Celticare Health Plan

CELTICARE GETS OK FROM STATE AS “QUALIFIED HEALTH PLAN”

celticaremarketing — Thu, 13 Jun 2013 19:04:44 +0000

MEDIA CONTACT:
Alex Goldstein
Alex@NorthwindStrategies.com

Mass Health Connector Vote Moves CeltiCare Forward To Provide Health Insurance in 2014 Under National Health Reform

BOSTON– June 13, 2013—CeltiCare Health Plan of Massachusetts today received the preliminary approval of the Massachusetts Health Connector Authority to provide health insurance coverage to individuals and small businesses through the Connector in 2014.
With the enactment of national health reform, the Connector is now responsible for reviewing and approving state health insurance plans to be offered through the Connector to ensure that they meet not only state, but also new federal requirements. Today’s vote of the Connector’s Board confirms that the health care coverage to be offered by ‘CeltiCare’ in 2014 meets all state and federal requirements under the Affordable Care Act.
“Our innovative approach to providing high quality, lower-cost health care coverage to thousands of Massachusetts residents through the Connector the last few years has contributed to the success of health care reform in Massachusetts,” said Jay Gonzalez, Senior Vice President and Chief Development Officer for CeltiCare. “With today’s approval, we are now one step closer to offering our member-focused services through the Connector next year in a manner that builds on our record and contributes to the success of national health reform.”

Since entering the Massachusetts market, CeltiCare has made expanded coverage more affordable. Through innovations like offering the first limited network plan for state-subsidized coverage, integrated care management, and administrative efficiencies, CeltiCare has introduced greater competition into the Massachusetts market. As a result, CeltiCare has helped the state save over $320 million while expanding affordable health insurance coverage for people across Massachusetts.
Working with the Patrick Administration, hospitals, doctors and consumer advocacy organizations, CeltiCare was also the only insurer to provide comprehensive, low-cost, quality health insurance coverage to over 26,000 legal immigrants that would have otherwise lost health insurance coverage due to budget cuts.
The Board of the Connector voted to preliminarily approve all of the health insurance options proposed by CeltiCare at today’s meeting. These options include: two Platinum plans, three Gold plans, two Silver plans and two Bronze plans. In accordance with the requirements of national health reform and the Connector, the Platinum plan gives those who are willing to pay higher premiums a more comprehensive set of health care benefits, while the Gold, Silver and Bronze plans offer progressively lower cost health care coverage options for less comprehensive benefit packages.
All of the approved health insurance options offered by CeltiCare include all of the minimum benefits required by federal and state law, including prescription drugs and wellness benefits. CeltiCare and other participating health insurance plans are required to submit proposed premium costs for these plans to the Division of Insurance and the Connector by July 1, 2013.

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CeltiCare
CeltiCare Health Plan of Massachusetts, Inc. (CeltiCare) is a managed care organization that provides health insurance to the people of Massachusetts. Established in 2009, CeltiCare is managed by Celtic Insurance Company, a subsidiary of Centene Corporation (NYSE:CNC). We are committed to delivering better health at lower costs through innovative plans and programs designed and managed locally to meet the unique needs of Massachusetts’ progressive health care system.

Open Enrollment

celticaremarketing — Thu, 06 Jun 2013 13:44:27 +0000

Open Enrollment
June 3rd marks the start of “Open Enrollment” for Commonwealth Care members. It is that time of year when you should be thinking about whether your current health plan provides the overall value of low cost and high quality that CeltiCare does. Now is your chance to find out what so many thousands of Massachusetts residents already know; CeltiCare gives you great coverage at a great price. If you haven’t already, you’ll receive information from the Health Connector in the mail that explains the options available to you and we encourage you to take a look.
Existing CeltiCare Members
Keep in mind that if you are already a CeltiCare member and do not wish to make changes to your health plan, you do not have to fill out any paperwork. Your plan will continue to renew as long as you are qualified. Your next Open Enrollment period will start on October 1, 2013. We’re happy to have you on board!
Considering Joining CeltiCare?
At CeltiCare, you get access to the best doctors and hospitals in the state at a low cost. You also get great service that sets us apart from the crowd. We have care managers who help you understand and manage your health conditions and help you get the best care; Member Connections representatives who will come to your home to help with medical or social service issues; and registered nurses available for support and advice 24 hours a day.
There are other benefits to CeltiCare membership too. They include our CentAccount program* that lets you earn up to $150 by doing activities to stay healthy; and our Coupon Saver Program that gives you great discounts on healthy items at the grocery store.
Need more information? We’re happy to answer any questions you have. Call Member Services anytime at 866.895.1786 (TTY/TDD 866-614-1949). For information about all your options, call the Health Connector customer service center Monday – Friday, 8 a.m. to 5 p.m. at 877-623-6765 (TTY: 877.623-7773) or visit MAHealthConnector.org.

For more information about CeltiCare click here
Remember open enrollment runs from June 3 to June 21 so don’t wait to act if you need to make any changes.
* CentAccount is available to Commonwealth Care members only

CeltiCare Hosts Book Reading to Teach Children about Eating Well and Staying Active

celticaremarketing — Thu, 23 May 2013 11:55:38 +0000

In partnership with Project Hope, we hosted a fun event for children on April 17th featuring a book reading by Michelle Bain, the author of the Darby Boingg books. The interactive books, developed in collaboration with CeltiCare’s parent company, Centene, feature socially conscious messages and reinforce positive behavior like being a good friend, teamwork and staying active.
We were thrilled to have Michelle Bain come to Boston and—alongside the star of the book series, Darby Boingg—engage the group of children and families. Michelle read from the book, “Super Centeam 5” which follows Darby Boingg as she learns how to eat well and stay active with help from friends along the way.

“We address these ideas in a format that a child will understand,” said Michelle, who has read to more than 120,000 children in twenty states. “We message in a very positive light.”
Robert LoNigro, Interim President and CEO of CeltiCare said, “What a great response to a great program. It is well worth investing all our time and energy to touch the lives of those beautiful youngsters at Project Hope.”
CeltiCare executive Jay Gonzalez, Member Connections Representative Shirley Rodriguez and other employees attended the reading and enjoyed the opportunity to interact with the children.
We look forward to continuing our year-long partnership with Project Hope and appreciate this nice feedback from Robyn Eastwood, Development and External Affairs Manager at Project Hope. “It was great to see so many children and families enjoying the evening. Thank you so much for a wonderful event. I hope our friends at CeltiCare enjoyed it as much as our staff and families.”

Stay tuned for photos from the event which will be posted soon.

Now Available: Care Gap Notifications

celticaremarketing — Wed, 08 May 2013 18:05:24 +0000

CeltiCare has enhanced our secured provider portal to include Care Gap notifications for your patients. To read a complete description click here. For screen shots of the secured portal, click here.

Women’s Health Week—Care for the Caregivers

celticaremarketing — Tue, 07 May 2013 13:42:27 +0000

Women are often the primary caregivers in their family and put the needs of others—such as children and spouses—above their own. This is one of the reasons why National Women’s Health Week, held May 12th-18th, is so important.

National Women’s Health Week kicks off on Mother’s Day and brings together communities, businesses and government in an effort to promote the importance of women’s health. The weeklong observance is coordinated by the U.S. Department of Health and Human Services’ Office on Women’s Health and empowers women to take charge of their physical and mental health.

Women’s Health Week will focus on the five following steps women can take to stay healthy this year:

Get Tested. Visit a health care professional to receive regular checkups and preventive screenings like mammograms, pap tests and HIV screenings.
- Worried about the cost? Most preventative screenings are no to low cost. Check the complete listing of covered preventive screenings.
- Not sure what screenings you need? Ask your doctor, or check out this interactive screening chart.
Stay Active. Keeping fit and preventing weight gain can reduce your risk of numerous diseases, including diabetes. Need some help getting started? Ask one of our health coaches in our Nurtur program.

Eat Healthy. For some great recipe ideas and discounts on healthy foods, check out CeltiCare’s Better-For-You Coupons.

Manage Stress. While we’re running around taking care of everyone else, mental health can often be overlooked. Aim to get 8 hours of sleep. Deep breaths, limiting caffeine and meditating before bed can make getting to sleep a little easier. Here are tips on meditating from the Mayo Clinic.

Be Safe. We tell our kids to be safe. Let’s take our own advice. Avoid unhealthy or risky behaviors, such as smoking, not wearing a seatbelt or bicycle helmet or texting while driving.

Why not kick off Women’s Health Week and celebrate Mother’s Day by cooking a healthy meal and going for a walk with your mom this year? Or plan a Women’s Health Week activity in your community using the great resources available on the national website. And then on Monday May 13th, National Women’s Checkup Day, call your healthcare professional to schedule that annual appointment.

Cenpatico Establishes Hotline for Families Affected by Recent Tragedies

celticaremarketing — Wed, 01 May 2013 11:37:04 +0000

Cenpatico announced that in response to the tragedies in Texas and Massachusetts, it has established a 24-hour toll-free hotline. This hotline is available to anyone, regardless of whether or not they are Cenpatico members. It will be staffed by behavioral health professionals offering counseling as well as referrals for additional local resources. The number is 877-941-8079. Language translation services are available.
“All of us at Cenpatico extend our deepest sympathy to the families affected.” said Sam Donaldson, Cenpatico’s CEO. “As behavioral health experts, we understand the emotional trauma that can result from such devastating events and we would like to offer our assistance in meeting the emergency needs of these families in their time of grief.”

Emdeon Moves to Single Payer ID

celticaremarketing — Thu, 25 Apr 2013 12:42:53 +0000

Beginning April 15, 2013 Emdeon will be moving to a single payer ID format for Medical and Cenpatico claim submission for CeltiCare Health Plan.

While Emdeon will crosswalk the old payer IDs, Emdeon will only crosswalk the old payer IDs for a 90-day period (July 15th). After that time, claims will be rejected for an invalid payer ID number.

Please see our Electronic Submissions Page for more detailed information by clicking here.

Keeping Your Heart Healthy

celticaremarketing — Tue, 09 Apr 2013 11:46:46 +0000

Many Americans don’t realize that heart disease is the leading cause of death for both men and women. According to the Centers for Disease Control and Prevention (CDC) more than 600,000 people in the United States die of the disease every year—roughly one in every four deaths. But what is different about heart disease is that many of the risk factors are preventable.

Three key risk factors that would make you more likely to have heart disease are high blood pressure, high LDL cholesterol and smoking. Right now about half of all Americans have one of these three risk factors—so chances are that you or someone in your family is at risk.

Ways to Reduce Your Risk for Heart Disease:

Stay active. Obesity and physical inactivity can increase your risk. Having diabetes can increase your risk even further.
Make it fun. What was your favorite activity as a kid? Give yourself a recess. Jump rope, dance or play tag with your kids for 30 minutes. Or check out new walking routes in your neighborhood through StartWalkingNow.org.

Eat healthy. Foods that are high in fats and oils can raise your cholesterol levels.
Make it easy on yourself. On the weekends cut up carrots, peppers or celery and place into five separate bags for the week. Experiment and see which combination is your favorite. And just grab and go.

Reduce alcohol consumption and stop smoking. Drinking alcohol excessively and smoking increase your chances of getting heart disease.

Make the right choices. Reducing or quitting smoking or drinking can be difficult. Explore your options from the Great American Smoke Out or the American Heart Association.

If you or someone you know might be suffering from a heart attack, get assistance from a medical professional right away by calling 9-1-1. The most common symptoms include pain in the chest, upper-body, arms, back, neck or jaw, shortness of breath or nausea, lightheadedness and cold sweats.
For more information on Heart Disease visit the CDC’s Division of Heart Disease and Stroke Prevention.

Early Check Payment

celticaremarketing — Tue, 26 Mar 2013 17:57:46 +0000

Changes to weekly check payment schedule for the week of March 25:

For the week of March 25, CeltiCare’s scheduled check write will be changed. EFT providers can expect payments on Thursday, March 28 and Non-EFT providers can expect checks to be mailed on Thursday, March 28. The following week (April 1) will resume normal scheduling.

Employee Spotlight: Tad Lawton

celticaremarketing — Wed, 20 Mar 2013 18:36:46 +0000

We are pleased to feature Theodore (Tad) Lawton, an Internal Provider Relations Specialist and four-year CeltiCare veteran in our latest Employee Spotlight. Here is a look at our conversation with Tad:

What is it that attracted you to CeltiCare?

A large part of it was Centene, the organization that owns CeltiCare. CeltiCare is a Massachusetts brand, but we have the confidence of being supported by a larger, Fortune 500 company. We might be a small operation here in Brighton, but being run by Centene is a good feeling.

Can you describe your role?

As an Internal Provider Relations Specialist I work directly with the External Provider Relations representatives to provide them with the tools they need to build and maintain relationships with our network of providers. Being the main liaison, it’s very busy. All internal questions relating to provider relations go to me directly. For example, if there is a problem with recruiting a new physician into the network or issues with claims payments, I will work internally to make sure it’s resolved before any members are affected. Right now I’m also in charge of a training program for new provider relations representatives, which I enjoy.

What is a typical day like for you?

I manage provider relations from a call center standpoint and handle any issues that have been escalated. For example, if a provider calls with a claim issue, I look into it and try to resolve the situation while determining whether I need to get others within the organization involved. I also represent provider relations in various internal meetings we have to ensure everything is operating smoothly. Even though it’s consistent daily, I like that my work is not the same every day.

What do you like most about CeltiCare?

I would say the staff—the people I work with as well as the veteran leadership. A lot of people at CeltiCare came from commercial health plans and you get a sense that they really know what they’re doing. We have people who joined CeltiCare from many different aspects of healthcare and we all work together to find that common ground.

What would you be doing if you didn’t work for CeltiCare?

I’ve been working in healthcare since 1997 and while I studied graphic design and communications in college, I realized early on how much I enjoyed the office environment and working with people both inside and outside the organization. I’m intrigued by the stock market so I could have ended up in the financial industry. Though right now, when I’m not at the office my main hobby is playing golf.