Objective: The purpose of the Pro Health Advisor program is to assist members with health challenges caused by certain diseases to improve their health and reduce complications.
Purpose: In many cases members with complicated diseases on good treatment programs make little or no progress towards health improvement. Frequently, the lack of success is related to misunderstandings, unaffordable medications or other barriers. Your Health Advisor’s role is to help make your treatment plan work for you. In some cases this requires just some additional information or special training. Your provider may need to modify their plan because of your special circumstance. Whatever the case your Health Advisor can help.
Eligibility: All members of the Western Grocers Employee Benefits Trust who have complicated diabetes, heart disease or kidney disease are eligible, but enrollment is limited.
Incentive: To encourage enrollment actively participating members are eligible for reduced deductible expenses and copays for outpatient visits (excluding ER), prescription medication (generic), and durable medical equipment related to the conditions above.
Participation: In order to be enrolled in the program and participate in the incentives members must agree to comply with the following guidelines:
Provide full access to medical information about the above conditions
- Follow my health care provider’s Treatment Plan and attend appointments
- Discuss challenges and progress with my Pro Health Advisor monthly or as requested
- Not make false statements
Duration: Members enrolled in Pro Health Advisor program may continue to participate in the incentives until they are unable to show further health improvement or follow these standards:
- Not be available for a scheduled appointment two or more consecutive times with your Pro Health Advisor or your health care provider
- Not contact Pro Health Advisor for more than 30 days
- Not comply with your health care provider’s Treatment Plan
Decision process: Dis-enrollment of members will be decided by Pro Health Advisor Board consisting of the program medical director, at least one health advisor and the trust administrator. Exceptions to policy will be considered for extraordinary situations. Members will be notified by telephone and in writing.
All of the information you provide is HIPAA protected and totally confidential except as released by you.
Although your medical claims are accessible by our Medical Director we would like for you to indicate your primary care providers (top 2).
Your reimbursement begins the date your signed consent to release medical records is received in our office.
Pro Health Advisor, A patient assistance program,
Medical Director: Dr. Philip Blair, MD;
President: Nancy J. Weber, LD, Registered Dietitian
Offices: 1880 Auburn Lane 24-H Surfside Beach, SC 29575
Western Grocers Employee Benefits Trust / Cypress Benefit Administrators