Emergency Room or Urgent Care?

Is it serious enough for the ER? Or would it be better off going to an Urgent Care?    The determining factors in choosing is based on how someone is feeling…such as when you have a life-threatening situation, such as chest pain, or a sudden and severe pain, the emergency department of the nearest hospital is the only option. If you went to an Urgent Care Clinic, they'd most likely just send you on to the ER in an ambulance. But if your condition is less serious, but still requires immediate attention, choosing an urgent care facility can save you loads of time and money, as well as keeping the emergency room free to handle more serious situations.  

When you need to go to the Emergency Room: If you have a serious condition - stroke, heart attack, severe bleeding, head injury or other major trauma - go straight to the nearest ER. The ER is the best place for these and other critical conditions, including:

• Chest pain
• Difficulty breathing
• Severe bleeding or head trauma
• Loss of consciousness
• Sudden loss of vision or blurred vision

When an Urgent Care Center is the faster/more cost-efficient choice:

• Minor burns or injuries
• Sprains and strains
• Coughs, colds, and sore throats
• Ear infections
• Allergic reactions (non-life-threatening)
• Fever or flu-like symptoms
• Rash or other skin irritations
• Mild asthma
• Animal bites
• Broken Bones

And when in doubt, call ahead. If the Urgent Care Clinic in question can't accommodate your condition, they will advise you to go the nearest emergency facility. 

Meet the Customer Care Team: Nick!

       We are going to introduce a member of our Customer Care Team over the next couple of weeks.  We hope this helps you to get to know us better.  Along with putting a face to a name or voice on the phone.  This week we are introducing: Nick.

       Nick has been with the team since September of 2011.  He is one of our newer members, but already possesses a wealth of knowledge.  Nick has had experience in customer service and came to our team ready to learn.  Nick's knowledge base and desire to go the extra mile for our members makes him a great addition to our team.  Nick resides in Bellbrook, OH with his wife.  He enjoys spending time with his family and exercising.  We are all glad to have Nick on the team.  Say Hello to Nick!

Sometimes You May Need to Have a 2nd Opinion....

Below is a current article on ways to make sure you get what you are requesting in a "second opinion". You may also want to check with your particular carrier if there are any specific steps to take when requesting a "second opinion".  A good source for reference is always the Member Services number on the back of your ID card. If you need further information you can always reach our team for assistance as your advocate.

Second Opinion Article

Tips if you have not received your ID card

Happy 2012!  The New Year often brings issues for employers/employees to deal with.  Here are some tips if you have not received ID cards for the 1/1/2012 renewal and need services or prescriptions:

• 1. You can pay for a prescription upfront and have the pharmacy re-run it through insurance as soon as ID cards are received.  Most pharmacies are able to re-run prescrpitions up to 2 weeks after it was filled. Time frame can vary depending on pharmacy.
• 2. Give our CCT number for providers to call to verify coverage or call our team and we will personally reach out to providers to verify coverage and explain the delay in ID cards being received.
• 3. Pay upfront for services and submit a claim form to the carrier for reimbursement.  We are able to help getting the claim processed.
• 4. Call HR for instructions how to handle per group.
• 5. Request that the provider holds the claim until ID is received. Usually if this is a doctor you see regularly they will understand and work with you.
• 6. Have providers call carrier to verify coverage if loaded but no ID card was received. 

Please know that if you experience difficulty obtaining services, CCT as your advocate is always here to help. Our hours are 8-5 Mon-Fri.