P.O. Box 188La Crosse WI 54602-0188

healthtradition.comVolume 21, No. 1 » WINTER 2014-15 HealthTradition.com or Customer Service 1-877-832-1823

Healthmate Health Tradition Health PlanA Mayo Clinic Health System Choice in Wisconsin

Health Tradition Health PlanA Mayo Clinic Health System Choice in Wisconsin

pg. 1

WELCOME MEDICAID & BADGERCARE

MEMBERSto the Healthmate

newsletter!

State of Wisconsin Members Only: The Mayo Clinic Health System - Northland, Eau Claire, Oakridge, Chippewa Valley and Red Cedar providers and facilities are NOT included in the Health Tradition Health Plan network for the State of WI employees and dependents.

BadgerCarePlus Members: Some of these providers may not be considered “in-network.” Check your plan’s provider directory at healthtradition.com and click on the BadgerCarePlus plan or call your member advocate at 800-545-8499.

Brian W. Rotty, Interim Executive DirectorMartha Binn, MD, Medical Director Tiffany Gulinson, DO, Associate Medical Director Michael Eckstein, Director of Sales & MarketingDavid Weichert, Director of Administration and Clinical Quality

The purpose of Healthmate is to inform and communicate with health plan members. Please submit suggestions or ideas to: 1808 East Main Street / Onalaska, WI 54650

Health Tradition Health PlanA Mayo Clinic Health System Choice in Wisconsin

BARRON & BLOOMERFogarty Surgical Services(Mayo Clinic Health System sites only)» James Forgarty, MD, General SurgeryBARRONMayo Clinic Health System» Joseph Bell Jr., MD, OB/GYNCAMERONMayo Clinic Health System» Nadine Nixon, MD, Family MedicineEAU CLAIRE, WIMayo Clinic Health SystemLuther Campus» Wajeeh Salah, MD, Gastroenterology» Matthew Anderson, LPC, Behavior Health» Emily Holle, PA-C, OrthopedicsMayo Clinic Health System Clairemont Campus» Tanushree Singhal, MD, Pediatrics

» Glenn Kauppila, DO, Family MedicineLA CROSSE, WIMayo Clinic Health System Franciscan Healthcare» Rebecca Scarseth, DO, OB/GYN» Julie Gorski, NP, GastroenterologyFamily and Children’s Center» Alicia Skiles, LPC, Professional CounselorMAUSTONMile Bluff Medical Center» Demarais Bradley, MC, General Surgery» Christine Jensen, PA-C, Physician AssistantAllied Health – Mauston» Tracy Francis, DC, ChiropracticMENOMONIEMayo Clinic Health System Red Cedar» Robyn Endrud, MD, Family Medicine

» Margaret Paulson, MD, Internal MedicineREEDSBURG, WIReedsburg Area Medical Center» Rebecca Reim, MD, Family Medicine» Christopher Eckerman, DPM, PodiatryRICE LAKEMayo Clinic Health System Northland » Jerald Barnard, MD, OB/GYNVIROQUAHirsch Clinic» Martha Karlstad, MD, PsychiatryCenter Point Counseling Services Cooperative» Behavioral Health and Substance AbuseWINONA, MNWinona Health Services» Erin Hanson, CNP, Family Medicine

New Providers

IMPORTANT:

HTHM097 © 2014, Health Tradition, Inc.

healthtradition.com or Customer Service at 1-877-832-1823

» NOTE: The providers in Hillsboro (St. Joseph’s Hospital and Clinics) can only be accessed at a St. Joseph’s Hospital or Clinic location. Health Tradition may not provide coverage by these providers at other locations.

BARRON, WIMayo Clinic Health System Northland» Lynnette Masters, MD, Family MedicineBOSCOBEL, WIBoscobel Area Health Care» Adriana Sikyta, PA-C, Family MedicineEAU CLAIRE, WIMayo Clinic Health System- Franciscan Healthcare » Nathan Hoekzema, MD, Orthopedics

» Laura Peter, MD, Physical Medicine and Rehab.» Rae Hanson, MD, NeurologyLA CROSSE, WIMayo Clinic Health System- Franciscan Healthcare» Gregory Cramer, MD, GastroenterologyMENOMONIE, WIMayo Clinic Health System, Red Cedar» Dana Bessen, NP, Family Medicine

PRAIRIE DU CHIEN, WICrossing Rivers Health Center (formerly PdC Memorial Hospital)» Susan Ipsen, CNP Family MedicineWINONA, MNWinona Health Services» Kimberly Straub, MD, Family Medicine» Scott Turner, MD, Family Medicine» Heather Pepinski, CNP, Family Medicine» Kene Ogbogu, MBBS, Family Medicine

Providers Leaving our Network

A winning formula to inspire behavior changeIntroducing: Mayo Clinic Healthy Living Online

Health Tradition Health Plan is pleased to announce exciting changes to your custom wellness portal from Mayo Clinic. In 2015, you’ll have full access to Mayo Clinic Healthy Living Online, the next generation in digital wellness. Mayo Clinic is changing the way wellness programs are delivered and experienced by unveiling a winning formula to inspire healthy habits. Healthy Living Online replaces the previous Mayo Clinic EmbodyHealth web portal.Built with your busy lifestyle in mind, you can access Healthy Living Online from your smart phone, tablet or computer – allowing you to track your exercise or log your calories on the go! Mayo Clinic Healthy Living Online can start you on a wellness journey that leads to long-term changes for better health. Healthy living has never been this much fun!

» Find out how you measure up in six domains of wellness. » Check out your personalized wellness plan and see how small changes can provide big benefits to your overall health.» Get started with easy-to use trackers, journals, meal planners and other tools to help you stick with your plan.

Mayo Clinic Healthy Living Online arms you with a personalized wellness plan and easy-to-use tools that can help you track your progress and see results! You can also connect your Fitbit® tracker and wristband or Withings® scale for seamless tracking. Visit healthtradition.com/members in 2015 to get started. BadgerCare and 65Plus members may sign up for online access to Healthy Living Online and the Mayo Clinic Health Assessment by calling 608-783-9503.

Understanding Your Coverage

Prior Authorization Required for Certain ServicesUnderstanding the details of your insurance coverage for all the different types of services you need can be confusing. It is extremely important for you to make sure that Health Tradition has authorized payment for the services your health care provider has ordered for you before you go to your appointment. This simply means that your health care provider needs to submit a form to Health Tradition which will determine if the requested service is a covered benefit of your insurance plan. You and your health care provider will receive written notice of the decision whether it is approved or denied for payment.

Some of the services that typically require a Prior Authorization include (but are not limited to):» Care received at Mayo Clinic Rochester» Radiology tests such as MRIs or PET scans» Psychological and neuropsychological testing» Certain surgical procedures

» Many medical equipment items» Genetic testing» Autism services» Procedures that could possibly be considered to be cosmetic.

Please remember that if the service is one that requires prior authorization and you choose to go to your appointment without receiving approval from Health Tradition, you may be responsible for all or a portion of the final bill.

For Your Safety:Notice of Our Privacy PracticesHealth Tradition is committed to keeping your personal health information safe and protected. You can see a copy of our Privacy Notice on our website at: healthtradition.com/feedback-please/privacy-notice-2 For more information about Health Tradition’s Privacy Practices, to exercise your privacy rights or to file a com-plaint, contact our Privacy Officer at:

Privacy Officer - Health Tradition Health PlanPO Box 188, La Crosse, WI 54602-0188608-781-9692 or Toll-free 1-888-459-3020

» Correction to last Healthmate: We incorrectly listed Mayo Clinic Health System Arcadia providers as “Leaving the Network.” These providers remain in the Health Tradition network.

For a current list of provider updates, visit: healthtradition.com and click on the mmsiservices.com link.

healthtradition.com or Customer Service at 1-877-832-1823 | pg. 3pg. 2

Pregnant? New Baby? First Breath Can Help You Stop SmokingThere are many benefits to being smoke free – especially if you’re pregnant or a new mother. Health Tradition wants to help our members gain success at stopping the smoking habit. As part of our smoking cessation services, we offer the State of Wisconsin’s First Breath Program for pregnant women and new mothers. The benefits of quitting smoking start immediately. As soon as you quit,

Discover the Joy of Living a Healthy, Balanced Life A New Me: Healthy Balance Matters

A New Me: Healthy Balance Matters isn’t just a weight loss, stress manage-ment or exercise program. It connects all three interrelated aspects of well-ness, multiplying the benefits – more energy and confidence, a calmer, more relaxed and mindful attitude, more positive social interactions and better cognitive function – a whole new awareness.

A New Me can provide the information and motivation to help you « Increase energy by eating well« Feel invigorated by moving more« Find joy by managing stress and making yourself a priority

Health Tradition Health Plan members who successfully complete A New Me may be able to earn up to $200 back through the Eat Well Move More Rebate. That brings the out-of-pocket cost to only $199!

For more information on the rebate, go to healthtradition.com, click on “Members” tab, and click on “A New Me” on the left.

Enroll TODAY: Classes are in La Crosse on Tuesdays from 5:15-6:15 p.m. beginning February 3 For more information and to enroll, go to: timeforanewme.com.

“I learned how to make my whole person healthy, not just one aspect of my health.”Past Participant

Receive a $200 Rebate

For more information contact Megan Lesky, BSN, RN, the First Breath Coordinator at Health Tradition Health Plan. Megan is specially trained in First Breath and offers health coaching to our members. For more information, contact Megan at 608-781-9433.

Tell Us What You ThinkWe Want to Hear From You! During the first few months of each year, Health Tradition Health Plan, with the help of an accredited survey organization DSS, conducts the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The survey asks you, our members, to provide feedback on and evaluate your experience with the healthcare you received during the previous year. The answers you provide help us improve our network and the services we offer, as well as, guide the development of new and innovative programs for our members. We value what you tell us and appreciate the time you take from your busy schedule to answer the survey. Not everyone will receive a survey, but if you do, we hope you will tell us what you want us to know by completing and returning it. We thank you!

Women’s Health RightsUnder the Women’s Health and Cancer Rights Act, group health plans that provide coverage for mastectomies are also required to cover reconstructive surgery and breast prosthesis (such as implants) following a mastectomy. Under this law, members of Health Tradition Health Plan receive coverage for the following mastectomy-related procedures:

» Reconstruction of the breast on which the mastectomy was performed

» Surgery and reconstruction of the unaffected breast to produce a symmetrical appearance

» Breast prosthesis (artificial substitute)» Treatment for physical

complications of all stages of the mastectomy,

including lymphedema

For more information, call Customer Service:1-877-832-1823.

Your unborn baby will:« Start getting more oxygen« Have a lower risk of miscarriage and stillbirth« Have a lower risk of being born prematurely or with low birth weight« Have less chance of experiencing health problems throughout his or her lifeYour new baby will:« Experience less coughing and wheezing« Experience fewer lung infections and diseases such as asthma, bronchitis and pneumonia« Experience fewer colds, sore throats and ear infections« Be less likely to die of SIDS (Sudden Infant Death Syndrome)You will:« Have more energy and breathe more easily« Be less likely to develop heart disease, stroke, lung cancer, and other smoking related diseases« Feel good about what you have done for yourself and your baby« Enjoy that your hair, clothes, and home will smell better« Have more money from the savings

Supporting Healthy LifestylesYou Can Earn up to $200 in 2015!Better health, and a rebateHealth Tradition supports your healthy lifestyle with rebates for good nutrition, fitness, managing your weight and even learning how to manage stress in your life – some of the steps toward a lifetime of good health. This rebate is our way of cheering you on.

A new educational component for 2015The educational requirement for this year’s rebate is the Mayo Clinic Health Assessment. Find the link at healthtradition.com/members. This health assessment helps you identify your health risks and create a wellness plan to get you on track. It connects your health information – like blood pressure and cholesterol numbers – with things you do every day. To make it even more useful, bring both the health assessment and your results into your conversations with your primary care provider.

Get started nowAs part of Health Tradition Health Plan, member households can receive the Eat Well Move More rebate on a produce share from Community Supported Agriculture (CSA) farms, fees for fitness center memberships, lifestyle and weight management programs such as A New Me (see below) and Weight Watchers®, and a 12-day health focused camp for kids. Up to $200 total rebate per primary member household! Visit Eat Well Move More at healthtradition.com for program details. Browse through the rebate options and choose the rebate you like best. Then, send us the rebate form and receipts for your healthy choices (up to $200 per primary member household). To get started, complete your Health Assessment on the Mayo Clinic Healthy Living Online portal at healthtradition.com.

healthtradition.com or Customer Service at 1-877-832-1823 | pg. 3pg. 2

Pregnant? New Baby? First Breath Can Help You Stop SmokingThere are many benefits to being smoke free – especially if you’re pregnant or a new mother. Health Tradition wants to help our members gain success at stopping the smoking habit. As part of our smoking cessation services, we offer the State of Wisconsin’s First Breath Program for pregnant women and new mothers. The benefits of quitting smoking start immediately. As soon as you quit,

Discover the Joy of Living a Healthy, Balanced Life A New Me: Healthy Balance Matters

A New Me: Healthy Balance Matters isn’t just a weight loss, stress manage-ment or exercise program. It connects all three interrelated aspects of well-ness, multiplying the benefits – more energy and confidence, a calmer, more relaxed and mindful attitude, more positive social interactions and better cognitive function – a whole new awareness.

A New Me can provide the information and motivation to help you « Increase energy by eating well« Feel invigorated by moving more« Find joy by managing stress and making yourself a priority

Health Tradition Health Plan members who successfully complete A New Me may be able to earn up to $200 back through the Eat Well Move More Rebate. That brings the out-of-pocket cost to only $199!

For more information on the rebate, go to healthtradition.com, click on “Members” tab, and click on “A New Me” on the left.

Enroll TODAY: Classes are in La Crosse on Tuesdays from 5:15-6:15 p.m. beginning February 3 For more information and to enroll, go to: timeforanewme.com.

“I learned how to make my whole person healthy, not just one aspect of my health.”Past Participant

Receive a $200 Rebate

For more information contact Megan Lesky, BSN, RN, the First Breath Coordinator at Health Tradition Health Plan. Megan is specially trained in First Breath and offers health coaching to our members. For more information, contact Megan at 608-781-9433.

Tell Us What You ThinkWe Want to Hear From You! During the first few months of each year, Health Tradition Health Plan, with the help of an accredited survey organization DSS, conducts the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The survey asks you, our members, to provide feedback on and evaluate your experience with the healthcare you received during the previous year. The answers you provide help us improve our network and the services we offer, as well as, guide the development of new and innovative programs for our members. We value what you tell us and appreciate the time you take from your busy schedule to answer the survey. Not everyone will receive a survey, but if you do, we hope you will tell us what you want us to know by completing and returning it. We thank you!

Women’s Health RightsUnder the Women’s Health and Cancer Rights Act, group health plans that provide coverage for mastectomies are also required to cover reconstructive surgery and breast prosthesis (such as implants) following a mastectomy. Under this law, members of Health Tradition Health Plan receive coverage for the following mastectomy-related procedures:

» Reconstruction of the breast on which the mastectomy was performed

» Surgery and reconstruction of the unaffected breast to produce a symmetrical appearance

» Breast prosthesis (artificial substitute)» Treatment for physical

complications of all stages of the mastectomy,

including lymphedema

For more information, call Customer Service:1-877-832-1823.

Your unborn baby will:« Start getting more oxygen« Have a lower risk of miscarriage and stillbirth« Have a lower risk of being born prematurely or with low birth weight« Have less chance of experiencing health problems throughout his or her lifeYour new baby will:« Experience less coughing and wheezing« Experience fewer lung infections and diseases such as asthma, bronchitis and pneumonia« Experience fewer colds, sore throats and ear infections« Be less likely to die of SIDS (Sudden Infant Death Syndrome)You will:« Have more energy and breathe more easily« Be less likely to develop heart disease, stroke, lung cancer, and other smoking related diseases« Feel good about what you have done for yourself and your baby« Enjoy that your hair, clothes, and home will smell better« Have more money from the savings

Supporting Healthy LifestylesYou Can Earn up to $200 in 2015!Better health, and a rebateHealth Tradition supports your healthy lifestyle with rebates for good nutrition, fitness, managing your weight and even learning how to manage stress in your life – some of the steps toward a lifetime of good health. This rebate is our way of cheering you on.

A new educational component for 2015The educational requirement for this year’s rebate is the Mayo Clinic Health Assessment. Find the link at healthtradition.com/members. This health assessment helps you identify your health risks and create a wellness plan to get you on track. It connects your health information – like blood pressure and cholesterol numbers – with things you do every day. To make it even more useful, bring both the health assessment and your results into your conversations with your primary care provider.

Get started nowAs part of Health Tradition Health Plan, member households can receive the Eat Well Move More rebate on a produce share from Community Supported Agriculture (CSA) farms, fees for fitness center memberships, lifestyle and weight management programs such as A New Me (see below) and Weight Watchers®, and a 12-day health focused camp for kids. Up to $200 total rebate per primary member household! Visit Eat Well Move More at healthtradition.com for program details. Browse through the rebate options and choose the rebate you like best. Then, send us the rebate form and receipts for your healthy choices (up to $200 per primary member household). To get started, complete your Health Assessment on the Mayo Clinic Healthy Living Online portal at healthtradition.com.

P.O. Box 188La Crosse WI 54602-0188

healthtradition.comVolume 21, No. 1 » WINTER 2014-15 HealthTradition.com or Customer Service 1-877-832-1823

Healthmate Health Tradition Health PlanA Mayo Clinic Health System Choice in Wisconsin

Health Tradition Health PlanA Mayo Clinic Health System Choice in Wisconsin

pg. 1

WELCOME MEDICAID & BADGERCARE

MEMBERSto the Healthmate

newsletter!

State of Wisconsin Members Only: The Mayo Clinic Health System - Northland, Eau Claire, Oakridge, Chippewa Valley and Red Cedar providers and facilities are NOT included in the Health Tradition Health Plan network for the State of WI employees and dependents.

BadgerCarePlus Members: Some of these providers may not be considered “in-network.” Check your plan’s provider directory at healthtradition.com and click on the BadgerCarePlus plan or call your member advocate at 800-545-8499.

Brian W. Rotty, Interim Executive DirectorMartha Binn, MD, Medical Director Tiffany Gulinson, DO, Associate Medical Director Michael Eckstein, Director of Sales & MarketingDavid Weichert, Director of Administration and Clinical Quality

The purpose of Healthmate is to inform and communicate with health plan members. Please submit suggestions or ideas to: 1808 East Main Street / Onalaska, WI 54650

Health Tradition Health PlanA Mayo Clinic Health System Choice in Wisconsin

BARRON & BLOOMERFogarty Surgical Services(Mayo Clinic Health System sites only)» James Forgarty, MD, General SurgeryBARRONMayo Clinic Health System» Joseph Bell Jr., MD, OB/GYNCAMERONMayo Clinic Health System» Nadine Nixon, MD, Family MedicineEAU CLAIRE, WIMayo Clinic Health SystemLuther Campus» Wajeeh Salah, MD, Gastroenterology» Matthew Anderson, LPC, Behavior Health» Emily Holle, PA-C, OrthopedicsMayo Clinic Health System Clairemont Campus» Tanushree Singhal, MD, Pediatrics

» Glenn Kauppila, DO, Family MedicineLA CROSSE, WIMayo Clinic Health System Franciscan Healthcare» Rebecca Scarseth, DO, OB/GYN» Julie Gorski, NP, GastroenterologyFamily and Children’s Center» Alicia Skiles, LPC, Professional CounselorMAUSTONMile Bluff Medical Center» Demarais Bradley, MC, General Surgery» Christine Jensen, PA-C, Physician AssistantAllied Health – Mauston» Tracy Francis, DC, ChiropracticMENOMONIEMayo Clinic Health System Red Cedar» Robyn Endrud, MD, Family Medicine

» Margaret Paulson, MD, Internal MedicineREEDSBURG, WIReedsburg Area Medical Center» Rebecca Reim, MD, Family Medicine» Christopher Eckerman, DPM, PodiatryRICE LAKEMayo Clinic Health System Northland » Jerald Barnard, MD, OB/GYNVIROQUAHirsch Clinic» Martha Karlstad, MD, PsychiatryCenter Point Counseling Services Cooperative» Behavioral Health and Substance AbuseWINONA, MNWinona Health Services» Erin Hanson, CNP, Family Medicine

New Providers

IMPORTANT:

HTHM097 © 2014, Health Tradition, Inc.

healthtradition.com or Customer Service at 1-877-832-1823

» NOTE: The providers in Hillsboro (St. Joseph’s Hospital and Clinics) can only be accessed at a St. Joseph’s Hospital or Clinic location. Health Tradition may not provide coverage by these providers at other locations.

BARRON, WIMayo Clinic Health System Northland» Lynnette Masters, MD, Family MedicineBOSCOBEL, WIBoscobel Area Health Care» Adriana Sikyta, PA-C, Family MedicineEAU CLAIRE, WIMayo Clinic Health System- Franciscan Healthcare » Nathan Hoekzema, MD, Orthopedics

» Laura Peter, MD, Physical Medicine and Rehab.» Rae Hanson, MD, NeurologyLA CROSSE, WIMayo Clinic Health System- Franciscan Healthcare» Gregory Cramer, MD, GastroenterologyMENOMONIE, WIMayo Clinic Health System, Red Cedar» Dana Bessen, NP, Family Medicine

PRAIRIE DU CHIEN, WICrossing Rivers Health Center (formerly PdC Memorial Hospital)» Susan Ipsen, CNP Family MedicineWINONA, MNWinona Health Services» Kimberly Straub, MD, Family Medicine» Scott Turner, MD, Family Medicine» Heather Pepinski, CNP, Family Medicine» Kene Ogbogu, MBBS, Family Medicine

Providers Leaving our Network

A winning formula to inspire behavior changeIntroducing: Mayo Clinic Healthy Living Online

Health Tradition Health Plan is pleased to announce exciting changes to your custom wellness portal from Mayo Clinic. In 2015, you’ll have full access to Mayo Clinic Healthy Living Online, the next generation in digital wellness. Mayo Clinic is changing the way wellness programs are delivered and experienced by unveiling a winning formula to inspire healthy habits. Healthy Living Online replaces the previous Mayo Clinic EmbodyHealth web portal.Built with your busy lifestyle in mind, you can access Healthy Living Online from your smart phone, tablet or computer – allowing you to track your exercise or log your calories on the go! Mayo Clinic Healthy Living Online can start you on a wellness journey that leads to long-term changes for better health. Healthy living has never been this much fun!

» Find out how you measure up in six domains of wellness. » Check out your personalized wellness plan and see how small changes can provide big benefits to your overall health.» Get started with easy-to use trackers, journals, meal planners and other tools to help you stick with your plan.

Mayo Clinic Healthy Living Online arms you with a personalized wellness plan and easy-to-use tools that can help you track your progress and see results! You can also connect your Fitbit® tracker and wristband or Withings® scale for seamless tracking. Visit healthtradition.com/members in 2015 to get started. BadgerCare and 65Plus members may sign up for online access to Healthy Living Online and the Mayo Clinic Health Assessment by calling 608-783-9503.

Understanding Your Coverage

Prior Authorization Required for Certain ServicesUnderstanding the details of your insurance coverage for all the different types of services you need can be confusing. It is extremely important for you to make sure that Health Tradition has authorized payment for the services your health care provider has ordered for you before you go to your appointment. This simply means that your health care provider needs to submit a form to Health Tradition which will determine if the requested service is a covered benefit of your insurance plan. You and your health care provider will receive written notice of the decision whether it is approved or denied for payment.

Some of the services that typically require a Prior Authorization include (but are not limited to):» Care received at Mayo Clinic Rochester» Radiology tests such as MRIs or PET scans» Psychological and neuropsychological testing» Certain surgical procedures

» Many medical equipment items» Genetic testing» Autism services» Procedures that could possibly be considered to be cosmetic.

Please remember that if the service is one that requires prior authorization and you choose to go to your appointment without receiving approval from Health Tradition, you may be responsible for all or a portion of the final bill.

For Your Safety:Notice of Our Privacy PracticesHealth Tradition is committed to keeping your personal health information safe and protected. You can see a copy of our Privacy Notice on our website at: healthtradition.com/feedback-please/privacy-notice-2 For more information about Health Tradition’s Privacy Practices, to exercise your privacy rights or to file a com-plaint, contact our Privacy Officer at:

Privacy Officer - Health Tradition Health PlanPO Box 188, La Crosse, WI 54602-0188608-781-9692 or Toll-free 1-888-459-3020

» Correction to last Healthmate: We incorrectly listed Mayo Clinic Health System Arcadia providers as “Leaving the Network.” These providers remain in the Health Tradition network.

For a current list of provider updates, visit: healthtradition.com and click on the mmsiservices.com link.