plan costs lower – AND – you will receive a check in the mail for being a smart healthcare shopper.

What Does Health Advantage Cost?
Health Advantage is free for employees and dependents.  You can use the service by calling our toll-free phone number or by email.  The cost of the service is paid by your employer or health plan.

How Do I Sign Up For Tandem Health Advantage?
There is no need to sign up for Tandem Health Advantage.  If you are enrolled in your employer’s health plan, then you are automatically eligible to use Tandem Health Advantage.  If your dependants are enrolled in your employer’s health plan, they are eligible to use Tandem Health Advantage, too.

What Is The Reward For Using A Low Cost Facility?
Rewards range from $400 to $200 depending on the type of treatment or procedure you receive.  When you call Tandem Health Advantage, we will tell who the low cost facilities are and how much your reward will be if you use one of the low cost options. 

When Will I Receive My Reward?
After your treatment or procedure, your provider will submit a claim for payment to your health plan.  After the health plan determines that the service is covered and payment is made to the provider, your reward will be mailed to your home.  If you do not receive your reward check within 60 days after receiving your explanation of benefits, call Tandem for information about the status of your reward.

Is There A Limit To The Amount Of Rewards A I Can Earn?
No.  Each time you or your dependant uses the Tandem Health Advantage service and uses a lower cost facility, you will receive a reward.

Do I Have To Pay Taxes On The Rewards I Receive? 
Yes.  Reward payments are taxable and must be reported to the IRS as income. 

What Happens If I Choose Not To Use Health Advantage?
Tandem Health Advantage is a voluntary program.  It is up to you whether you use the service or not.  You and your dependents may use Tandem Health Advantage for some services and not for others.  The choice of facilities is always up to you.  But you will only earn a reward if you call Tandem prior to your test or procedure and you choose a low cost facility. 

What Should I Do If My Doctor Has Already Scheduled Me For A Test Or Procedure With A High Cost Facility?
Tandem Health Advantage is staffed by a team of nurses and healthcare professionals who will help you make the arrangements necessary to reschedule your service with a lower cost provider.  If your doctor has already scheduled an appointment at a higher cost provider, Tandem can schedule the new appointment and make sure that the required medical records and health plan information is given to the new provider.  Tandem will also arrange for the results of any tests or to be sent to your physician.