PASSPORT TO GOOD HEALTH

Transcription

1 PASSPORT TO GOOD HEALTH H6864_GN519_Rewards Program

2 PASSPORT TO GOOD HEALTH GuildNet is offering the rewards program for members enrolled in the GuildNet Gold plan again in 2017! Your health is important to us and we want to reward our members who take care of themselves. You can get a gift card for up to $70 when you complete the following recommended services in COMPLETE THE FOLLOWING BEFORE DECEMBER 31, 2017 AND GET REWARDED! Get your blood pressure checked, body mass index (BMI) measured and your medications reviewed by your PCP: $20 reward Complete and sign your Advance Care Document (see insert): $10 reward Annual Eye Exam (including dilated eye exam): $15 reward Get your Flu Vaccine: $10 reward If you have been diagnosed with Diabetes get the following important test and get rewarded: A1 C test and results: $15 reward Regular checkups with your doctor are very important to help find problems early. You doctor can start treatment soon which may help you live healthier and longer. You can tear off the completed document and send it to GuildNet using the enclosed GuildNet stamped return envelope. Send your completed documents as soon as you get it done. Gift card rewards will be sent to members on a quarterly basis. Completed documents must be submitted before January 31st, 2018 to get your gift card. You can call GuildNet at (TTY ), Monday Friday, 9am 5pm, if you have any questions regarding the rewards program. Note: You must be enrolled at the time of visit to be eligible for the rewards. Only one reward per category may be claimed in the calendar year. Gift cards are not transferable for cash. Gift card rewards will only be rewarded for services that were provided to you as an actively enrolled GuildNet Gold member. Thank you for completing the important tests/vaccination that will help you manage your health better!

3 Get a $20 gift card reward when you get your blood pressure checked, Body Mass Index (BMI) measured and medications that you are taking reviewed on your next doctor s office visit. Office visit must be completed between January 1, 2017 December 31, You must be enrolled in GuildNet Gold at the time of your visit. Use the chart below to enter the date services were completed. Have your Primary Care Physician (PCP) complete the information below and sign the document. Submit the completed document to GuildNet to get your reward. FIRST NAME LAST NAME ADDRESS PRIMARY CARE PHYSICIAN NAME PRIMARY CARE PHYSICIAN PHONE NUMBER BLOOD PRESSURE* RESULTS DATE COMPLETED PHYSICIAN STAMP & SIGNATURE HEIGHT WEIGHT BODY MASS INDEX (BMI)* MEDICATION REVIEW/ RECONCILATION* *Note: $20 gift card award applies to only one visit in R1

4 Get a $10 gift card reward when you complete discussing your advance care plans with your Physician. Advance care planning is a discussion about your preferences for resuscitation, life-sustaining treatment and end of life care. Documentation of an advance care planning discussion with your doctor and the date when it was discussed should be part of your clinical record. Have your Primary Care Physician (PCP) complete the information below and sign the document. Submit the completed copy of your Advance Care document to GuildNet to get your reward. FIRST NAME LAST NAME ADDRESS PRIMARY CARE PHYSICIAN NAME PRIMARY CARE PHYSICIAN PHONE NUMBER DATE DISCUSSED / ADVANCE CARE DOCUMENTS SIGNED PHYSICIAN STAMP & SIGNATURE ADVANCE CARE PLANNING R2

5 Get a $10 gift card reward when you get your Flu Vaccine between September 1, 2017 December 31, You must be enrolled in GuildNet Gold when you receive your vaccine. Your Primary Care Physician (PCP) or the provider who gave you the vaccine must complete the information below and sign the document. Submit the document to GuildNet to get your reward. FIRST NAME LAST NAME ADDRESS PRIMARY CARE PHYSICIAN NAME PRIMARY CARE PHYSICIAN PHONE NUMBER DATE VIAL NUMBER PROVIDER STAMP & SIGNATURE FLU VACCINE R3

6 Get a $15 gift card reward when you complete your annual Eye Examination by a participating GuildNet Ophthalmologist or Optometrist. Eye examination should be done between January 1, 2017 December 31, You must be enrolled in GuildNet Gold at the time of your exam. Have your eye doctor complete the information below and sign the document. Submit the completed document to GuildNet to get your reward. FIRST NAME LAST NAME ADDRESS PROVIDER NAME PROVIDER PHONE NUMBER DATE PROVIDER STAMP & SIGNATURE EYE EXAMINATION -INCLUDING DILATED EYE EXAM* *Note: $15 gift card award applies to only one visit in R4

7 FOR MEMBERS WITH DIABETES Taking care of your Diabetes is very important to prevent complications. Get your blood work and eyes checked regularly and get rewarded! Get a $15 gift card reward when you get your blood work done for A1 C test. Testing must be completed between January 1st, 2017 December 31st, Have your doctor complete the information below and sign the document. Submit the completed chart to GuildNet to get your reward. FIRST NAME LAST NAME ADDRESS PROVIDER NAME PROVIDER PHONE DATE NUMBER TEST RESULT PROVIDER STAMP & SIGNATURE A1 C TEST* * Note: Blood work must be completed before December 31, 2017 to receive the gift card reward. R5

8 GuildNet Gold is an HMO SNP plan with Medicare and New York State contracts. Enrollment in GuildNet Gold depends on contract renewal. 15 West 65th Street New York, NY guildnetny.org TTY You can send your completed documents to: GuildNet Population Health Management Department 15 West 65th Street New York, NY 10023