Health Messenger Spring 2005

FirstCarolinaCare is committed to helping its members attain the highest level of wellness possible. To work toward this goal, FirstCarolinaCare offers a Chronic Care Management program that is provided at no cost to our members.

The Chronic Care Management Program identifies members who could benefit from the program's services and provides these members with the tools to help improve their health and well-being. The program uses tools such as Medical Health Questionnaires and health screenings (consisting of checking triglycerides, cholesterol, glucose levels and blood pressure) to identify members who may need assistance. Bone density screening is also provided for age appropriate female members.

The health screenings are provided at the work site shortly after enrollment and periodically thereafter. The work site location provides convenient member access and maximizes member participation. In addition to identifying potential candidates for the program, the screenings help make participants aware of their health risks and create a consumer health focus.

The objective of The Chronic Care Management Program is to provide participants with a comprehensive set of tools to improve their health status. Options available to members include access to education materials, telephone support, oneon- one interaction and support from the FirstCarolinaCare chronic care nurses, Kathy Imhoff, RN. and Carolyn Usher, RN.

Kathy and Carolyn are registered nurses who bring to FCC 40years of experience in various nursing areas such as medical/surgical nursing, home health and hospice. As chronic care nurses, Kathy and Carolyn identify FirstCarolinaCare members who may potentially benefit from participation in the program. Members who are identified as program candidates may receive a call from Kathy or Carolyn, or they may meet them at their work site health fair or during a visit to their place of employment. Our nurses’ goal is to work with identified members to achieve and maintain the best possible health outcomes in a caring, appropriate and cost-effective manner.

If you have any questions regarding the Chronic Care Management Program, please call us at (910) 715-8100.

As we approach the busy vacation season, many of you will be traveling outside the FirstCarolinaCare service area.While we hope that none of you will need medical care while on vacation, we know that many of you have concerns about how to access care while away from home. Here are a few of the most frequently asked questions about what to do when away from home.

What will it cost me if I have to go the emergency department when I’m on vacation?
Your co-payment and co-insurance percentage for an EmergencyDepartment or urgent care facility will be the same regardless of where it is located.You may be asked to pay for the visit before you leave, especially at an urgent care center. If this happens, get an itemized bill from the facility when you check out. You will need to file this claim when you return home. Both your Human Resources Department and FirstCarolinaCare have the claim forms available and will be happy to assist you in completing them.

If I am out of the area and get sick and a physician can see me, can I see that physician or should I just go to the emergency room?
You should first try to contact your primary care physician. He/she might be able to help you. If not, you may contact a physician where you are located and it will be treated as an urgent care center visit. You must file this claim with FirstCarolinaCare in order for the claim to be paid correctly. Either mail the claim with an explanation to FirstCarolinaCare, 42 Memorial Drive, Suite 1, Pinehurst, NC 28374, or bring it by our office at located at the same address.

What should I do if I am planning to travel outside the United States?
FirstCarolinaCare will cover emergency services regardless of where you need them. You should anticipate having to pay in full for any services you receive while out of the country. You will need to obtain an itemized bill, preferably stated in U.S. dollars and in English, so that you may file your claim when you get home. You may want to discuss this with your travel agent before leaving as there is travel insurance available at a reasonable cost that is usually accepted in most countries. Be sure to take any medications you may need with you.

Please be sure to carry your ID cards for all members of your family who are covered by FirstCarolinaCare with you at all times, especially when traveling.
If you have any questions please call FirstCarolinaCare at
(910) 715-8100.

Effective immediately FirstCarolinaCare may be reached by calling the following:

Main number	(910) 715-8100
Fax Number	(910) 715-8101

Soon you will receive a new member identification (ID) card.

Your member ID number will change as of June 1, 2005. Your card will be activated and ready for you to use as soon as you receive it.

Please keep your card in a convenient place so that it is readily available. You will need to present your new ID card to:

Your doctor and Your participating retail pharmacy

Also use your new ID number when you call our Member Services Department. Effective February 1, 2005, members must see a participating chiropractor in order to continue to receive In Network Benefits. As a reminder, chiropractic services require precertification.

This may be obtained by calling toll free 1-800-574-8556.