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Incentive Programs:
Billing
Error –
You are encouraged to examine hospital and doctor bills for accuracy to
ensure you received all the services for which you were charged. If you find
an error on your bill, the Plan will pay you 50 percent of the money you
saved the plan. There is a minimum incentive payment of $25 and a maximum of
$1,000. This incentive applies only to covered charges for inpatient
hospital care, outpatient surgery in an ambulatory care facility, services
received from clinics and related tests. You are responsible for auditing
the charges, requesting corrected billings from providers and submitting all
documentation to the Bureau of Personnel for processing. To determine
whether you qualify for the billing error incentive, you must send copies of
the incorrect bill, the corrected bill, and a brief explanation of the error
to the Bureau of Personnel. For every incentive dollar paid out, the health
plan has realized a savings of about $3.00. Keep looking for those errors.
Note: With DRG-based
billing (see the Summary Plan Description), itemized charges do not affect
your hospital bill. Therefore, the Billing and Processing Error Incentive
Program does not apply.
Mother-To-Be Incentive
– If you or your covered spouse is
expecting, you should enroll in the "Our Healthy Baby" prenatal program
during the first three months of the pregnancy. To enroll, call
1-888-821-2242. The purpose of the program is to help bring pregnancies to
full term and prevent the high costs of premature births. Once the baby is
born and added to the Health Plan, you will receive a $100 US Savings Bond
-- if you enrolled within the first three months of the pregnancy.
After you enroll, you will be
mailed special educational materials to help you or your spouse maintain
good prenatal health.
Important Note:
Enrollment in the Mother-to-Be Prenatal Program does not automatically add
your baby to the Health Plan. To do this, you must notify the Human
Resources Office within 90 days of the birth and pay required contributions.
Failure to enroll the child within the 90-day enrollment period means your
baby is not covered by the Plan. You will not be able to add the
child until the next annual enrollment period or until you have another
qualifying family status change. In addition, evidence of insurability may
be required when you add the baby to your coverage
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Employee Wellness Program
www.HealthyEmployees.sd.gov
is a confidential employee wellness program that
provides you the tools to become healthier and more
physically fit.
All benefited
State employees, retirees under age 65, COBRA
participants, and their covered spouses are eligible
to participate in the HealthyEmployees.sd.gov
Wellness Program each Plan Year - including
employees who “Opt-Out” of the State Health Plan
coverage.
To begin, simply log
onto https://healthyemployees.sd.gov and
set up your goal(s). The program requires all
participants to achieve one goal, five days a
week, for three consecutive months. All you need to do
is submit your goal(s) at the end of the three months
and you will be credited the $100 incentive money into a
Health Rewards and Wellness Account (HRWA). If you would
like more information, you may also refer to our Wellness
Program Q&A found at
www.bopweb.com under Forms & Documents. |
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