Squad goals: Meet Oscar’s Concierge teams | Oscar Rx | hioscar Blog | Oscar
Squad goals: Meet Oscar’s Concierge teams
Your Concierge team can help you understand your plan, find care when you need it, and manage your health issues.
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Calling a health insurance company typically involves a lot of deep breathing. Long wait times. Confusing jargon. Cyclical answers. Repeating yourself. It’s no fun.
At Oscar, we want to make interacting with your health insurance company a little less painful. Which is why we’ve invested in providing a dedicated Concierge team for every member.
Whether you need billing support, a new specialist (opens in new tab), or help coordinating medical care, you’ve got your own go-to team of care guides and a licensed nurse who can help you understand your plan, find a doctor when you need one, and manage your health issues.
Here’s everything you need to know about Oscar Concierge teams.
How our Concierge teams work.
Each Concierge team is outfitted with several care guides and a nurse to give you access to expert clinical advice and guidance about your plan. Your Concierge team is dedicated to you and your unique needs – so you’re more than just a name and ID number. When you call in for help, they get to know the ins and outs of your medical and insurance history so you don’t have to start at square one with a stranger. With fewer members to manage and the added clinical resource of a nurse on the team, our Concierge teams’ goal is to provide personalized, quality care and support.
Nichol Burton, a Nurse Lead at Oscar, describes the Concierge approach this way:
"There’s no cookie cutter process to our concierge model. We use critical thinking skills to help do what’s best for the member and build a foundation by letting our members know we’re a resource."
We know you probably don’t want to call your health insurance company unless you have to, but there are lots of great ways your Concierge team can help you get faster, better care. Here are 3 important ways they can help you, even before you go to the doctor.
1. Find a doctor.
Start your search for a new provider with your Concierge team. They can help you avoid spending extra money on unnecessary care, and get you connected with the right kind of doctor for your health needs. Your care guides will help you find a provider who takes Oscar and has the qualities that are important to you, like:
Experience.
Member feedback.
Language.
Location.
Gender.
Specialty and expertise.
2. Coordinate care.
Our nurses offer hands-on care management, which includes clinical guidance and coordination of care between your doctors. Care management services can be particularly helpful in situations where you need care from multiple providers or help managing a complex condition. Your nurse can help you communicate with your providers so you stay in the loop throughout your treatment and are never left in the dark. They also serve as a clinical support system whenever you have questions about how to get treated for a specific a condition.
Mercedes Williams, Nurse Lead at Oscar, says about her role supporting members:
"My philosophy is: whatever it takes, as long as it takes. And that varies from member to member. There isn’t a finite period. It's as a long as it takes to get the member all the things they need that they otherwise couldn’t get without our assistance. It’s really fluid."
Care coordination and management is available for members who have:
Upcoming surgeries: Nurses offer pre- and post-operation support. Prior to your surgery, your Concierge nurse will reach out to make sure you understand the details of your procedure and help make sure you have the necessary authorizations in place. They’ll help coordinate post-op details such as discharge planning, transfers to skilled nursing (opens in new tab) facilities, and special transportation. After your surgery, your nurse will give you a call to make sure you receive your prescriptions (opens in new tab), durable medical equipment (opens in new tab), and plan for follow-up care. They’ll also check in with your doctors to make sure you’ve got everything you need for your recovery.
Chronic conditions: Health conditions like cardiovascular disease, diabetes, and cancer require day-to-day management. Our nurses work with you and your doctors to discuss your needs and help you build a long-term care plan. Your care plan includes information about ways you can manage your condition through prescriptions, exercise, screenings, doctor visits, and routine check-ins with your nurse so you can update them on how you’re doing. Our nurses also work with your doctors to ensure that you’re getting the care that you need from them.
Emergencies: Your Concierge team gets an alert each time one of their members visits the ER or is admitted to the hospital. If you have an emergency (opens in new tab), one of our nurses will reach out to you within 24 - 48 hours to assist with transfers (if you received care out of network), follow-up care, medications, and help prevent hospital readmissions. Since emergency medical care often happens out-of-network, having a nurse guide you through the billing and follow-up care process can help you avoid unnecessary costs.
Complex health situations: Some types of medical procedures, such as transplants, amputations, heart surgery, and new or ongoing cancer diagnoses require long-term care management over the course of a few months. In these situations, your nurse works closely with your doctors, hospital, and family members to ensure that you heal as quickly as possible.
3. Navigate your plan and benefits.
Let’s face it: Health insurance is complicated, and understanding the ins and outs of your health plan can feel like a second job. With Oscar, your care guides are here to help. They’re experts who can help break down all of the specifics of your health insurance plan. They’ll help you:
Deal with any confusing bills from doctors or labs.
Screen your health history for future care management needs and connect you with a nurse.
Concierge teams are available by phone from 8 a.m. to 8 p.m. local time Monday - Friday, and 9 a.m. to 5 p.m. on weekends. You can send your team a message from your account on hioscar.com (opens in new tab) or the Oscar app, or contact us the good old fashioned way at 855-672-2755. We’d love to hear from you!
