~ RESPIRATORY CARE information inside ~
Winter 2001
F.A.Q. ons frequently asked questions frequently asked questions frequently asked questions ... from our Health Advantage members Q: What should I do if I lose my Health Advantage member ID card? A: Please contact Health Advantage Customer Service at (501) 221-3733 or 1-800-843-1329 and request a new ID card. After the request, you should receive your new ID card within seven to 10 days.
Q: Do I need to take my Health Advantage member ID card each time I visit my doctor or have a prescription filled? A: Yes. Health Advantage strongly recommends that you carry your ID card with you at all times and that your family members carry their ID cards as well. Q: Will my new baby be covered under Health Advantage immediately after birth? A: A newborn is eligible for coverage from the date of birth, provided the child is enrolled within 90 days. To avoid a delay in claims being paid, you should complete an enrollment form, have your group administrator sign it and submit it to Health Advantage as soon as possible. Your employer may require that this be done within 30 days, so we recommend that you check with your personnel office.
Q: What is the proper procedure for scheduling an appointment with my primary care physician (PCP)? A: If you are a new patient, Health Advantage recommends that you have your medical records transferred to your new PCP and schedule an appointment as needed. If your appointment is for a routine examination, allow 30 days to schedule.
Q: What role does my PCP play in my health care as a Health Advantage member? A: The PCP is responsible for providing, arranging and coordinating all aspects of your health care. Q: What is a point-of-service (POS) plan? A: A POS plan means that the member has the option of receiving non-emergency services from plan providers or non-plan providers without first receiving authorization/referral from the PCP and/or Health Advantage. However, Health Advantage does not cover such services to the same degree as services authorized by the member’s PCP. The member also must meet a deductible before coverage begins. For some services, there is no coverage provided for out-of-network services or physicians. Remember a non-plan provider must have both PCP and Health Advantage authorization for in-network benefits.
Q: What is the age limit for dependent coverage? A: Dependent coverage is provided for the following dependents: 1. A child less than 19 years of age and living at home. 2. A child who is enrolled and regularly attending on-campus classes as a full-time student at an accredited college, university or vocational training school, who is under the age specified in the group contract and who is financially dependent on the member/parent. 3. A child of any age who is medically certified as totally disabled due to mental or physical incapacity and chiefly dependent on the member/parent for financial support.
Customer Service Numbers Little Rock Toll-free Number (501) Number
Category
State/Public School Employees 378-2437 1-800-482-8416 e-mail: publicschoolemployees@arkbluecross.com stateemployees@arkbluecross.com Medi-Pak (Medicare supplement)
378-3062 1-800-338-2312
Medicare (for beneficiaries only): Part A (hospital benefits) Part B (physician benefits)
378-3151 1-877-356-2368 378-2320 1-800-482-5525
UniqueCare, UniqueCare Blue, Blue Select®, BlueCare PPO & PPO Plus (individual products) 378-2010 1-800-238-8379 Group Services
378-2070
1-800-421-1112
BlueCard®
378-2127 1-800-880-0918
Federal Employee Program (FEP)
378-2531 1-800-482-6655
Health Advantage
221-3733 1-800-843-1329
Medi-Pak HMO (Health Advantage) 954-5200 1-800-354-9904 USAble Administrators
378-3600 1-800-522-9878
For information about obtaining coverage, call: Category
Little Rock Toll-free Number (501) Number
Medi-Pak (Medicare supplement)
378-2937 1-800-392-2583
UniqueCare Blue, Blue Select®, BlueCare PPO & PPO Plus (individual products) 378-2937 1-800-392-2583
Regional Office locations: Central Northeast Northwest South Central Southeast Southwest West Central
Little Rock Jonesboro Fayetteville Hot Springs Pine Bluff Texarkana Fort Smith
Customers who live in these regions may contact the regional offices or call the appropriate toll-free telephone numbers above.
Web sites:
www.arkansasbluecross.com, www.healthadvantage-hmo.com, www.BlueAnnEwe-ark.com
is published four times a year by Arkansas Blue Cross and Blue Shield for the company’s members, health care professionals and other persons interested in health care and wellness.
INSIDE THIS ISSUE
~winter 2001~
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Battle of the bugs ........................................ 4 Cold, flu … what’s the difference? ............. 5 Respiratory illness, common diagnosis ....... 5 Flu & pneumonia ....................................... 6-7 The cold. Just how common? ................... 8-9 The nose knows, sinusitis ......................... 8-9 Health care costs, what we are doing .. 10-11 When a cough is not a cold ........................ 12 Take a deep breath, asthma facts ............. 13 Secondhand smoke facts ........................... 13 When do you need antibiotics? .................. 14 Respiratory Health Education Program ...... 15 Who benefits from RHEP? ..................... 14-15 Allergies .................................................... 16 Medi-Pak and retiree information ............. 17 The pharmacist is in .................................. 17 Member benefit change for the better ....... 18 Benefit info for insulin infusion pump ....... 18 Blue & Your Community; member discounts ... 19 Blue On-line ............................................... 20 Vice President of Advertising and Communications Patrick O’Sullivan Editor Kelly Whitehorn — BNYou-Ed@arkbluecross.com Designer Gio Bruno Contributors Janice Drennan, Damona Fisher and Kathy Luzietti
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Battle of the bugs
All people, no matter what age or gender, are equally susceptible to the common cold.
I
f you want to avoid catching (or spreading) infections, here’s what you need to know: 1. Viruses and bacteria are spread by droplets released by the nose, mouth and eyes. 2. Most infections are spread by touching the infected person’s hands or touching something the infected person has touched and then touching your hand to your eyes or nose. 3. Coughing and sneezing can spread the infection. 4. Cold viruses can live on objects for up to three hours. 5. All people, no matter what age or gender, are equally susceptible to the common cold.
from the start of a runny nose or cough until the fever is gone. Some bacterial infections, such as strep throat, are contagious until the ill person has been taking an antibiotic for 24 hours.
Stay healthy. 1. Don’t smoke. 2. Eat a balanced diet, get enough sleep and take time to exercise. 3. Keep your teeth and gums healthy — consider using an antibacterial mouthwash in addition to brushing your teeth regularly. 4. Slow down when you have a mild respiratory illness.
Take preventive precautions at home, work and play. 1. Clean surfaces with a virus-killing disinfectant. 2. Wash your hands often. 3. Throw tissues in the trash immediately after use. 4. Cover your mouth and nose when coughing or sneezing. 5. Use only your own drinking cup and toothbrush. 6. Consider staying home from work when you are the most contagious. Most viruses are contagious
FACT: Although some people are convinced that a cold results from exposure to cold weather or from getting chilled or overheated, studies have found that these conditions have little or no effect on the development or severity of a cold.
Respiratory Illness:
COLD, FLU …
A common diagnosis for members
what’s the difference?
A
The Common Cold If you have a “common cold” with a tickle in your throat, a runny nose, sneezing and watery eyes, then you have probably caught one of the many cold viruses that are “going around.” This mild viral infection of the respiratory tract will usually clear up in four to 10 days, with or without treatment.
The Flu If your illness begins with a fever, headache, other aches and pains and lethargy — followed by cold-like symptoms — you probably have a more serious virus, the flu. Because the flu is a viral infection, most symptoms are likely to go away in otherwise healthy people in seven to 14 days. You may need over-thecounter medications and/or home remedies to temporarily relieve symptoms.
Symptom Relief The following over-thecounter medications won’t shorten your illness, but they can make you more comfortable.
For fever — try acetaminophen. For a cough — try dextromethorphan. For congestion — try a humidifier or saline spray. Additionally, lots of fluids, bed rest and steam can help relieve your symptoms.
Complications of the cold or flu It’s possible for viruses to lead to bacterial infections, such as sinusitis, middle ear infections or pneumonia. Signs of a bacterial infection include: fever that lasts for more than a few days or suddenly goes up, or coughed up phlegm that is yellow, green or bloody. If you think you have a bacterial infection, you should visit your doctor.
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ccording to data compiled by Arkansas Blue Cross and Blue Shield, approximately 8 percent of our members who visited the emergency room (ER) in both 1999 and 2000 were diagnosed with a respiratory illness. Additionally, approximately 17 percent of our Health Advantage and Arkansas Blue Cross members who have visited a health care facility (physician, hospital, clinic, etc.) in 2001 were seeking medical care for a respiratory illness. By simply reviewing data from Arkansas Blue Cross, it’s easy to see that respiratory illness is a significant condition among members. Through Blue & You, Arkansas Blue Cross is providing information about respiratory illness prevention and symptoms that will help members to be able to take care of their health and possibly avoid illnesses involving the respiratory systems.
Lost days of work and activity According to national health survey data, acute respiratory illnesses account for more than one-half of all disabling conditions annually, with the common cold being the most prevalent illness. The U.S. experiences about 300 million days of restricted activity, 60 million days of lost school and 50 million days of lost work. Direct costs in association with the common cold are estimated at $15 billion per year (including doctor visits and over-the-counter medication). The flu, with its terrible effects on its victims, is the leading cause of restricted activity and work-loss days in our society. According to the Centers for Disease Control and Prevention, the flu causes an average of 55.7 work-loss days per 100 persons per year in employees 18 years of age and older. Pneumonia, however, is not a significant contributor to restricted activity work-loss days as it is most common in those more than 65 years old.
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Flu & Pneumonia: F
Sinusitis
lu and pneumonia cause 20,000 to 40,000 deaths in the United States each year. More than 90 percent of the deaths occur in people who are age 65 and older.
Flu
Bronchitis
Pneumonia
Flu is caused by viruses and is highly contagious. Flu symptoms include fever, muscle aches, headache, lack of energy, a dry cough, sore throat and possibly a runny nose. These symptoms may last from several days to two weeks. Although flu is usually a mild disease, it can be serious in older adults and people of any age who have chronic illnesses. An annual flu shot can greatly lower your chances of getting the flu. In older people and those with certain chronic illnesses, the vaccine often is less effective in preventing flu than in reducing symptoms and the risk of serious illness and death. The vaccine does not cause side effects in most people. Flu season runs from November through April. Because flu viruses change all the time, the vaccine is updated each year to include the most current flu virus strains. The Centers for Disease Control and Prevention (CDC) reports that the 2001 vaccine supply will be sufficient to meet demand and should be plentiful in November. People at high risk, including those 65 or older, those who have chronic diseases, and health care workers should get the vaccine as early as possible.
Flu or Anthrax Initial symptoms of inhalation anthrax, which is breathed into the body, are much like the common cold and may mimic flu symptoms. Several hours to several days later, these symptoms progress to severe breathing problems and shock. Cutaneous or skin anthrax begins as a raised itchy bump that resembles an insect bite. Within one to two days, the bump develops into a sore and then a painless ulcer with a black center. Lymph glands in the adjacent area may swell. Intestinal anthrax — contracted by eating infected meat — causes nausea, loss of appetite, vomiting and fever. These initial symptoms are followed by abdominal pain, vomiting of blood and severe diarrhea.
Pneumonia Pneumonia is a lung disease that can be caused by viruses, bacteria, tuberculosis, protozoa and fungi. Pneumonia is the fifth leading cause of death in the United States. Pneumococcal pneumonia begins with a high fever, cough and stabbing chest pains. The disease results when a bacterium called streptococcus pneumiae invades the lungs. The infection can spread to the blood, lungs, middle ear or nervous system. Pneumococcal pneumonia primarily causes illness in children younger than 2 and adults 65 or older. Each year in the United States, pneumococcal diseases account for approximately 50,000 cases of
Your Best Defense bloodstream infection (bacteremia); 3,000 cases of meningitis; 100,000 to 175,000 hospitalizations from pneumonia; and 7 million cases of otitis media (ear infections). Pneumococcal vaccine is only recommended for those age 65 and over and for those under 65 with chronic diseases. It can be given at the same time as a flu shot (by separate injection in the other arm). It is recommended that the vaccine be administered every 10 years. Taking the pneumococcal vaccine protects only against pneumococcal pneumonia and does not guarantee that you will never get pneumococcal or another pneumonia.
New Vaccine for Children Under 2 The Food and Drug Administration approved the first pneumococcal vaccine for infants and toddlers last year. Known as pneumococcal conjugate vaccine or Prevnar®, the vaccine targets the most common strains of pneumococcus, which account for approximately 80 percent of invasive disease in infants. Infants can receive the vaccine as a series of four inoculations administered at 2, 4, 6, and 12-15 months of age. If children cannot receive the vaccine starting at age 2 months, their parents should consult their health care provider for alternative schedules.
An estimated 16,000 cases of pneumococcal bacteremia and 1,400 cases of pneumococcal meningitis occur each year in the U.S. among children under age 5 (under age 2 are at highest risk for infection). In up to half the meningitis cases, brain damage and hearing loss occur, and about 10 percent of those infected die. The American Academy of Family Physicians, the American Academy of Pediatrics and the CDC’s Advisory Committee on Immunization Practices have added the pneumococcal conjugate vaccine to their recommended schedule of childhood immunizations for 2001.
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— Sources: Centers for Disease Control and Prevention, National Institute on Aging, National Institute of Allergy and Infectious Diseases
IMMUNIZATIONS RECOMMENDED BY HEALTH ADVANTAGE FOR FLU AND PNEUMONIA Birth to 24 Months: Pneumococcal Conjugate Vaccine
2, 4, 6 months with a booster at 12 to 15 months
Age 40-64:
Influenza Vaccine
Annually for those at high risk (residents of chronic-care facilities and persons suffering from chronic cardiopulmonary disorders, metabolic diseases including diabetes mellitus, hemoglobinopathies, immunosuppression or renal dysfunction)
Pneumococcal Vaccine
Clinical discretion based on risk for persons with medical conditions that increase the risk of pneumococcal infection (e.g., chronic cardiac or pulmonary disease, sickle cell disease, nephrotic syndrome, Hodgkin’s disease, asplenia, diabetes mellitus, alcoholism, cirrhosis, multiple myeloma, renal disease or conditions associated with immunosuppression)
Influenza Vaccine
Annually
Pneumococcal Vaccine
Recommended every 10 years
Over Age 65:
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The
he common cold is probably the most T common illness known to man. It is such a part of our lives that situation comedies are written around the remedies, and medications are marketed that claim to be the “sniffling-sneezing-achy-fever-sore-throat-so-you-canrest medicine.” Although the common cold is usually mild, with symptoms lasting one to two weeks, it is a leading cause of doctor visits and of school and job absenteeism. In a year, Americans suffer 1 billion colds, according to some estimates. Colds are most prevalent among children who, on average have about six to 10 colds a year. Adults average about two to four colds a year, although the range varies widely. Women, especially those aged 20-30 years, have more colds than men. Generally, individuals older than 60 have fewer than one cold a year.
The
cold. Just how
The economic impact of the common cold is enormous. According to Eby Handbook statistics, 110 million cases of the common cold occur in the United States each year, which require medical attention or result in restricted activity. Colds cause 300 million days of restricted activity, 50 million lost days of work, and 60 million days lost from school. Between doctor’s visits and medications to relieve cold symptoms, almost $15 billion per year is spent on treating the common cold. In addition, our nation’s employers incur about $9 billion per year in indirect costs associated with lost time from work and decreased productivity by workers infected with colds (Mackowiak, Common Cold). More than 200 different viruses are known to cause the symptoms of the common cold. Some, such as the rhinoviruses, (from the Greek rhin, meaning “nose”) which is the most active and causes an estimated 30-35 percent of all adult colds, seldom produce serious illnesses. Others, such as parainfluenza and respiratory syncytial virus, produce mild infections in adults but can precipitate severe lower respiratory infections in young children.
nose knows
he symptoms begin with coughing and sneezing, T and feeling tired and achy. “Is it a cold?” you ask your-
self. But, when the medicines you’ve been taking to relieve the symptoms aren’t working and the pounding headache arrives, the answer to the question could be, “no, it’s sinusitis.” Sinusitis is an inflammation or swelling of the sinuses (the air passages behind your cheekbones, eyebrows and jaw). Sinusitis symptoms include headache when you wake up in the morning, pain in the face, head or neck, a runny nose, and a cough that’s often worse at night. Other symptoms can include sore throat (from nasal drainage), fever, weakness, tiredness and not feeling well in general. Sinusitis can be caused by infections, asthma, allergies or medicines and can occur because of changes in temperature, air pressure or air pollutants (irritants). The common cold can increase
your risk of sinusitis as can swimming and diving, smoking and the overuse of decongestant nasal sprays. There are three categories of sinusitis: Acute — lasts for 3 weeks or less; Chronic — lasts for 3-8 weeks but can continue for months or even years; and Recurrent — several acute attacks per year. It is estimated that 37 million Americans are affected by sinusitis annually and spend $2 billion for medications that promise to relieve their sinus symptoms. According to the U.S. Centers for Disease Control and Prevention, health care workers report 33 million cases of chronic sinusitis each year. Sinusitis accounts for an average of four work-loss days. It is easy to confuse the common cold with sinusitis.
common? The causes of 30-50 percent of adult colds, presumed to be viral, remain unidentified. The same viruses that produce colds in adults appear to cause colds in children. The cold season in America begins in late August or early September, and incidence of colds remains high until March or April, when it begins to decline. The most common cold-causing viruses survive better when humidity is low — the colder months of the year. Cold weather also may make the lining of the nasal passages drier and more vulnerable to viral infection. Common symptoms of the common cold include nasal discharge, obstruction of nasal breathing, swelling of the sinus membranes, sneezing, sore throat, cough and headache. Fever is usually slight but can climb to 102 degrees in infants and young people. Symptoms can last from two to 14 days, but two-thirds of people recover in a week. If symptoms last much longer than two weeks, it could be the result of an allergy rather than a cold. Colds occasionally can lead to secondary bacterial infections of the middle ear or sinuses, requiring treat-
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ment with antibiotics. But, antibiotics do not kill viruses. Colds are caused by viruses. Colds are spread most commonly by touching infectious respiratory secretions on skin and by inhaling secretions released by people coughing and sneezing. Hand washing is the simplest and most effective way to keep from getting rhinovirus colds. Not touching the nose or eyes is another. Individuals with colds should always sneeze or cough into a facial tissue and promptly throw it away. If possible, one should avoid close, prolonged exposure to persons who have colds. Decongestants and cough suppressants may relieve some cold symptoms but will not prevent, cure or even shorten the duration of a cold. And some have side effects. Nonprescription antihistamines may have some effect in relieving inflammatory responses such as runny nose and watery eyes that often come with a cold. No conclusive data has shown that taking large quantities of Vitamin C prevents colds. Even “Granny” of “The Beverly Hillbillies” knew she had the “cure” for the common cold: bed rest, plenty of fluids, gargling with warm salt water, petroleum jelly for a raw nose, and aspirin or acetaminophen to relieve headache or fever.
— Sources: National Institute of Allergy and Infectious Diseases, U.S. Department of Health and Human Services
However, a cold usually lasts 7-14 days and disappears without treatment, while acute sinusitis often lasts longer and typically causes more symptoms. Following a sinusitis diagnosis from your doctor, treatment may include decongestants to reduce congestion; antibiotics to control a bacterial infection (if present); and pain relievers to reduce pain. Over-the-counter or prescription decongestant nose drops and sprays should only be used for a few days. Used for longer periods, they can lead to even more congestion and swollen nasal passages. Inhaling steam from a vaporizer or a hot cup of water can soothe inflamed sinus cavities. Saline nasal spray can provide some relief, and gentle heat applied over the inflamed area is comforting. When medical treatment fails, surgery may be the only alternative for treating chronic sinusitis. Although you cannot prevent all sinus disorders, you can reduce the number and severity of the attacks and possibly prevent sinusitis from becoming chronic:
• Humidifiers may help relieve symptoms, especially if your home is heated by a dry forced-air system. • Air conditioners help provide an even temperature. • Electrostatic filters attached to heating and air conditioning equipment are helpful in removing allergens from the air. • Avoid cigarette smoke and other air pollutants. • Avoid drinking alcohol (it causes nasal and sinus membranes to swell). • Drink lots of water and other fluids to keep nasal discharge thin. • Avoid air travel. • If you have allergies, avoid the things that trigger attacks. — Sources: American Academy of Family Physicians, American Academy of Otolaryngology, National Institute of Allergy and Infectious Diseases, U.S. Department of Health and Human Services
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What are we doing to help
A
t Arkansas Blue Cross and Blue Shield, we conduct our business with three simple thoughts in mind: 1. We want you to be healthy. 2. If you get sick, we want you to receive excellent care from quality doctors and hospitals. 3. We don’t want you to go bankrupt in the process. Below are some of the ways we are working to hold down the cost of health care.
Contracting for Savings — As Arkansas’ largest health insurer serving hundreds of thousands of Arkansans, we are able to work with physicians and hospitals to provide our members with appropriate medical care at a lower cost. In exchange for a steady volume of patients with health insurance, we are able to contract with doctors and hospitals that agree to provide their services to our members at a discounted fee. In return for timely payment from Arkansas Blue Cross, participating providers also agree not to “balance bill” our members for any additional charges above the agreed-upon fees. By working together, we are able to strike a balance between providing reasonable reimbursement to medical professionals and keeping costs down for our members.
Not-For-Profit — With rising medical costs causing health insurance premiums to increase, it’s important to understand that Arkansas Blue Cross is a not-for-profit, mutual insurance company. That means that we are owned by our policyholders, not by stockholders. Because we pay no dividends to stockholders, all revenues earned by Arkansas Blue Cross are used in only two ways: To pay providers and members for covered benefits and to pay associated administrative expense. Any revenues received that are greater than these two categories of expense are held as unassigned funds (surplus) for the future benefit of our members. Low Operating Costs — More than 87 cents of every premium dollar in 2000 was used to pay for actual medical care received by our members. Only 12.5 cents of every dollar was used for costs associated with processing and paying member claims, providing customer service and other administrative costs. In addition, we saved our members more than $369 million in 2000 alone through our cost-containment initiatives. This is a savings to our members of $3.30 for every $1 in administrative expenses. Electronic Submission of Claims — A major part of administrative expense is the cost of processing claims.
Claims may be submitted in paper as well as electronic form. However, it costs approximately 50 percent more to process a paper claim as compared to an electronic one. To take advantage of this cost difference, Arkansas Blue Cross has invested in technology that facilitates the electronic submission of claims from providers. As a result, approximately 70 percent of all claims now are submitted electronically. The savings from this more efficient process helps keep the cost of coverage at the lowest level possible.
Customer Service Workstation — Providing faster, more complete customer service is another way we hold down costs. A new computer information system — called the Customer Service Workstation (CSW) — enables our employees to provide better and faster customer service to our providers and members. Using the new CSW, employees are able to access all needed customer information (from claims status to what’s covered) from their computer terminals — regardless of which insurance (Arkansas Blue Cross, Health Advantage or USAble Administrators) the customer may have. The CSW improves efficiency and increases response time to customer inquiries, helping to lower administrative costs.
Pharmacy Formulary — Arkansas Blue Cross works to control escalating drug costs through its Pharmacy and Therapeutics Committee, whose decisions form the basis of the Three-Tier Medications Formulary. The committee, the majority of whose members are doctors and pharmacists from outside our organization, makes recommendations regarding preferred and non-preferred medications. Members can save the most money by using generic drugs, which are always on the first tier of the formulary, requiring the lowest co-payment. Using brand-name, preferred drugs (selected for their effectiveness, safety, uniqueness and cost-efficiency) also saves members money because preferred drugs are on the second tier and require a mid-level co-payment. Non-preferred drugs (those considered by the committee to fall short of other drugs in the same therapeutic class in regard to effectiveness, safety, uniqueness or cost-efficiency) comprise the third tier and require the highest co-payment.
Case Management — Nurses work with members and their physicians through case management to recommend
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hold down health care costs? the most cost-effective benefit options to meet an individual’s physician-recommended treatment plan. In catastrophic cases, such as brain or spinal cord injuries, burns or multiple traumas, a national network of expert consultants is available to help patients and physicians assess health plan benefit options.
Transplant Network — Arkansas Blue Cross works with members and their physicians to secure transplant services through the Blue Quality Centers for Transplants, founded nationally by the Blue Cross and Blue Shield Association (BCBSA). Facilities that are selected for the transplant network must meet specific clinical criteria (based on positive patient outcomes and quality), which are established with the advice of a panel of nationally prominent transplant specialists. After a facility meets the inclusion criteria, an agreement is made on favorable pricing. By using this network, the member receives transplant services performed at facilities and by medical professionals who have been scrutinized for quality and good outcomes, with the added benefit of BCBSA-negotiated cost savings. The transplant network also helps with organ procurement services for the pre-authorized transplant.
BlueCard® — Members of an Arkansas Blue Crossaffiliated health plan may use the BlueCard program to obtain coverage and access network physicians and hospitals throughout the U.S. and in more than 40 other countries. Members simply show their ID card to receive health care benefits similar to their local Blue Plan while traveling outside of Arkansas. These providers file claims automatically for members and agree to accept negotiated fees for their services. BlueCard out-of-state coverage for some HMO plans may cover urgent/emergency care only. Check with your local Blue Plan for specific benefits.
Fraud Investigation — Detection, prevention and elimination of fraud, abuse and over-utilization are essential to maintaining a health care system that is affordable for everyone. Arkansas Blue Cross aggressively investigates and pursues the prosecution of perpetrators, who drive up premium costs for everyone. The company also actively cooperates with criminal investigations conducted by federal, state and local authorities and encourages education about fraud and abuse.
Health Education Programs — Arkansas Blue Cross and Health Advantage offer health education programs to members free of charge. These programs provide information and links to local, regional and national resources to help members manage disease and prevent complications of illness. Programs now are available for diabetes, respiratory health and Special Delivery, which educates expectant mothers about preterm births. In 2002, programs will be added in cardiovascular disease and low back pain. Informed members are more able to make choices that help them achieve better health, which leads to improved quality of life and lower health care costs. Wellness Discounts — Arkansas Blue Cross has negotiated discounts with health and fitness clubs, sporting goods and fitness equipment stores for members of Arkansas Blue Cross, USAble Administrators and Health Advantage. Discounts are obtained by showing your individual or family health insurance card at the time of club enrollment, purchase of services or retail sales. A directory of vendors offering discounts is available on our Web sites in the sections entitled “Members.”
Web Sites and Health Magazine — Arkansas Blue Cross uses Blue & You, its quarterly magazine, and its Web sites (www.arkansasbluecross.com and www.healthadvantage-hmo.com) to communicate with members. These communications tools offer a costeffective way of informing members about their benefits and help reduce calls to Customer Service. They also provide an avenue for preventive health information, which helps reduce health care costs.
Community Health Programs — “An ounce of prevention is worth a pound of cure.” That’s the simple idea behind the Arkansas Blue Cross Blue & Youth Health Program — health education designed to improve the health status of Arkansas’ young people. The Blue & Youth program uses a big blue sheep, BlueAnn Ewe, to teach school-aged children the importance of practicing healthy habits such as eating right, exercising, practicing safety, and preventing tobacco and drug abuse. Through a variety of approaches, including an elementary classroom presentation, a middle-school student teaching/mentoring program (High School Heroes), a health “club” for kids, animated musical television commercials and a wild and woolly kid’s Web site (www.BlueAnnEwe-ark.com), the Blue & Youth program has taken healthy messages to more than 281,000 Arkansas youth in the past five years.
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When a cough is not a coldis not a cold
ronchitis is an inflammation of the lining (bronchi) of the bronchial tubes, which connect the windpipe to the lungs. Less air is able to flow to and from the lungs, and a heavy mucus or phlegm is coughed up when the bronchi are inflamed and/or infected. This is bronchitis. Many people suffer a brief attack of acute bronchitis with cough and mucus production when they have severe colds. Chronic bronchitis is defined by the presence of a mucus-producing cough most days of the month, three months of a year for two successive years without other underlying diseases to explain the cough. It may precede or accompany pulmonary emphysema. Acute bronchitis is usually not associated with fever. Acute bronchitis is considered a chronic obstructive pulmonary disease (COPD). Cigarette smoking is by far the most common cause of chronic bronchitis. The bronchial tubes of people with chronic bronchitis also may have been irritated initially by bacterial or viral infections. Air pollution and industrial dusts and fumes are also causes. Bronchitis may develop before colds, during colds, after colds, all year round. As time goes on, colds become more damaging. Untreated, coughing and bringing up phlegm last longer after each cold. Once the bronchial tubes have been irritated over a long period of time, excessive mucus is produced constantly, the lining of the bronchial tubes becomes thickened, an irritating cough develops, air flow may be hampered, and the lungs are endangered. The bronchial tubes then make an ideal breeding place for infections. Almost 9 million Americans are diagnosed
with chronic bronchitis annually. It is the ninth-ranking chronic condition in our nation. Annually, 107,146 deaths occur in America — 1,296 deaths in Arkansas — which are certified as due to COPD and related conditions, ranking as the fourth leading cause of death in the United States. The annual national cost for bronchitis and COPD is about $30.4 billion. Developed more often in females than males, chronic bronchitis is often neglected by individuals until it is in an advanced state because people mistakenly believe that the disease is not life-threatening. By the time a patient goes to his or her doctor, the lungs have frequently been seriously injured. Then the patient may be in danger of developing serious respiratory problems or heart failure. Antibiotics have been helpful in treating acute infection associated with chronic bronchitis, but you do not need to take them continually. Treatment is primarily aimed at reducing irritation of the bronchial tubes. Bronchodilator drugs — which may be inhaled as aerosol sprays or taken as pills — may be prescribed to help relax and open up air passages in the lungs, if there is a tendency for these to close up. To effectively control chronic bronchitis, it is necessary to eliminate sources of irritation and infection in the nose, throat, mouth, sinuses and bronchial tubes ... avoid polluted air, dusty work conditions or give up smoking. Always see a doctor to determine conclusively a diagnosis of chronic bronchitis and follow his/her instructions for care. — Sources: American Lung Association, National Institute of Allergy and Infectious Diseases, U.S. Department of Health and Human Services
Take- -a-deep breath -----B
reathing is something most of us do without even thinking. For others, it can be an ongoing struggle. The airways in the lungs get blocked. You may have difficulty breathing. You begin to cough and wheeze. For people with asthma, an “attack” may range from mild discomfort to a life-threatening situation. Although asthma problems are often separated by symptom-free periods, it is a chronic (long-term) disease of the lungs that can affect people throughout their lives.
Who has asthma? In the U.S., more than 17 million of all ages and races have asthma. It is more common in children than adults with nearly 1 in 13 school-age children being affected. It is the leading cause of absenteeism due to a chronic illness. Children breathe more air, eat more food and drink more liquid in proportion to their body weight than do adults. Their bodies are developing, and they may be more at risk to environmental agents.
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molds and pollen. Irritants are things such as cold air, cigarette smoke, industrial chemicals, perfume, paint and gasoline fumes.
What happens during an asthma attack? 1. Cells in the air tubes make more mucus than usual. It is thick and sticky and clogs up the air tubes. 2. Cells in the respiratory tract get inflamed, causing the air tubes to swell. 3. The muscles around the air tubes tighten. These changes cause the air tubes to narrow, making it difficult to breathe. If you have asthma, you should consult your doctor to create an asthma management plan. Your doctor can help you learn to monitor your asthma, take appropriate medication and identify and avoid asthma triggers.
What causes asthma attacks? Anything that bothers the lungs can trigger an asthma attack. The two major categories are allergens and irritants. Examples of allergens are house dust, pets,
— Sources: U.S. Environmental Protection Agency and the Arkansas Chapter of the American Lung Association
Get the facts about ~~~~~~ ~~~~~~ secondhand smoke C
igarette smoking is indisputably a major cause of death and illness. It is responsible for an estimated 434,000 deaths per year in the United States. It is known to cause cancer and is a major risk factor for heart disease. And if you are not a cigarette smoker, but are exposed to cigarette smoke, are you at risk for some of those same ill effects as a smoker? The answer is yes. In adults, secondhand smoke is responsible for approximately 3,000 lung cancer deaths annually in U.S. nonsmokers. Secondhand smoke causes irritation of the eyes, nose and throat. It also has been linked with the onset of chest pain and is associated with death from heart disease in 37,000 people each year. In children, exposure to secondhand smoke increases the risk of lower respiratory infections such as bronchitis and pneumonia. According to the American Lung
Association, there are an estimated 150,000 to 300,000 cases every year of infections (such as bronchitis and pneumonia) in infants and children under 18 months of age who breathe secondhand smoke. Exposure increases the prevalence of fluid in the middle ear (a sign of chronic middle ear disease), irritates the upper respiratory tract, reduces lung function, and increases the episodes and frequency of symptoms in children with asthma (and is a risk factor for new cases of asthma). — Source: The American Lung Association
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f you only remember one thing about antibiotics, remember this: Antibiotics are not a cureall for any and all illnesses. If you overuse or misuse antibiotics, they become less effective.
antibiotics as soon as you feel better without finishing the prescription, effectiveness again is reduced.
What is antibiotic resistance?
Antibiotics
Antibiotics do not work against viruses. Most of the time when you have a runny nose, a cough, muscle aches, a head cold, a sore throat or even a fever — you have a virus. Viruses usually cause illness for one to two weeks, and the symptoms can be treated with non-prescription (overthe-counter) medicines, such as decongestants, cough syrups and cold formulas.
Antibiotics do work against bacteria.
Do you know when you really need them?
Bacteria cause serious illnesses such as pneumonia, meningitis, dysentery and blood poisoning. These illnesses can be life-threatening and should be treated with antibiotics. If the bacteria is resistant, then it becomes very difficult — even impossible — to treat them. Bacteria also cause more common ailments such as ear, urinary and sinus infections. An antibiotic may reduce the symptoms of these types of infections by a few days. If symptoms are not serious and the risk of complications is low, an antibiotic may not be necessary because your body is capable of fighting off the infection.
Do not overuse or misuse antibiotics. By using antibiotics too often, too much or not finishing a prescription, you are reducing the effectiveness, which may cause a problem know as “antibiotic resistance.” Approximately half of the 100 million antibiotics prescribed each year are unnecessary. This overuse causes antibiotics to become less effective when they are really needed. Also, if you stop taking your
Body surfaces are normally covered with “resident” bacteria even when we are healthy. Every time we use an antibiotic for any reason (by mouth or applied to the skin), we attack the resident bacteria even when the bacteria aren’t causing illness. Some fight to survive, adapting to their new antibiotic environment. Thus, they make antibiotic-resistant genes on bacteria that do make us sick and make them resistant as well.
Here’s how you can help.
Antibiotic resistance can be reduced with the following measures. 1. When visiting your physician, don’t insist on antibiotics for yourself or your children. Your physician will know when an antibiotic is needed. 2. Take antibiotics only with a doctor’s instructions. Do not take antibiotics left over from old prescriptions that are given to you by family or friends or purchased outside of the U.S. 3. Prevent infections by washing your hands thoroughly. Be sure to wash fruits and vegetables before eating and make sure you avoid eating raw eggs (don’t let your children snack on the cookie dough) and undercooked meats — especially ground meats. 4. Keep immunizations up-to-date especially for flu and pneumonia. If you have questions about whether you need an antibiotic, please contact your physician. — Sources: Centers for Disease Control and Prevention (CDC) and the American College of Physicians
Who is benefiting from the Free Respiratory Members of Arkansas Blue Cross and Blue Shield and its family of companies who are at risk for respiratory illness are enrolling in the Respiratory Health Education Program to help
themselves stay healthy. As of Oct. 31, 2001, more than 2,150 members have enrolled in the free program. Of those enrolled, 13 percent have asthma, 42 percent had been diagnosed with sinusitis at some point, and 58 percent are identified as high risk for pneumonia/flu. Of those enrolled, 20 percent have missed 1-3 days of work because of illness, 10 percent have missed 4-5 days
RESPIRATORY HEALTH EDUCATION PROGRAM AVAILABLE TO MEMBERS
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he Respiratory Health Education Program offered by Arkansas Blue Cross and Blue Shield to members focuses on prevention and self-management of respiratory illnesses for members who are at greater risk for serious complications of a respiratory illness. Although the discomfort caused by a cold or the flu is usually temporary, these illnesses can lead to more serious complications such as sinusitis or pneumonia. Those especially at risk include smokers, the elderly and those who suffer from chronic diseases such as asthma, heart disease, diabetes, kidney disease, emphysema and bronchitis. The information offered by Arkansas Blue Cross should help you: • Understand the causes of respiratory infections as well as how they spread and how they can be treated. • Help you take action to prevent or reduce your chances of getting respiratory illnesses. • Provide specific information about asthma, sinusitis and pneumonia and how to prevent and manage symptoms. The program benefits include registered nurse case managers who can assist with health plan benefits, provide information from community and national resources about the relief of symptoms and the role of medication in the treatment of respiratory infection, and provide information on local smoking-cessation classes for those interested in quitting smoking. Program highlights include: a voluntary health survey; physician collaboration; health care resource lists; education on self-management techniques; and satisfaction surveys.
Advantages of the Respiratory Health Education Program
If you have ever had a cold or the flu, or another respiratory illness, you have firsthand experience with the impact respiratory illnesses can have on your life. The financial costs are an additional issue. Better health leads to a higher quality of life and lower costs to you. Preventing respiratory complications can have a substantial impact on reducing hospitalization and further reducing your health care costs.
How to Enroll If you are a member of Arkansas Blue Cross or Health Advantage, you can enroll in the free Respiratory Health Education Program by calling a registered nurse case manager at your nearest regional office, or downloading the Patient Enrollment Form from www.arkansasbluecross.com and sending it in to your nearest regional office (see locations on Page 3). Editor’s Note: The Respiratory Health Education Program is for educational purposes only. You should consult your physician for any medical advice or services you may need.
Health Education Program? of work, and 14 percent have missed more than five days of work. Of those who have enrolled in the program, 14 percent are smokers, 30 percent have received pneumonia immunizations, and 57 percent have received flu immunizations. Where can you find more information about respiratory health?
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Healthfinder Web site — www.Healthfinder.gov American Lung Association — www.lungusa.org National Institute of Allergies and Infectious Disease — www.niaid.nih.gov.
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Allergies: sniffles, sneezing and sensitivity
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ccording to the American Academy of Allergy, Asthma and Immunology, allergies affect one out of every six Americans. The cost of treating allergies runs in the millions of dollars and includes the cost of missed days of school and work as well as medications and physician services.
What is an allergy? An allergy is an abnormal reaction to a usually harmless substance. If a person has an allergy to something (like pollen), and it is absorbed into the body, the immune system views the pollen as an invader and a chain reaction begins. White blood cells begin to produce antibodies, which attach themselves to special cells called mast cells, causing a release of potent chemicals such as histamine. These chemicals cause symptoms such as a runny nose, watery eyes, itching and sneezing.
What are the common causes of allergies? A person could be allergic to one or several things. The most common allergies include pollens, molds, dust mites, animal dander (dead skin flakes from animals with fur), foods, medications and insect stings.
What are the most common types of allergic reactions? 1. Seasonal allergic rhinitis (sometimes called hay fever) is caused by an allergy to the pollen of trees, grasses, weeds or mold. Reactions include sneezing, itching, watery eyes, runny nose, burning palate and throat. 2. Allergic rhinitis is a general term used for anyone who has allergy symptoms, and it may be a seasonal or year-round problem caused by dust mites, dander, mold, etc. 3. Eczema or atopic dermatitis is a non-contagious itchy rash that often occurs on hands, arms, legs and neck. 4. Contact dermatitis is a reaction affecting areas of the skin. The skin may become red, itchy and inflamed after contact with irritants such as plants, cosmetics, medications, metals and chemicals. 5. Urticaria or hives are red, itchy, swollen areas of the skin and may appear on any part of the body. Most acute cases of hives are easily identifiable as reactions to such things as food, viruses, latex or medications. Chronic cases of hives may occur regularly for years with no identifiable triggers.
Are allergies curable? The tendency to suffer from allergies is genetically inherited. Instead of looking for a cure, those with allergies should work with their physician to keep their allergies under control. Successful treatment of allergies includes early detection, proper use of medications and simple allergen avoidance techniques.
More about pollen allergies Skipping through a field of springtime flowers may look pretty in pictures, but in reality, that sort of behavior may send some people into an uncomfortable sneezing, sniffling and eye-watering episode. Welcome to the wonderful world of pollen. Pollen is microspores that usually appear on plants as a fine dust. Contrary to popular belief, spring isn’t the only time that pollen is in the air. Pollen grains may be dispersed into the air in summer and fall also, depending on the type of tree, grass or weed. Besides avoidance, other allergy treatments include oral over-the-counter antihistamine medications, oral and nasal over-the-counter decongestants, and nose drops or nose sprays. For more information on treatment options for allergies, please consult your physician. If you are allergic to pollen, you should minimize your symptoms by avoiding exposure to pollen. Those with pollen allergies should do the following (if possible): remain indoors in the morning when outdoor pollen levels are the highest; wear face masks designed to filter air if you must be outdoors; keep windows closed and use the air conditioner in the house or car if possible; do not dry your clothes by hanging them outdoors; avoid contact with other irritants such as insect sprays, tobacco smoke, fresh tar or paint; and avoid doing yard work such as mowing the lawn. For information on the pollen count in your area, contact the National Allergy Bureau at 1-800-9-POLLEN.
Medi-Pak and Retiree Information A
rkansas Blue Cross and Blue Shield entered into an agreement, effective April 1, 2001, with Health Data Management (HDM) Corporation to begin electronically submitting our Medi-Pak member’s Medicare Part A and B supplemental claims. These claims are submitted from Medicare Fiscal Intermediaries/Carriers throughout the U.S. directly to Arkansas Blue Cross. (HDM is a national clearinghouse for Medicare Part A and B claims.)
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This agreement allows HDM to electronically submit Medicare Part A and B supplemental claims from providers nationwide. This means that providers from states other than Arkansas do not have to submit paper claims to Arkansas Blue Cross. They simply complete the “other insurance” information on their claims submitted to Medicare, which includes the Arkansas Blue Cross member’s identification number, and the claims will be electronically submitted to Arkansas Blue Cross. Arkansas Blue Cross remains committed to continually finding more efficient ways to serve our customers, such as our new electronic claims process. If you have any questions, please call our Customer Service Division at (501) 378-2010 or toll-free at 1-800-238-8379.
The Phar macist is in Do you have any questions? Because of news accounts of terroristic use of germ
warfare in the United States lately, many questions have been raised about anthrax infection and how it may spread. The new reality of war tactics that touch us in our own homeland has awakened Americans to the fact that this new war is aimed at us rather than those on another continent. The most concern appears to be related to anthrax infection since this spore-forming bacteria has been, so far, used to a limited extent. A frequently asked question is “Should I take an antibiotic or have one available to prevent or treat an anthrax infection?” The response has several parts: 1. Do not panic or make any major family or personal health decision regarding this issue without seeking your physician’s guidance. A major objective with any germ warfare tactic is to create fear and panic. 2. Remain alert for current and potential terrorist activities as published by trusted news sources.
3. Become knowledgeable of basic symptoms for Anthrax or other problems that may be occurring. 4. Remember that national and state health agencies are working to prepare for your safety. Investigative agencies at all levels have this designated as top priority. 5. Do not take any antibiotic unless directed by your physician. Unnecessary use of the powerful antibiotics used for treatment of anthrax can create antibiotic resistant bacteria that could prove much more harmful than your fears. 6. Do not stockpile antibiotics or attempt to use another person’s medication. This may be basic information, but sometimes we rush ahead of where we need to begin. Try to remain alert, but do not panic. Use sound judgment, and seek qualified medical direction if questions arise. Let your physician guide your medical care should the need arise.
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CHANGE REDUCES “HASSLE FACTOR” Y 3 F 4 L 5 9 1 6 8 S FOR MEMBERS
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rkansas Blue Cross and Blue Shield is changing its Arkansas’ FirstSource® Wellness Benefit for those groups with this benefit feature. Our goal is to reduce the “hassle factor” that members often experience with this benefit. The benefit has been changed so that regardless of how the physician files the claim, it will be paid properly. Our members will not need to call should the physician file incorrectly, and wait for the claim to be adjusted. In the past, this has been a problem for members with this benefit. Arkansas Blue Cross also has removed the age limits from the Wellness Benefit. Members will not have to ensure that they receive services within a narrow age window to receive payment, as had been the policy. Another enhancement included in the new Wellness Benefit is the coverage of PSA tests. Members have frequently requested coverage for this wellness service. The redesign of this benefit also will allow us to automatically process most of these claims. And that
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means fewer errors and faster turnaround times for our customers. Best of all, the annual maximum has been increased to $500. The old benefit paid up to $150 for routine care and $200 for routine gynecological services. Under the new benefit, when members receive wellness services from a provider, the services will be paid subject to the deductible and co-insurance up to $500 per calendar year maximum per person. Should a member’s benefit plan have both a wellness and a primary care physician office visit co-payment, the wellness services will be paid subject to the co-payment up to $500. Please note that preventive child care and immunization benefits will not change. The changes we have outlined only apply to adult Preferred Provider Organization (PPO) Wellness Benefits. These benefit enhancements will start with dates of service beginning on Jan. 1, 2002. All services received by members prior to that date will fall under the old wellness guidelines, regardless of when the claim is paid.
INSULIN INFUSION PUMP BENEFIT INFORMATION A
s of Sept. 1, 2001, the following benefits apply to all Arkansas Blue Cross and Blue Shield plans (including Health Advantage and USAble Administrators).
Insulin Infusion Pumps: •
Paid under the diabetic benefit. (See your plan benefits chart for the specific co-payment.) • Maximum allowable per pump is $4,400. • No contracted providers for this equipment. Members can be billed the difference in the billed and allowed amounts. • Requires prior approval by your specific insurance plan. Your physician may fax in a prior approval request to (501) 378-6647.
Insulin Infusion Pump Supplies: • • • •
Paid under the diabetic benefit. (See your plan benefit chart for the specific co-payment.) Paid at the Medicare allowable amount and no annual maximum or limit. No contracted provider for this service. Members can be billed the difference in the billed and allowed amounts. If the pump has been approved, supplies do not require prior approval. If the pump has not been prior-approved, the supplies require prior approval. Your physician may fax in a prior approval request to (501) 378-6647. • If Arkansas Blue Cross (or one of our affiliates) did not approve your insulin pump (i.e. it was procured before coverage began), it must meet insurance plan criteria in order for supplies to be covered.
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rkansas Blue Cross and Blue Shield strives to be a good corporate citizen. Our employees raise money and spend many hours helping those causes near and dear to the hearts of Arkansans. Light the Night BlueAnn Ewe was on hand to greet pint-sized participants in the Leukemia & Lymphoma Society’s “Light the Night” Walk in Maumelle on Sept. 21. Family and friends of those who have experienced a bloodrelated disease gathered to walk around Lake Willastein with lighted, blinking balloons in an effort to raise money and awareness for diseases such as leukemia, lymphoma, Hodgkin’s Disease and myeloma. KATV-TV Channel 7 and B98.5 BlueAnn greets a young FM Radio served as participant to “light the night.” media sponsors for the event. There were clowns, dancers, singers and costumed characters all around to cheer on the participants. Walking for a cure Arkansas Blue Cross and Blue Shield employees ran, walked … and even danced down Capitol Avenue at the Juvenile Diabetes Research Foundation’s (JDRF) 2001 Central Arkansas Walk to Cure Diabetes held Sept. 22. More than 600 employees (plus friends and family) preregistered for the walk and raised more than $44,500 (employee and corporate contributions combined) in the fight against diabetes. Sharon Allen, executive vice president and chief operating officer of Arkansas Blue Cross, served as the corporate recruitment chairperson for this year’s walk, and for meeting the company’s goals, she kissed a cute little piglet! Arkansas Blue Cross’ efforts helped JDRF raise more than $350,000 to fund their programs and research.
Pirates and pearls Ahoy! More than 34,000 people from throughout Arkansas converged on the streets of downtown Little Rock Sept. 29 for the annual Susan G. Komen Breast Cancer Foundation’s Arkansas Race For The Cure to raise awareness and funds for the fight against breast cancer. And most of the participants cruised by the Arkansas Blue Cross and Blue Shield block at Sixth and Gaines — a.k.a. the Blue Lagoon Pirate’s Cove — where they were greeted with a hearty “arrrrgh,” a cup of cool water, and a strand of pearls. More than 620 “gems” and 100 “swashbucklers” made up the enterprise teams who shared with Race participants and breast cancer survivors that they are a “treasure” and vowed to “capture a cure” for breast cancer.
Member discounts just for you! Arkansas Blue Cross and Blue Shield is hard at
work canvassing the state looking for “wellness” discounts with health clubs, fitness centers and more — specifically for our members. Powerhouse Gym in Little Rock, Fitness Zone in Rogers, TNT Fitness in Harrison, the Northwest Athletic Clubs in Rogers and Springdale and Total Fitness in Springdale are the newest fitness centers in Arkansas to offer discounts to our members. If you are curious about whether your favorite fitness spot offers a discount, visit the Arkansas Blue Cross Web site at www.arkansasbluecross.com for a complete list of participating fitness vendors. If you don’t see your work-out site on the list but would like Arkansas Blue Cross to contact them about offering a discount to our members, just send the name and location of your fitness center to BNYEd@arkbluecross.com and we’ll take it from there.
www.arkansasbluecross.com & www.healthadvantage-hmo.com
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here are many things in life that can’t be controlled. Fortunately, illness isn’t always one of them. People faced with chronic illnesses or the possibility of a premature birth may feel helpless. Even though no one can deny the gravity of these problems, often there are preventive health steps you can take. If you or a family member has diabetes or a respiratory illness or is expecting a child, a new section of our Web sites should provide valuable resources. Visit www.arkansasbluecross.com or www.healthadvantagehmo.com to learn about the Health Education Programs available to members of Arkansas Blue Cross and Blue Shield, Health Advantage and those members of USAble Administrators whose employers have purchased the programs. Click “Members” on the bar under the photos on the home page. When the “Members” page loads, you will see a link to the “Health Education Programs.” The introductory menu page links to three programs: • Diabetes Health Education Program to assist those who have diabetes in managing their disease; • Respiratory Health Education Program with a focus on prevention and self-management of respiratory illnesses for those at risk for serious complications plus tips on managing asthma, sinusitis and pneumonia; • Special Delivery for expectant mothers. For the diabetes and respiratory programs, the Web site provides a list of resources for additional information. Enrollment forms and directories of nurse case managers who can be contacted for further help are included. Forms are in portable document format (PDF). Visitors can open these forms with Acrobat Reader and print them out for completing and mailing. The free Diabetes Program offers you: • Automatic enrollment in the Diabetes Control Network for free publications, including a diabetes care brochure, test results record and newsletters; • Registered nurse case managers who can assist with your health plan benefits; • Information and education from community and national resources, which follow the guidelines of the American Diabetes Association; • Information for you to share with your physician who is developing your care plan; • A health survey and customized report.
The free Respiratory Program offers you: • Specific information about asthma, sinusitis and pneumonia; • Registered nurse case managers who can assist with your health plan benefits; • Information and education from community and national resources that follow the National Heart, Lung, and Blood Institute standards. These include tips on prevention of respiratory infections, techniques to relieve symptoms, and information on the role of medication; • Information and education from local resources on availability and cost of smoking-cessation classes; • A health survey with a report of your results. Special Delivery is dedicated to the good health of all mothers and their babies. Each registered expectant mom will receive educational material and coupons to encourage good health practices during pregnancy, including materials to increase her awareness of symptoms that may signal preterm labor. The Special Delivery nurse can assist in coordinating coverage of home-health care for the high-risk patient whose physician feels she would benefit from this alternative care. Special Delivery can provide coverage of services that are not normally offered, such as skillednursing assessments and nursing-assistant care in the home for conditions including pregnancy-induced hypertension, diabetes mellitus and preterm labor. Arkansas Blue Cross and Blue Shield P.O. Box 2181 Little Rock, AR 72203-2181