CIGNA Well Aware Program

CIGNA Well Aware for Better Health^® Physicians' Frequently Asked Questions
Here is a list of questions frequently asked by physicians regarding CIGNA Well Aware programs. Patient Benefits Questions Participation Questions Questions about your role Confidentiality Questions Medical Management Questions Patient Benefits Questions:
Q:	Can the Well Aware team answer insurance coverage or benefits questions?
A:	No, please call the number on the patient's insurance card for patient benefits or questions about patient coverage.

Q:	Will you be sending my patients education materials?
A:	Yes, your patients will receive materials to support their specific goals. The materials we use follow the guidelines of nationally recognized organizations such as the American Heart Association, the American Diabetes Association or the National Heart, Lung and Blood Institute.

Q:	If my patient participates, will his or her benefits be affected?
A:	No, participation is voluntary and will not affect current coverage or future eligibility.

Q:	Is the Well Aware program an effort to reduce benefits?
A:	No, your patient's employer is sponsoring the program to focus on individualized care for your patients with chronic conditions. The Well Aware Program will provide your patients with information and tools to better manage their condition and reinforce your instructions.
Q:	Is the cost of this program being taken out of my capitation rate?
A:	No, this service is being sponsored by the health plan. If you have specific questions about the financial arrangements, please contact your health plan medical executive or provider representative.

Participation Questions:
Q:	What if I don't want my patients to participate?
A:	The program is strictly voluntary, and the decision to participate is left up to the patient. However, by electing not to participate, your patients could be missing the opportunity to be in a program that is designed to help them take better care of their diabetes.

Q:	If my patient chooses not to participate now, can he or she join later?
A:	Yes, as long as he or she is eligible under their employer's benefit plan, your patient can join the program anytime.

Q:	If I have a newly diagnosed patient in my office, how can I get him or her into the program?
A:	Have your office staff call one of our toll-free hotline numbers, 1-800-249-6512 (HMO/Network or POS benefit plan) or 1-877-888-3091 (PPO, OAP or indemnity benefit plan) with the following information: Patient name Patient phone number Member ID number Date of birth HMO code Address Physician name Physician phone and fax number Physician ID number Best time to contact the patient Our CIGNA Well Aware for Better Health team will then follow up with a phone call to your patient to welcome him or her to the program.
Q:	Does this program require that I make a referral or authorization?
A:	No special referral or authorization is required for your patients to participate. Your patient needs only to consent to participate.

Questions about your role:
Q:	What type of reports will you need from my office?
A:	There are no standard reports we will need from your office. Occasionally our staff may request a copy of the latest lab report or report from a specialist.
Q:	What kind of information will I be getting back from the Well Aware program?
A:	You will receive the following from Well Aware (depending on the program the patient is participating in): Introductory Letter explaining the program and support offered to participants Clinical guidelines reference list Physician Guide to Patient Materials Depression and medical illness fact sheet Quarterly Newsletters Care guides that include treatment guidelines for each condition. The guide is complied using various clinical references and is intended to be an evidence-based medicine reference guide. Patient-specific reports: Patient medication lists to validate the medication the patient is taking, inform you of medications prescribed by other physicians, and allow you to identify potential gaps in care Patient reports indicating evidence-based recommendations (medication and lab tests), and corresponding patient compliance data based on claim data and self-reporting.
Q:	Will this information be used to set my future payment rates?
A:	No. The health plan is committed to improving the quality of care its members receive. This information is meant to assist you in taking better care of your patients. Any questions you have about payment rates and fees need to be addressed by your provider relations representative.

Confidentiality Questions:
Q:	Who sees my patients' information if they participate in the program?
A:	If your patients choose to participate in the program, CIGNA Well Aware and Healthways Inc. will have access to their information.

Q:	Will my patients' information be kept confidential?
A:	Yes, all information will be kept confidential by CIGNA Well Aware and Healthways Inc..

Medical Management Questions:
Q:	If my patient has a medical problem or emergency, whom is he or she instructed to call?
A:	All patients calling with medical questions will be referred to their physician. If a patient calls with an emergency, the patient will be directed to call 911 or to contact his or her physician. In either event, you will receive faxed notification of any instructions given to your patient.

Q:	Does this program take the place of my medical management of my patients?
A:	No, this program is an education program only. You will continue to be responsible for the medical management of your patients. Our goal is to reinforce your instructions.

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