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Q: What is the purpose of the Health Clinic?
A: To provide SEBT members with quality, convenient medical services including primary care, laboratory services, many prescriptions, and comprehensive wellness programs.
Q: What type of medical provider services can members receive at the clinic?
A: Medical services may vary from clinic to clinic based on the specific provider’s experience. Example services include but are not limited to the following: Sore throat/ears/headache, strains, sprains, musculoskeletal problems, abdominal pain, non-specific neck pain, cough, sinus, allergies, allergy injections with patient supplying drug, rashes, acute injuries, acute routine office procedures, minor surgical procedures, such as sutures for laceration treatment or mole/skin tag removal, flu shots, EKGs and much more. The clinic also will dispense medications commonly utilized by your health plan and provide laboratory testing.
Q: Do members have to use the clinic?
A: No. Although we feel members will benefit from making the clinic their “medical home,” participation is voluntary. The clinic does not have to replace their current provider and can be used on an as-needed basis.
Q: Will medical benefits change once the clinic is open?
A: No. Your medical benefits through SEBT will remain in place.
Q: Are member visits shared with SEBT or their employers?
A: No. Only the physician and the other clinical staff will have access to the data. It will only be used by the clinic staff for the purpose of treating health issues. By law, this information cannot be shared with SEBT or their employers.
Q: Can the clinic make referrals to any specialists?
A: Yes. The clinic staff will assist with referrals to a specialist within the Aetna network.
Q: Are labs available at the clinic?
A: Yes. The clinics can run many internal labs. Labs not available in the clinic will be sent out to a contracted vendor.
Q: If a member has a PCP (family doctor) outside of the clinic order lab work, can these tests be done at the clinic?
A: If a PCP or specialist outside of the clinic provides orders for labs, members can make an appointment at the clinic to have their labs drawn. The results will go back to the ordering provider. There will be no member cost for any labs drawn through the clinic.
Q: Is radiology available at the clinics?
A: Radiology is NOT available at the clinics. The clinic staff will provide the member with options based on cost and quality. In the end, it’s the member’s choice as to where they go.
Q: Can maintenance medications be filled through the clinics?
A: Yes; however, for prescriptions to be filled at the on-site clinic, the medicine must be available and an appointment must be made to meet with a provider to review the medication/s and the associated condition/s. Prescriptions can be filled for 30 or 90 days.
Q: Is there a charge for wellness exams if the member has an HSA?
A: No. If the member has an HSA and they visit the clinic for a wellness check or any service deemed preventative or routine, there is no cost to the member. The $30 copay only applies for sick or acute visits.
Q: If a member has an HSA, when is the visit at no cost and when does the co-pay apply – wellness vs. acute visit?
A: The clinic will be able to tell the member if the services require the copay. A wellness visit would be anything preventative or routine that isn’t tied to an injury or illness. Example 1: A member makes an appointment for suspected strep throat. During that visit, they will have an office visit with the provider, a strep culture, and receive an antibiotic if they test positive for strep. The total cost for those services would be $30. Example 2: A member makes an appointment for their annual physical. During that visit, they meet with the provider and have blood drawn for a routine biometric screening. There would be no charge for these services.
Q: If a member has an HSA and they are being seen for something that has previously been identified, like high blood pressure, would the copay apply?
A: Typically, appointments for chronic conditions are not considered acute appointments and therefore would not require a $30 co-pay.
Q: If a member has an HSA, is the copay required on prescription refills?
A: No. The $30 copay only applies in conjunction with an office visit.
Q: How will the clinic know if the member has an HSA?
A: The clinic will ask the member at the time of service. If the member has an HSA, they will request payment at that time. The clinics do not handle cash therefore a credit or debit card will be required.
Q: Are appointments required or do they accept walk-ins?
A: Out of respect for patients’ and employers’ time, Activate requires that appointments be made in advance of a visit. This allows clinic staff to understand the member’s needs, schedule an appropriate amount of time, and keep wait time to a minimum. If a member walks in, the office will try to fit them in at their next available time slot. Otherwise, an appointment will be scheduled for a later date and time.
Q: Are sports physicals available at the clinics?
A: Yes. Members can contact the clinic to set up an appointment for sports physicals. These are available at no cost.
Q: Can you call and talk to a nurse for over-the-phone assistance?
A: We encourage you to call the clinic with health care questions. If it is an issue that requires further follow up, an appointment will be scheduled with the appropriate provider. After hours, patients can call a nurse call service. The nurse will assess the patient’s needs and guide care appropriately, including provide a message for clinic staff to contact the patient the following business day and schedule an appointment, if needed.
Q: Do the members have to use the clinic they are assigned to or can they use the other locations?
A: The members will have a “home” clinic; however, they do have access to the other locations.
Q: Can a member transfer their records to the clinic?
A: Yes. They can ask their current providers office to release copies of their records to the member or they can have the clinic send a medical release form.