The Wellness Division of This program is designed to help our members identify their health risks and take steps to improve their health.

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Presentation transcript:

The Wellness Division of

This program is designed to help our members identify their health risks and take steps to improve their health.

Eligible HealthChoice members must: Complete their free comprehensive preventive services visit Complete their free comprehensive metabolic and lipid panels Complete their health risk assessment

Eligible Providers must: Participate in the HealthChoice Provider Network Provide services in an outpatient or medical setting Bill the designated CPT Codes for 100% reimbursement of Allowed Charges

New Patient – Initial Comprehensive Preventive Medicine Exam – patient age – patient age – patient age 65+ (non-Medicare)

Established Patient – Comprehensive Preventive Medicine Exam – patient age – patient age – patient age 65+ (non-Medicare)

Metabolic Panel – comprehensive metabolic panel or – general health panel Lipid Panel – comprehensive lipid panel

When you use the CPT Codes designated for the H.E.L.P. program, services are covered once per calendar year at 100% of the HealthChoice Allowed Charges, regardless of the patient’s diagnosis. There is no copay or other out-of-pocket cost to the HealthChoice member.

Multiple procedures/codes can be billed at the same time as the free preventive exam; however, additional services outside the H.E.L.P. program are subject to all Plan provisions including deductibles, copays, and coinsurance.

Biometric Results Height and weight Blood pressure (systolic/diastolic) Resting heart rate (pulse) Lab Results Fasting blood glucose Fasting LDL, HDL, and total cholesterol Fasting triglycerides

Certain preventive services are now covered at 100% of the HealthChoice Allowed Charges. Members must meet specific criteria including age, sex, policy limits, and diagnosis and procedure codes. Eligible members have no copay or other out-of- pocket costs. A list of these preventive services, including criteria, can be found on the HealthChoice Provider Website under Quick Links.

If you have questions or need additional information, please contact HP Administrative Services, LLC at or toll free