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Navigator for Members

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At Aetna we seek to provide members with credible health ... 'Information Week 500' Since 1990, InformationWeek has recognized Aetna's technology leadership and ... – PowerPoint PPT presentation

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Title: Navigator for Members


1
NavigatorforMembers
  • Karen Papa
  • Small Group Sales Manager

2
Informed Health Care Consumers
  • Are empowered members with solutions for
    healthier lives
  • At Aetna we seek to provide members with credible
    health information so members, in association
    with their health care providers, can take an
    active role in health care decisions
  • Access to the tools, information, self-care and
    communications gateways needed to become better
    and more effective managers of their benefits
    plan
  • Interact with their health plan -- when they need
    information or services -- often around the clock

3
What Members Need
  • Access via the Internetanytime, anywhere
  • Hassle-free access to managing their benefits
    plans
  • Timely information on claims and other benefits
    information
  • Accurate and reliable consumer health information
  • And for our Plan Sponsors
  • Help in reducing routine benefits inquiries from
    employees
  • No cost to plan sponsors or members
  • Ongoing development and enhancements

4
Recognized Technology Leader Year After Year
2002 Aetna Inc. Ranked 5 In Industry
"Information Week 500" Since 1990,
InformationWeek has recognized Aetna's technology
leadership and innovation in this annual report.
  • Aetna InteliHealthSM
  • Aetnas award-winning health website
  • World Wide Web Health Award -- gold medal winner
    (1999-2002)
  • PC Magazine "Editors' Choice" -- Health website
    winner
  • URAC Accredited Health Website -- one of the first

Altogether the best health site on the
Web. Newsweek
5
Aetnas Member Portal Provides
  • Access to Aetnas internet resources
  • Member self-service
  • Secure personalized information
  • Enriched credible health content and hospital
    information for registered members
  • Push technology e-mail notifications
  • Contacts to member services via state-of-the-art
    contact management tool

6
Aetnas Member Portal Aetna Navigator
  • Access to Aetnas Information
  • Award-winning health content (Aetna InteliHealth)
  • Online provider search (DocFind)
  • Clinical Policy Bulletins
  • Rx formulary search engine
  • Member Self-Service
  • Change PCP/PCD
  • Replace ID cards
  • Mail-order drug link
  • Personalized Information
  • Claims status and electronic EOBs
  • Eligibility and benefits
  • Enriched Health Content for registered members
  • Push Technology -- e-mail notifications
  • Contacts to Member Services via state-of-the-art
    contact management tool

7
Empowerment through Information
  • Member self-service
  • For all Aetna products Pharmacy, Medical,
    Dental, FSA
  • Improved access to claims and product information
  • Access to plan documents and ID cards
  • Member care
  • Enhanced e.Care features and functions
  • Continued integration with wellness and disease
    management programs
  • Member communications
  • Secure two-way messaging with Member Services
  • Online Website Feedback Survey
  • Member access and utilization
  • Site navigation improvements and enhanced search
    capabilities
  • Enhancements to support diversity

8
From the Personalized Navigator Home Page
Members can access tools and information about
their Aetna plan, about their claims, and about
health topics
9
Instant Eligibility
Members can obtain a quick and printable view of
their eligibility
10
Hospital Comparison Information
Interactive access to evidence-based hospital
outcomes data for registered members
  • Members can create personalized, side-by-side
    comparisons
  • 45 specific diagnoses and procedures
  • Includes Leapfrog Group hospital patient safety
    survey results

11
Members Evaluate Their Health Care Providers
Results will be posted on DocFind? for providers
with 5 or more surveys completed.
Thinking about your experience with this provider
or office in the last 12 months, how satisfied
were you? 1. With the ability to make an
appointment for regular or routine care? 2. With
the ability to make an appointment for an illness
or injury? 3. With the ability to contact a
provider when the office was closed (nights or
weekend)? 4. With the length of time spent
waiting in the office to see the
provider? 5. That the office staff treated you
with courtesy and respect? 6. That the provider
listened carefully to you? 7. That the provider
explained things in a way you could
understand? 8. With the ability to obtain
follow-up test results? 9. Would you recommend
this provider or office to family members and
friends?
12
Average Price of Drugs in Your State
Determine the cost of prescriptions
Information on alternatives helps with cost
decisions
13
Health and Wellness Forms
Aetna members can access Aetnas Health and
Wellness Programs from their own home page
14
Healthwise Knowledgebase
  • Credible health content
  • Over 1900 topics
  • Consumer-friendly language
  • Search feature for rapid access
  • Hundreds of illustrations
  • Pop-up glossaries help with medical terminology
  • Easy-to-use point-and-click technology
  • Value for all registered members
  • Self-care information
  • Decision-making tools
  • Patient empowerment

15
Registrations Accelerate
1,636,000
Small / Select Account Rollout
National / Key Account Rollout
Pilot Ends
MAR 02
2Q01
4Q01
JAN02
DEC 03
16
Aetna Navigator Stats for 2003
  • Registrations through 1/08/04 1.7 million
    subscribers
  • As of 12/31/03
  • Log ins over 7.4 million
  • Claim status over 5.5 million hits
  • DocFind over 1.8 million hits
  • Price-A-DrugSM 240,000 hits
  • Evaluate Your Health Care Provider 174,000 hits
  • Hospital Comparison 64,000 hits

17
What Our Members Like Most
  • Whos covered (30)
  • e.EOB inquiry (19)
  • Claim status (16)
  • DocFind (13)
  • Pharmacy benefits summary (9)

18
Enhanced Features 2004
  • Recently released
  • Instant eligibility (effective date added
    wallet-size printed image)
  • FSA paper suppression
  • Claim detail
  • Benefits and coverage details (plan documents)
  • Forgot User Name online functionality
  • Price-A-Dental ProcedureSM

19
Aetna Navigator The Technology Solution
Cutting-edge technology
Electronic-based transactions
Ease of administration
Data integration
Empowering members with information
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