Understanding Your Plan Benefits
As an independent third party administrator, J.P. Farley works with your plan sponsor to administer a variety of customized benefit options. By customizing plans to fit your company’s needs and culture, J.P. Farley helps your employer keep the cost of your health plan down without compromising the quality of the benefits they offer.
Since each plan is different it is very important that plan participants refer to their plan’s Summary of Benefits and Plan Document(s) to familiarize themselves with the benefits and coverage(s) offered through your employer/plan sponsor. Your Plan Document offers the most comprehensive description of the coverage(s) offered to you, including information regarding covered services and the cost of receiving out-of-network care.
Your Benefit Plan ID Card
Your Health Plan ID Card is designed to provide you and your health care provider with the information needed to access your Group Employee Benefit Plan.
Participants should reference their ID Card to learn what provider network(s) or pharmacy network they can access for in-network benefits, as well as other information, including the number to call to obtain pre-certification for a service or procedure (if applicable to your plan).
When you visit your health plan provider show them your ID Card. The card has the instructions your provider needs to submit a claim to your Health Plan for payment and find out more information about the specific benefits your plan covers.
Care Management Services – Care for YOU
Strong Clinical Support matters and that is the type of patient-centered care J.P. Farley provides. Our nurses help patients move ahead after being diagnosed with a serious illness or having experienced an on-going or significant health issue, such as a heart attack, diabetes or cancer.
Our nurses are available to assist you and your family in receiving medical care that is:
- At the appropriate level
- Of good quality, according to nationally recognized medical standards
- Provided by a covered doctor, hospital or facility
- Maximizes the benefits available from the Health Plan
Your Nurse Care Manager is trained to provide you with a customized, coordinated treatment plan and health education that compliments your provider’s on-going care.
Patient Advocacy – Help When You Need It
When you become a patient, our Patient Advocacy Team is here to lend support during an often overwhelming claims and billing process. We assist participants with understanding their group employee benefit plan, responsibilities and rights and help them to make sure they never pay more than what is appropriate for care.
- We Help You Understand Your Health Plan
- We Help Protect You from Balance Billing and Improper Collection Attempts
- We Help Provide for Your Well-Being
Your health, time and money are valuable. J.P. Farley’s Patient Advocates are here to discuss your benefits, care, questions and concerns every step of the way. Our goal is to help you and your family when you need it so you can focus on what matters most.