ilumed Info Sheet
For ilumed Aligned Members Only
Coinsurance and Deductible
Are waived at PCP visits
Post-discharge follow-up Appointments
Are scheduled for 72-hours (3 business days) after discharge
Appointment Cadence
There should be a 90-day follow-up visit scheduled at checkout (4 visits a year for non-stratified patients).
Transportation
You can reach out to your ilumed Member Outreach Representative to schedule transportation for members.
“Call Me First” Campaign
Educate patients to call the office first before visiting the ER if they are unsure of the severity of the situation.
Your ilumed Support Team!
PROVIDER REPRESENTATIVE
Samantha Hays
561-203-1872
shays@ilumed.com
MEMBER OUTREACH REPRESENTATIVE
Yves Auguste
561-990-2744
1-800-481-8745
NURSE CASE MANAGER
Jasmine Mann
862-201-4902
SOCIAL WORKER
Shirley Mathieu
786-634-2182
There are a few different types of beneficiaries/questions you may encounter regarding your
office’s partnership with ilumed. This document serves as a guide to help navigate those
conversations
Tier I
The Basics
“I got a call/letter about ilumed. I didn’t sign up for anything extra.”
• Our office has partnered with a group called ilumed to provide even better care for our Medicare patients like you!
• Your doctor (PCP Name) is collaborating with ilumed to provide you with the highest quality healthcare, ilumed reaches out to assist us in scheduling your appointments or to offer extra benefits to you like providing a nurse case manager to help you navigate your health care needs.
Tier II
Questions & Concerns
If the patient asks for more information, go into a bit more detail.
Does ilumed’s program cost extra?
ilumed’s program doesn’t cost you a thing, but it does come with some enhanced benefits, like $0 copays and no deductible to see your PCP and a dedicated member outreach team who can help with things like scheduling appointments and addressing your concerns.”
Does this change my insurance coverage?
This is not an insurance plan and won’t change your current plan.”
Does participating in ilumed’s program mean I’m tethered to only this PCP?
Absolutely not. You’re still free to see any doctor you want, same as you always have. The extra benefits you receive are tied to this office, though.
Tier III
What is ACO REACH?
Is the Patient Still Unsure? Explain the ACO REACH Model!
Keywords like “free?” and “Who pays for this” would prompt using this response.
An ACO REACH is a Medicare model built to offer its members added value programs at no cost. In the ACO REACH Model, Medicare partners with companies like ilumed to improve patient care quality.
When quality of care is improved and patients remain healthy, that saves Medicare money. The success of an ACO REACH Program is directly linked to the health of its members. Keeping the beneficiary healthy is the goal!
*Keep in mind, it very rarely gets to this level. Also note, patients who ask for a conceptual or business geared explanation of the form often have a relevant professional background. (i.e., Insurance, healthcare, etc.) Since the ACO REACH is a new model, it is unfamiliar. (It can be useful to reference the Medicare website where ilumed is listed). If the patient is still concerned, ask them what their concerns are or refer them to Member Services at 1-800-481-8745.