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Primary Care Provider Wellness Program

What is the Primary Care Provider Wellness Program

In 2024, Northwest will continue the primary care provider wellness program. This program consists of an annual preventive visit and routine labs ordered by a healthcare provider. Our health plan covers an annual preventive visit and routine labs, funded at 100 percent, when you see an in-network provider. 

Employees will need to login to your mybluekc.com account, download and print a Physician Screening Form (PSF) from the A Healthier You portal to bring with them to their preventive care appointment. Employees on a Northwest health plan who do not return the PSF by Oct. 15, 2024, will be assessed a $50 per month premium differential beginning with the December 2023 paycheck. 

The online health risk assessment questionnaire will not be required as a part of the primary care provider wellness program, but employees are still encouraged to complete the online assessment. 

At this time, spouses on a Northwest health plan will not be required, but are encouraged, to participate in the primary care provider wellness program.

Next Steps

  • Make your annual preventive care appointment with your primary care provider and request that your labs be sent through Quest, an independent, in-network lab facility.
  • Download your Physician Screening Form from the A Healthier You portal. To access the portal, log in to your mybluekc.com account.
  • Make arrangements with your provider for returning the Physician Screening Form.
  • Ensure the completed form is returned to A Healthier You by Oct. 15, 2024.

Lab billing information

In order for your visit and labs to be considered preventive, it cannot be incorporated with a regularly scheduled appointment, for example, if you are seen every three or six months for diabetes, high blood pressure, high cholesterol, or another acute diagnosis for which you receive medication or medical treatment. Treatment, labs or office visits for that existing condition are not preventive care and are subject to deductibles, copays and/or coinsurance. 

If you have a regularly scheduled appointment and labs with your primary care provider due to diabetes, high blood pressure, high cholesterol or another acute diagnosis, those labs can be used to complete the Physician Screening form, however, they will likely not be covered at 100% since the appointment is for a medical diagnosis and not considered preventive. 

When scheduling your appointment:

  • Ask whether any tests or treatments conducted during your appointment might not be considered preventive care.
  • Ask whether talking during your appointment about other health concerns that are not considered preventive care will lead to extra costs. 
  • Request that your labs be sent through Quest (see attached flyer for additional information).

Quick References

Frequently Asked Questions

What should I say when I call to make my preventive care appointment? 

When you call to schedule your appointment, be sure to say:

  • I would like to schedule an appointment for my annual preventive care visit and lab work that is covered at 100% by my health insurance 
  • I have a form from my employer that has to be completed and requires body measurements (height, weight, waist), blood pressure and blood testing results for total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides and glucose
  • I request to have my labs sent through Quest (or other in-network facility, see attached for more information)
  • Is there a fee to complete the Physician Screening Form? (at this time, there should not be a fee to complete the form if seeing a provider at Mosaic Medical Center in Maryville)

Why do I need to request my labs be sent through Quest?

At one time, an order for labs meant having them done at the hospital campus or a facility your healthcare provider selected. However, hospital systems generally charge substantially more for these services.

Today, you have control to choose the in-network facility that has the lowest out-of-pocket expense. That may mean an outside lab provider or freestanding lab.

You can have labs drawn at your primary care provider's facility but have the option to request they be sent through Quest or another in-network facility in order to avoid hefty charges. See attached flyer for additional in-network locations in the area. 

How do I access A Healthier You?

A Healthier You is Blue KC's suite of health and wellness services. The cornerstone of A Healthier You is your personalized member portal, which can be accessed online or via the mobile app.

To access A Healthier You you must first login to your mybluekc.com account. For instructions, visit Accessing A Healthier You View PDF

If you forgot your mybluekc.com password, visit MyBlueKC Forgot Password View PDF for instructions on resetting your password (you must know the email address associated with your account) 

If you don't know the email address associated with your mybluekc.com account or are having other issues logging in, you can contact Blue KC customer service at 888.920.6304. You should have your member ID card when calling customer service. 

If you need to create a mybluekc.com account because you have never logged in, visit How to create your MyBlueKC.com account View PDF for instructions. You can also contact Blue KC customer service at 888.920.6304.

How do I download the Physician Screening Form?

To download and print your personalized Physician Screening Form from your A Healthier You portal, you will first need to login at mybluekc.com or open your mybluekc app and then select A Healthier You from the Health & Wellness menu on the left of the screen. For help, visit Accessing A Healthier You View PDF

For step-by-step instructions for accessing your Physician Screening form from your A Healthier You portal, visit Physician Screening Option View PDF.

If you have any issues with accessing your personalized Physician Screening Form, you can contact the Office of Human Resources at 660.562.1127.  

How do I return my completed Physician Screening Form?

Employees should make arrangements with the healthcare provider during their preventive care visit to determine if they will submit the Physician Screening Form OR if the employee needs to retrieve the completed form at a later date and return to A Healthier You directly.

**It is recommended that the employee retrieve the completed form from their healthcare provider and return it to A Healthier You directly using one of the methods below:

You will receive an email within 48 hours to confirm receipt of your form. If you do not receive a confirmation email, please contact eHealth Screenings (the A Healthier You screening vendor) at 888.708.8807 or send an email to AHYscreening@ehealthscreenings.com

Physician Screening Forms are due to A Healthier You by October 15, 2024.

When is the Physician Screening Form due?

The Physician Screening Form is due to A Healthier You by October 15, 2024. The following methods can be used to return the completed form:

You will receive an email within 48 hours to confirm receipt of your form. If you do not receive a confirmation email, please contact eHealth Screenings (the A Healthier You screening vendor) at 888.708.8807 or send an email to AHYscreening@ehealthscreenings.com

What information is collected on the Physician Screening Form?

The Physician Screening Form requires the following information:

  • Participant information (name, DOB, email/phone, signature)
  • Provider information (name, phone, signature)
  • Biometric and lab results
    • Fasting status
    • Body measurements to calculate BMI (height, weight, waist)
    • Blood pressure
    • Blood testing results (total, HDL and LDL cholesterols, triglycerides, glucose)

For step-by-step instructions for accessing your Physician Screening form from your A Healthier You portal, visit Physician Screening Option View PDF. If you have any issues accessing the form, please contact the Office of Human Resources at 660.562.1127.

Will there be a fee to complete the Physician Screening Form?

You will need to ask your healthcare provider if there will be a fee to complete the Physician Screening Form. At this time, Mosaic Medical Center in Maryville has indicated there will be no fee for providers at their facility to complete the form. 

How do I locate an in-network provider?

You can search for in-network providers when you login to your mybluekc.com account.  

Once logged in select Find Care on your dashboard on the left of the screen.

Then select the Find Doctors, Specialists & Hospitals link.

You will then be automatically direct to a new web browser where you can search by category, specialty, zip code, accepting new patients, etc.

You can also call Blue KC customer service at 888.920.6304.

What if my healthcare provider tells me I don't need the preventive labs?

If your healthcare provider tells you that you do not need the labs that are normally collected during a preventive care exam, present them with the Physician Screening Form and let them know the blood testing results are required in order for the form to be considered complete.

If your healthcare provider tells you that you do not need the labs that are normally collected during a preventive care visit because you just had them recently, have the healthcare provider complete the Physician Screening Form using the results from that visit.

If the healthcare provider tells you it hasn't been 12 months since your last preventive visit, let them know that according to our health plan, preventive visits are covered on a calendar year basis, there does not need to be 12 months between the appointments. 

 Be sure to return the completed Physician Screening Form to A Healthier You by October 15, 2024.

Is there a blank Physician Screening Form that I can submit instead of the personalized form from my A Healthier You portal?

Yes, but there are additional steps required if submitting a blank form instead of your personalized form from your A Healthier You portal.

Please contact the Office of Human Resources at 660.562.1127 for additional information. 

How will I know when my Physician Screen Form is received?

Once the form is submitted, you should receive an email within 48 hours to confirm receipt. If you do not receive a confirmation email, please contact eHealth Screenings (the A Healthier You screening vendor) at 888.708.8807 or send an email to AHYscreening@ehealthscreenings.com

Once the physician screening form is received and processed (can take up to 10 days), the biometric and lab results from the physician screening form will also be uploaded and made viewable in your A Healthier You portal. Simply click "View Biometric Screening Results" from the home page of your portal.

What happens if I don't return the Physician Screening Form by the deadline?

If the Physician Screening Form is not returned to A Healthier You by October 15, 2024, you will be assessed a $50/month premium differential beginning with the December 2024 paycheck.

 

What should I do if I receive a bill for my preventive care visit?

Services from your preventive care visit must be billed with a primary diagnosis of preventive to be covered at 100%.

Your healthcare provider may have ordered tests during your preventive care visit that are not preventive care. These tests may be subject to deductibles, copays and/or coinsurance.

Your healthcare provider may have also treated an existing condition or symptoms of an illess at the time of your visit. Treatment, labs or office visits for that existing condition are not preventive care and are subject to deductibles, copays and/or coinsurance. 

You will need to contact your healthcare provider directly to see why the visit was not billed with a primary diagnosis of preventive.

Do I have to complete the online health risk assessment questionnaire?

No, the online health risk assessment will not be a requirement of the primary care provider wellness program at this time.

Employees are encouraged to take a few minutes and complete the assessment, which contains a series of questions designed to help you learn where you are in your health journey.

Completing the assessment helps you answer questions about your health, understand your risks and get the tools you need to stay healthy. 

You will receive points for completing the questionnaire and those points can be used toward gift card drawings at major retailers like Amazon, Target and Walmart.

Visit How to Complete the Health Risk Assessment View PDF for further instructions.

If my spouse is on our health plan, are they required to participate in this wellness program?

Spouses on our health insurance plan are not required at this time to participate in the primary care provider wellness program.

Participation is encouraged and will likely be required in the future. 

Does the University get any of my personal health information from the Physician Screening Form?

The University does not receive any of your personal health information obtained through the Physician Screening Form. The University receives aggregate information only. Some information received includes who has completed the wellness program requirements and the percentage of employees with risk factors, such as high blood pressure or high cholesterol. Northwest and the Benefits and Wellness Committee use this data to determine the programs and resources to offer employees. 

What is A Healthier You?

A Healthier You (AHY) is Blue KC's suite of health and wellness services. The cornerstone of AHY is your personalized member portal, which can be accessed online or via the mobile app.

Some of your portal features include:

  • Access to a health library for a variety of educational topics
  • Stay on track with preventive care reminders
  • Ability to earn points and be entered into sweepstakes for gift cards to various retailers

video tour of the A Healthier You portal (mp4)

Why is preventive care important?

Preventive care is routine healthcare that includes screenings and labs to help prevent illness, disease or other health problems.

Chronic diseases like heart disease, cancer, and diabetes are leading causes of death and disability in the United States. They are also high cost-drivers that contribute to annual increases in health insurance premiums for everyone.

Preventive care can detect these chronic conditions early which can help to shorten the severity of certain conditions or help you recover more quickly. Along with a healthy lifestyle, taking some basic preventive care steps can immensely improve your health down the road.

Visit Preventative Care Basics: Your Checklist View PDF for additional information about the benefits of preventive care. Visit Routine Preventative Services View PDFto see a complete list of services covered by your Blue KC Health Plan.