The Highmark House Call Program: Improving Heath Outcomes from the Comfort of Home... and more

The Highmark House Call Program

The Highmark House Call Program is an annual face-to-face encounter between Highmark members and health practitioners in the comfort of the member's home. It is designed to address issues that are hard to identify in a clinical setting, including social determinants of health like nutrition, transportation, financial barriers, and social isolation. Here's what you and your clients need to know!

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How does the House Call Program work?

Eligible Highmark members are contacted directly to schedule and complete a House Call. A Licensed Nurse Practitioner from one of Highmark's House Call vendors visits the member's home or connects virtually, depending on the member's preference. Visits generally take an hour to complete

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What happens during a House Call?

A Licensed Nurse Practitioner from one of the House Call vendors will:

• Complete a comprehensive health and wellness assessment.
• Provide screening/testing if applicable.
• Review medications for safety and effectiveness.
• Introduce members to care services.
• Assist members in better understanding their conditions.
• Answer member’s health questions and concerns.
• Explain how members can access needed resources.

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How are eligible members contacted about the House Call Program?

Eligible members receive information about the program in a variety of manners, including (click links for examples):

• Direct mail,
• Email, and
• SMS/text messages.

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What's in it for members?

Members receive resources and referrals to additional services and providers as needed. Members' visit summaries are shared with their Primary Care Physician to ensure continuity of care, and members may be eligible for a Highmark Wellness Rewards Take Care Prepaid Mastercard after their visit.

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D-SNP Eligibility Checks: Required Information

When calling Highmark D-SNP broker support to perform an eligibility check, please have the following information available:

• Medicare Number
• Beneficiary Name
• Either Social Security Number or Medicaid Number

Providing this information helps to properly locate prospects in the system and expedites the confirmation process, allowing you to complete enrollments more efficiently.

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Reminder: Verify Plan Names When Ordering Enrollment Materials

Highmark has recently seen an increase in enrollment material orders for products that are not available in the region where they’re being ordered.

For example, they are seeing Complete Blue Plus PPO and Community Blue Medicare Plus PPO material orders outside of Northeastern Pennsylvania, which is the only region where these Plus products are available. Please verify plan names prior to placing your enrollment material orders to avoid delays and ensure you receive only the materials you need.

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