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    • Renown Health
    • Health Insurance and Coverage

    Health Insurance Terms Explained: HMO, EPO and PPO Plans

    When it comes to purchasing a health insurance plan, you’ve probably heard of the two plan types, HMO and PPO, but what exactly do these terms mean, and what is an EPO? Let’s learn more about these plan types and how you can choose the plan that meets your needs. What is an HMO Plan? HMO stands for “Health Maintenance Organization.” HMO plans contract with doctors and hospitals creating a network to provide health services for members in a specific area at lower rates, while also meeting quality standards. HMO plans typically require you to select a primary care physician (PCP) and obtain a referral from your PCP to see a specialist or to have certain tests done. If you choose to see a provider outside of the HMO’s network, the plan will not cover those services and you will be responsible for all charges. What is an EPO Plan? An EPO stands for “Exclusive Provider Organization.” This plan provides members with the opportunity to choose in-network providers within a broader network and to visit specialists without a referral from their primary care doctor. EPO plans offer a larger network than an HMO plan but typically do not have the out-of-network benefits of PPO plans. EPO plans do not require you to select a primary care physician (PCP) giving you a broader network of providers. EPO options are a great cost-saving option with more flexibility than a standard HMO plan. What is a PPO Plan? PPO stands for “Preferred Provider Organization.” PPO plans are often more flexible when it comes to choosing a doctor or a hospital. These plans still include a network of providers, but there are fewer restrictions on the providers you choose. PPO plans do not require you to select a primary care physician (PCP), giving you a broader network of providers. So, which plan should you choose? Each plan type has different benefits, so it depends on your health needs when choosing the right plan type. If you are looking for flexibility when choosing providers and locations, a PPO plan may better fit your needs. An EPO plan may be a better option if you want the flexibility of a larger network, but don’t necessarily need out-of-network benefits. If you regularly seek care in a certain geographic area and are looking for a health insurance plan at a lower price point, consider an HMO plan. To keep costs low, insurance carriers contract with providers and partner in plan members’ health to ensure quality care at the lowest cost. Whether you choose an HMO, EPO or PPO option, partnering with your health insurance carrier and your healthcare provider will help you receive the best care while controlling your out-of-pocket costs. Keep in mind that most insurance carriers offer emergency care coverage for all three plan options (HMO, PPO, EPO). Get the most out of your health insurance benefits! Established in 1988, Hometown Health is the insurance division of Renown Health and is northern Nevada’s largest and only locally-owned, not-for-profit insurance company providing wide-ranging medical coverage and great customer service to members.

    Read More About Health Insurance Terms Explained: HMO, EPO and PPO Plans

    • Health Insurance and Coverage

    Health Insurance Terms Explained: Deductible and Out-of-Pocket Maximum

    Health insurance might be one of the most complicated purchases you will make throughout your life, so it is important to understand the terms and definitions insurance companies use. Keep these in mind as you are comparing health insurance plan options to choose the right plan for you and make the most of your health insurance benefits. One area of health insurance that can cause confusion is the difference between a plan's deductible and out-of-pocket maximum. They both represent points at which the insurance company starts paying for covered services, but what are they and how do they work? What is a deductible? A deductible is the dollar amount you pay to healthcare providers for covered services each year before insurance pays for services, other than preventive care. After you pay your deductible, you usually pay only a copayment (copay) or coinsurance for covered services. Your insurance company pays the rest. Generally, plans with lower monthly premiums have higher deductibles. Plans with higher monthly premiums usually have lower deductibles. What is the out-of-pocket maximum? An out-of-pocket maximum is the most you or your family will pay for covered services in a calendar year. It combines deductibles and cost-sharing costs (coinsurance and copays). The out-of-pocket maximum does not include costs you paid for insurance premiums, costs for not-covered services or services received out-of-network.  Here's an example: You get into an accident and go to the emergency room. Your insurance policy has a $1,000 deductible and an out-of-pocket maximum of $4,500. You pay the $1,000 deductible to the hospital before your insurance company will pay for any of the covered services you need. If you received services at the hospital that exceed $1,000, the insurance company will pay the covered charges because you have met your deductible for the year. The $1,000 you paid goes toward your out-of-pocket maximum, leaving you with $3,500 left to pay on copays and coinsurance for the rest of the calendar year. If you need services at the emergency room or any other covered services in the future, you will still have to pay the copay or coinsurance amount included in your policy, which goes toward your out-of-pocket maximum. If you reach your out-of-pocket maximum, you will no longer pay copays or coinsurance and your insurance will pay for all of the covered services you require for the rest of the calendar year.

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    • Health Insurance and Coverage

    Copays vs. Coinsurance: Know the Difference

    Health insurance is complicated, but you don't have to figure it out alone. Understanding terms and definitions is important when comparing health insurance plans. When you know more about health insurance, it can be much easier to make the right choice for you and your family. A common question when it comes to health insurance is, "Who pays for what?" Health insurance plans are very diverse and depending on your plan, you can have different types of cost-sharing: the cost of a medical visit or procedure an insured person shares with their insurance company. Two common examples of cost-sharing are copayments and coinsurance. You've likely heard both terms, but what are they and how are they different? Copayments Copayments (or copays) are typically a fixed dollar amount the insured person pays for their visit or procedure. They are a standard part of many health insurance plans and are usually collected for services like doctor visits or prescription drugs. For example: You go to the doctor because you are feeling sick. Your insurance policy states that you have a $20 copay for doctor office visits. You pay your $20 copay at the time of service and see the doctor. Coinsurance This is typically a percentage of the total cost of a visit or procedure. Like copays, coinsurance is a standard form of cost-sharing found in many insurance plans. For example: After a fall, you require crutches while you heal. Your coinsurance for durable medical equipment, like crutches, is 20% of the total cost. The crutches cost $50, so your insurance company will pay $40, or 80%, of the total cost. You will be billed $10 for your 20% coinsurance.

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    • Health Insurance and Coverage

    3 Ways to Enroll in a Hometown Health Insurance Plan

    Are you looking for health insurance coverage for the upcoming year? In that case, it's time to browse your options for an Individual or Family Plan. The Open Enrollment Period is from Nov. 1, 2023 until Dec 15, 2023. So, if you're looking for coverage by Jan 1, 2024, you must enroll by Dec 15, 2023. Get a Quote Online Suppose you don't qualify for a health insurance subsidy, no need to worry! You can still choose an individual and family health insurance plan from Hometown Health. Get a quote online by providing your location, the type of coverage you're looking for and your personal/family details. Once you've provided this information, you'll receive health plan options and pricing. And, if you find a plan you like, you can easily self-enroll online. Get Your Online Quote Today Enroll Through the Nevada Health Link Hometown Health offers Individual and Family health insurance plans on Nevada's Healthcare Marketplace, the Nevada Health Link. Through Nevada Health Link, eligible Nevada consumers can shop for, compare and purchase quality and affordable health insurance plans with ease. Nevada Health Link is the only health insurance resource that can provide eligible candidates with federal tax credits and subsidies to help cover the cost of your health insurance. Use Hometown Health's Insurance Subsidy Federal Poverty Level Calculator to see if you qualify for a tax credit or subsidy. Enroll via Nevada Health Link Work with a Health Insurance Broker  Hometown Health is northern Nevada's local insurance provider and if you have questions about Individual and Family Plan insurance benefits, you’re in luck! Hometown Health partners with our local health insurance brokers who will work with you, typically at no cost, to help you understand health insurance plans and benefits and find the plan that is best for you. Need assistance finding a broker? Connect with our team by submitting the form below. They'll provide you with a list of our local broker partners. Find a Broker Near You

    Read More About 3 Ways to Enroll in a Hometown Health Insurance Plan

    • Health Insurance and Coverage
    • Telesalud
    • MyChart

    3 Unexpected Perks of Choosing a Hometown Health Plan

    Becoming a Hometown Health plan member opens you up to the largest provider network in our region. As northern Nevada’s only not-for-profit health insurance company, the hometown advantage goes beyond your health coverage – and you may not be using all the perks available to you. Here are three benefits that Hometown Health is proud to offer all members to enhance wellbeing and connect the dots between healthcare and technology.  MyChart  MyChart is Renown Health's and Hometown Health’s secure online member portal that gives you direct access to your health and benefit information. From 24/7 access to your benefits and important documents to scheduling an appointment with your provider, this free tool is a great way to keep track of your family’s health. If you have a Renown primary care provider, you can use MyChart to:  Securely email your healthcare provider. Get your test results faster and view your After Visit Summaries. Request prescription refills. Schedule and check-in for appointments. Pay your bill. Request your medical records and review immunization records. Manage designated health care agents and upload end-of-life documents, such as advance directives and a living will. View or download your documents: Member ID Card, Summary of Care, Explanation of Benefits, Referrals and Authorizations. Get in touch with our Customer Engagement Center.  Telehealth  Virtual visits have never been easier thanks to Renown Telehealth and Teladoc. These two tools are convenient options that allow members to be seen by a qualified doctor via phone or video chat who can diagnose, recommend treatment and prescribe medication for many non-emergent medical conditions – no matter where you are. Some of the health issues your virtual provider can treat include:   Cold and flu Allergies Sore throat Sinus infection Respiratory infection Stomach bug Ear infection Urinary tract infection  Both Renown Telehealth and Teladoc are also staffed with specialists in behavioral health, where you can speak with a therapist or psychiatrist on a wide variety of issues, including:  Stress and anxiety Depression Trauma Grief Burnout Medication management  Renown is also proud to offer access to top-level specialty care to address your ongoing condition and help guide you through illness maintenance and education. Through Renown Telehealth, Hometown Health members have access to a variety of specialties, including (but not limited to):  Adolescent Medicine Cardiology Hematology, Oncology and Pediatric Oncology Nephrology Pediatric Endocrinology Pediatric Neurology Pulmonary and Pediatric Pulmonary Sleep Medicine  New in recent years, Teladoc is now proud to offer both dermatology and nutrition visits. Teladoc dermatologists can treat conditions like acne, rosacea and rashes, while their registered dieticians can help you manage your nutrition and weight goals.  Booking an appointment with Renown Telehealth is easy by heading over to MyChart and selecting “Schedule an Appointment.” To book an appointment with a Teladoc provider, visit teladoc.com or download the Teladoc app.  Renown Telehealth is available within the state of Nevada, and Teladoc is available in all 50 states. Your copay can be as low as $0 for each visit; check your plan documents for more information.  Doctoroo  The house call has returned – avoid long urgent care waits with Doctoroo. Through Doctoroo, Hometown Health members have access to in-home urgent care services at the same price as your regular urgent care copay. A call to Doctoroo will dispatch a fully equipped medical team consisting of an EMT and either a nurse practitioner or physician assistant to your home within a few hours. Whether you need treatment or testing, each team is ready to provide care in the comfort of your own home with their over 60 medications and antibiotics, EKGs, wound dressings, IVs, catheters and more.  Doctoroo care teams can address and treat many non-emergent care areas and conditions, including (but not limited to): Respiratory Ear, Nose, Throat Eye Wound Care Cardiac Care Musculoskeletal Gastroenterology  Doctoroo is open year-round from 7 a.m. to midnight. Book a house call in minutes in the Doctoroo app or by calling (888) 888-9930.

    Read More About 3 Unexpected Perks of Choosing a Hometown Health Plan

    • Ensayos clínicos
    • Investigación y estudios
    • University of Nevada, Reno
    • Empleados

    Department Spotlight Clinical Research

    May 20 is National Clinical Trials Day. Celebrate with us by recognizing the Clinical Research team at Renown Health!  The root of every medication, treatment and procedure in healthcare can be traced back to research. From the beginning of the history of medicine, research has always played a crucial role in improving the lives of patients around the world, leaving a permanent mark on how we expand our medical capabilities to this day.  Renown Health’s Clinical Research team, in partnership with the University of Nevada, Reno School of Medicine (UNR Med), are leading that effort in our very own community. As our in-house leaders of clinical trials, this team is dedicated to advancing the science of medicine to help further our bottom line of making a genuine difference in the health and well-being of the patients they serve.   Trial by (Medical) Jury  Every day looks different for the Clinical Research team, especially when it comes to interacting with patients, providers and “sponsors,” which are the organizations providing the treatment for the study. One fact always remains true: communication and collaboration are key, especially among the team who act as the face of this process.  Meet Lisa English (pictured above on the far right in a blue shirt), a Lead Clinical Research Coordinator at Renown who serves as the study "project manager." One aspect of Lisa’s day-to-day is seeing patients through their clinical trials from start to finish.  It all begins with the setup.  “Before we can launch a study, there is a lot of back-and-forth dialogue between everyone involved to ensure the best fit,” said Lisa. “Sponsors will come to us with novel treatments, such as medications or devices, and the inclusion criteria that patients need to meet in order to qualify for the study. We then immediately jump into working with the providers, looking closely at the science and comparing the treatments to what is on the market already.”  From there, Lisa coordinates conversations between the providers, sponsors and study teams to gauge everyone’s capacity based on the length of the study, ensuring everyone involved has the time to dedicate to the process. Next, the providers identify patients that meet the criteria for the study, and together, the team decides where the patient visits will happen and discusses any potential barriers that may affect patient retention. The budget is clearly defined at this stage, set up to make sure no patient is ever billed for medical costs incurred as a result of the study.  Often, research participants are seen within the specialty clinics throughout the health system, while other times the Clinical Research Coordinators see patients at the recently centralized Clinical Research Office at Renown Regional Medical Center. This location provides an essential public-facing space for the community to learn more about clinical trials and demonstrates the breadth of resources available at Renown to sponsors to strengthen external partnerships and research funding opportunities.  Once the study officially begins, team members like Lisa will set patients up for a “screening/qualifying visit.” During this appointment, she makes sure patients get scheduled for their lab work, imaging scans and anything else the provider may need to make an executive decision on whether or not the patient is a good candidate for the study.  “I build it all in Epic,” said Lisa. “The study information, directions, requirements and next steps are all loaded in Epic for easy tracking. We are also required to input any notes in the sponsor’s electronic data capture website. All the information I track is inputted without protected health information (PHI), so every patient is completely anonymous.”  After the patient officially qualifies, the study goes full steam ahead. Team members like Lisa and the providers receive continual updates from sponsors on the status of the study.  “Throughout the entire process, I make sure patients get scheduled for everything that meets the requirements for the study,” said Lisa. “I meet with patients one-on-one to discuss their needs and concerns and ask questions about the study, organize their appointments and charts and deal with any issues or pivots that may arise. It’s very important that every patient fully understands what is going to happen with their care.”  The Clinical Research department strives to serve as a care partner to patients, providers and clinics they work with. The majority of our Clinical Research Coordinators are trained phlebotomists and medical assistants, performing their own assessments such as lab draws and electrocardiograms (ECGs) to streamline the research visit process and reduce resource constraints on the clinics and health system.  Lisa typically sees a couple of patients per week, depending on the study and where patients are in the cycle. Depending on the complexity of the trial, patients may see the research team only one time or several times over many years. Typically, clinical trial patients are seen in clinic every 2-4 weeks. There are many tasks required before, during and after a research visit to ensure everything runs smoothly, so Clinical Research Coordinators dedicate an average of 5-11 hours of work per patient, per visit.  Regardless of patient load, each employee in the Clinical Research department – as well as participating teams across Renown and UNR Med – always step in to help each other out. According to Lisa, the environment is immensely supportive.  “We have a program here at Renown to train employees who have never done clinical trials,” said Lisa. “We love seeing people get more engaged with the important work we do, and every department has been great at collaborating with us. Everyone brings a different perspective.”  At the end of the study, Lisa gathers all the information and collects notes into a zip drive or paper binder for archiving. The sponsor lets the Clinical Research team, providers and patients know whether they are on the trial drug or on the placebo. The teams use the data gathered during the study to publish a report or present at conferences, promoting the critical research done to better the lives of patients in our community, and potentially, the world.  “I appreciate the time everyone gives us to make sure our research is successful,” said Lisa. “It feels great to work together to make a difference, improve healthcare quality and save lives.”  Behind-the-Scenes, Yet on the Frontlines  The impact of research studies transcends hospital walls, and this can all be attributed to the dedication of our Clinical Research department. The constant collaboration between this team, lab science, medical assistants and providers, cardiology technologists, sonographers, finance teams and our partners at UNR Med is crucial to safeguarding the success of the studies.  Devoted to keeping research close to home, Renown and UNR Med teamed up to form the Clinical Research Office (CRO) in 2021. With the strength of northern Nevada's largest not-for-profit health system and Nevada’s first medical school, this team is dedicated to giving our community access to the latest care innovations.  “At UNR Med, we are working with students, residents and academic faculty; on the Renown side, we are working with clinicians and community participants,” said Amber Emerson, Manager for Community Outreach and Research Engagement for UNR Med.  “Everything we do is data-driven,” added Kristen Gurnea, Manager of Clinical Research for Renown. “Our main goal is to optimize our impact and provide a community benefit for our patients. The scope of our roles in the Clinical Research office is very diverse.”  To help meet the growing need locally for healthcare and cutting-edge treatment solutions, the CRO has continued to grow, expanding its research capabilities and helping bring new medications, medical devices and more to patients across northern Nevada and northeastern California.  “Once upon a time, our team had only six members; today we have grown to a team of 25,” added Diana Torres, Research Resource Analyst for Renown. “We used to be considered one department, including Medical Education, and we have since branched off into our own cost center. We branched off even further and created a separate Genetics department that runs the Healthy Nevada Project. Throughout this process, the Clinical Research department was always the main point of the umbrella.”  “We participate in hospital-wide outreach and marketing, and we feel this has really helped us get the word out about our department,” added Raul Arellano, Research Resource Analyst for Renown. “In fact, we doubled our clinical trial portfolio from last year.”  The CRO currently operates over 100 clinical trials locally in cardiology, endocrinology, infectious disease, neurology, pediatric and adult oncology, pediatric sub-specialties and pulmonology.   Behind the curtains of in-person research, the CRO is home to several experts who help turn our research studies into a reality, from budgeting and billing to barrier-breaking and building relationships.  “I help with barriers patients and Clinical Research Coordinators are facing, building connections and relationships inside and outside of our health system,” said Kristen Gurnea. “I enjoy handling all the supporting pieces that are required for studies to happen.”  “My role changes every day,” added Jenna Berger, Administrative Assistant for the CRO at Renown. “Some days, I’ll be helping coordinate patient stipends and going through document management to ensure we have all necessary signatures. Other days, I will be planning events – like Clinical Trials Week – for our department and creating marketing materials and fliers.”  “Our day-to-day involves going over anything related to research financials,” added Diana Torres. “We handle sponsor billings, process efficiency and collecting revenue for research contracts, and we collaborate closely with our Finance department and Revenue Integrity in order to accomplish this. It’s important for us to make sure all billing on both the sponsor and patient side is taken care of, especially because patients should never receive a bill for medical services they receive for the trial. A year and a half ago, we started doing budget negotiations for research contracts,” said Diana Torres. “We are proud to help clinical teams with any training they may need on these negotiations as well as billing reviews and allocations.”  Seeing patients progress during a study and transform before their eyes inspires the CRO team to continue doing what they do every day.  “I’ve been here for many years, first working on the floor as an oncology nurse and transitioning to oncology research in 2005,” said Anna Winchell, Cancer Protocol Nurse for Renown. “I love getting to know the patients and seeing them progress into a healthy lifestyle.”  Medical students and residents at UNR Med also play a significant role in the research process, advancing medicine by exploring causes and novel treatments for a wide range of conditions, including HIV, muscular dystrophy, gastrointestinal disorders, infectious diseases and more. Medical research at UNR Med is headed by committed research coordinators, community outreach managers, grants managers, pharmacists and physicians.  “I oversee scientific review and help the physicians that come to us for those resources,” said Amil Trujillo-King, Medical Research Coordinator at UNR Med. “I guide medical students in their research protocols and help with different projects to improve research activities for both students and medical residents.”  It takes a village to make clinical research happen. Because of that, the ACRO cannot thank the following teams enough for moving mountains for the future of medicine:  Renown Health and UNR Med leadership for demonstrating the integrated health system’s commitment to expanding access to clinical research in our community within both the Renown / UNR Med affiliation and Renown active strategic plans.  Renown Pharmacy especially Research Clinical Pharmacist Tim Morton, who supports all clinical trial medication dispensing and patient education across all clinical trials at Renown.  Accounts Payable for having a huge impact on patient and employee reimbursement.  Renown Medical Group for their participating providers, especially in oncology, cardiology, pulmonology, pediatrics, endocrinology and neurology, who are involved in research year after year.  Marketing and Communications for helping with printed materials and raising awareness for clinical research at Renown and UNR Med.  An Affiliation to Last Through the Ages  A collective, shared vision of exploring community health – that is the impetus behind the affiliation between Renown and UNR Med. By leveraging resources across both institutions, the CRO has maximized their impact, giving the people of northern Nevada greater access to new interventions and treatments and promoting an impassioned culture with patients, providers, residents and medical students.  “Community-based research always sat well with me,” said Amber Emerson. “As Renown and UNR Med, we have this unique opportunity to shape clinical research here in northern Nevada. We always make sure we present research in a meaningful way that speaks to the work we produce and demonstrates the opportunities we offer. After all, participating in clinical research doesn’t mean our patients are ‘guinea pigs’ – quite the opposite! They are partners in their health care, and we support them through providing access to novel treatments.”  “Research is my passion, and my career has spanned broadly from grants administration to study coordination,” added Valerie Smith, Clinical Research Center Administrative Manager at UNR Med. “I am excited to be at the forefront of research frontiers in northern Nevada.”  Through robust engagement and collaboration with healthcare providers, department administrators, internal research team members and leadership, the strength of this affiliation is unmeasurable. The CRO’s ultimate goal is to have clinical trials be the standard of care for every condition that Renown and UNR Med treats. Clinical research participation is all about patient autonomy, shared decision-making between patients and their providers and advancing medicine to save lives. From their beginnings as a small group of passionate researchers to their present reality as a leader in the research space in northern Nevada, their efforts do not go unnoticed.  “The success of our department is inspiring,” said Amil Trujillo-King. “Renown and UNR Med supports the wellbeing of all employees and contributes directly to the growth of the department.”  “When I first joined Renown in Patient Access, I didn’t realize that we had a research department; with a strong healthcare background in my family, I knew I wanted to grow in my career, and our expanding Clinical Research office was that next step,” said Raul Arellano. “With our affiliation with UNR Med, it’s especially inspiring to be able to apply what I learned as a Patient Access Representative to help further outcomes for our patients through managing our finances.”  Through their unwavering commitment to research excellence and patient-centered care, the CRO will continue to pave the way for groundbreaking medical discoveries and improved outcomes for patients for years to come.  “Fundamentally, we’re working to build a culture of research in our community because we believe it is the right thing to do. Our community deserves to have access to clinical trials and novel care close to home with a dedicated team to support them every step of the way,” closes Kristen Gurnea.

    Read More About Department Spotlight Clinical Research

    • Health Insurance and Coverage
    • MyChart
    • Renown Health

    How Referrals Work at Hometown Health and Senior Care Plus

    Your provider wants to send you to a specialist. Now what?  You are about to enter the referral process. A referral is your provider’s recommendation for you to see a specialist or receive specialized treatment. When it comes to referrals, the process can seem like the wild west for people not familiar with it. At Hometown Health and Senior Care Plus, we make the process simple for all our members. We know that access to specialists is a vital aspect of total health, and our goal is to break down those barriers to care at every level.   Here is a step-by-step guide to how the referral process with your Hometown Health or Senior Care Plus provider works:  1.   Your primary care provider (PCP) or urgent care provider will send a referral to the specialist’s office. A referral can also be sent from another specialist or after discharge from the hospital. This is usually done via email or fax.   2.   As your referral is sent, now would be the ideal time to discuss with your provider’s office how the specialist will receive your medical records prior to your appointment. Your provider’s office will most likely send these records to the specialist for you, but it is always a good idea to double-check with them directly.  At Renown, the referrals team will send the following items to your specialist’s office when available:  ID Insurance card Most recent and relevant office notes to support the referral The referral order Any relevant labs or imaging pertaining to the referral Demographics information  3.   The specialist’s office will call you to schedule the appointment after they receive the referral. Each office processes the referrals they receive in a slightly different time frame, so if you have any questions about the status of your referral, it is best to call their office directly. At Renown, if you are enrolled in MyChart, you can access the phone number for your specialist as soon as the team processes the referral. Those not enrolled MyChart will receive a letter in the mail with scheduling information.  4.   The specialist will start to develop a course of treatment. That may include procedures, diagnostic tests or medications. Some of these treatments may require prior authorization from your insurance plan, so don’t forget to discuss how and when your specialist will receive the authorizations before you begin your course of care to avoid any surprise bills.  What can I expect if I have a Renown specialist?  At Renown, we handle a lot of the behind-the-scenes nitty-gritty so you don’t have to. After the referral is placed, it routes to Renown’s centralized referrals team and triaged to make sure you are scheduled with one of our providers with the right specialization for your specialty care needs. This team will also obtain the prior authorization you need and will you to a specialist that is in your network and based on you and/or your provider’s preference and continuity of care. The referrals team will attempt to find you a Renown provider first if you are not yet established elsewhere.   For Hometown Health and Senior Care Plus members, prior authorization is not required for certain services if you are being referred to a Renown provider. This makes the scheduling process go quicker for both the provider and the patient.   Our referrals team strives to keep their turnaround time for referrals within three business days, not including prior authorization wait times. If your referral is marked as ‘urgent,’ it will be reviewed within one business day so you are seen as soon as possible based on the needs of your medical condition, and you will receive a direct phone call with scheduling information.   After prior authorization is obtained, the Renown scheduling team will call you through an automated phone system or via a message in MyChart with a direct link to schedule your appointment. To speak with a Renown scheduler or if you have any questions, please call 775-982-5000.  What does prior authorization mean?  Prior authorization isn’t as scary as it sounds! Essentially, prior authorization is your provider “going to bat” for you to receive this specialty level of care. Some medical services, including many specialists, are covered only if your ordering provider (usually your PCP) submits an authorization request to your insurance plan. They will include specific details about the type and duration of treatment they would like you to receive and any medical records that support your need for the specialist.  After your insurer receives the request, a licensed medical professional will review the request, your records and your plan benefits. They will decide whether the specialty treatment is considered medically necessary based on recognized standards of care.  Where can I go for more information?  Your referrals and authorizations can be viewed in MyChart. To view them, navigate to Your Menu in the upper left corner of the page, scroll to the Insurance section and click on “Referrals.”   The Renown referrals team is available to answer your questions and address any concerns. Give them a call at 775-982-2707 Monday through Friday from 8 a.m. to 5 p.m.  Any questions you may have related to referrals and authorizations, including outside-of-Renown providers, can be directed to our expert Hometown Health or Senior Care Plus customer engagement representatives.

    Read More About How Referrals Work at Hometown Health and Senior Care Plus

    • Atención pediátrica
    • Niños seguros

    2 Errores peligrosos en el asiento del automóvil y sus soluciones

    Car seat mistakes can have very serious consequences. Misuse of a car seat can injure your child, or fail to keep them safe in the event of a crash. A lot goes into finding the right car seat for your child. With so many factors to consider (including age, weight and height of the child, type and brand of a car seat, cost of the car seat, etc.) it can be easy to forget critical factors. Here are two common mistakes that certified technicians often find when speaking with parents. Mistake #1: Getting a used car seat without knowing its history Why: A used or secondhand car seat can pose several factors that can compromise its safety in a crash. First, car seats expire six to ten years after their date of manufacture, so refer to the car seat's manual for recommended car seat longevity. The safety mechanisms can be compromised if a car seat has been in a crash. So it's crucial to replace your car seat following a collision. Solution: Only use a car seat if you know its history. A new car seat is your best bet, as they are up to date on the latest safety guidelines, and safety mechanisms are up to standard. However, if you are considering a used car seat for your child, please ensure the following: The car seat has never been in a car crash. The car seat isn't expired or outside the manufacturer's recommended longevity. It comes with the car seat manual and has all safety labels, including manufacture date, model number, and use instructions and restrictions. The car seat or any of its parts have not been recalled. The overall state and integrity of the car seat and its parts are undamaged. The carseat or any of its parts have not been recalled and are present and in working order.

    Read More About 2 Dangerous Car Seat Mistakes and Solutions

    • Health Insurance and Coverage

    Understanding "In-Network" and "Out-of-Network" Providers

    When finding a provider to receive your health services, you've probably heard the terms "in-network" and "out-of-network" when it comes to your health plan. But what do these terms mean for a patient? And why should you be aware if a provider is out-of-network? What does it mean when a provider is "in-network" with a health plan? A provider is a person or facility that provides healthcare. When a provider is in-network it means there is a contractual agreement with that health plan regarding the rates for services. The provider will accept negotiated rates for services from the insurance. This means a patient will typically pay less for medical services received and is less likely to receive surprise bills. What does it mean when a provider is "out-of-network" with a health plan? Providers that are out-of-network are those that do not participate in that health plan's network. The provider is not contracted with the health insurance plan to accepted negotiated rates. This mean that patients will typically pay more or the full amount for the service they receive. Why should patients see in-network providers? Seeing an in-network provider for medical services can significantly reduce your medical expenses. Remember that in-network providers have a contractual agreement for negotiated rates with the health plan, so they cannot charge you more than that negotiated rate for a service. Seeing an in-network provider will always ensure any costs you do incur (copays or co-insurance) are applied to your health plan's deductible and out-of-pocket maximum (out-of-network costs don't apply to these amounts). To find the amounts you will pay for specific services, you can check your health insurance plan's Summary of Benefits. What is the best way to find which providers are in-network with a patient's health plan? Most health insurance companies offer multiple ways to find if a provider is in-network. To find the most accurate benefit information from your health plan, you can: Call their Customer Service department Check their website for their online provider directories If offered, check your online member portal.

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    • Atención pediátrica
    • Salud infantil
    • Niños seguros
    • Smoking

    How to Talk to Your Children About Vaping

    According to the Centers for Disease Control (CDC), e-cigarette use isn’t just up among adults, but it has also tripled in usage for teens. Dr. Jose Cucalon Calderon, a Pediatrics Physician at Renown Health and an Assistant Professor of Pediatrics at the University of Nevada, Reno School of Medicine, provides helpful insight into e-cigarettes and the dangers it poses to kids and teens.   What Are E-Cigarettes? E-cigarettes are electronic nicotine delivery devices. e-cigarettes use liquid nicotine as an alternative to traditional smoked cigarettes. e-cigarettes contain nicotine which is an addictive substance with known toxic side effects that, when released in very high doses, that can have health consequences and causes addiction. Nicotine is described as “toxic,” but the most "toxic" part of e-cigarettes' is everything else within the E-juice. Nicotine mainly keeps people coming back for more. According to the CDC, e-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth use of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources, and approximately 74% of students who used social media had seen e-cigarette–related content. What Does This Mean for the Health My Teen? We know that nicotine can affect brain development in kids and teens, so it is important to educate your teen on the risks of exposure. If you have young children in the home, it is important to be vigilant as well. One teaspoonful of liquid nicotine can be fatal for a young child. How Do I Monitor My Teen for E-Cigarette Use? Monitoring your children can be tricky for parents. E-cigarettes can be harder to detect, unlike traditional cigarettes that were easy to detect by smell and residual odor. E-cigarette use, or “vaping,” is often associated with a dry cough or chronic throat/mouth irritation. Overall, increasing research shows strong links between mental health conditions and posterior combustible tobacco use along with increased risk of marijuana use. Nicotine is addictive, but it does not cause altered mental status like the other drugs of abuse can. All parents are strongly encouraged to talk to their children about the potential dangers of e-cigarettes.   What are the health risks of vaping? Vaping devices have been on the market for a relatively short period of time, with evidence-based health effects and complications still being discovered. Vaping effects poses many harmful risks to children and teens. The risks of vaping include: Chest pain Difficulty breathing Dizziness Headaches Impaired response to infection in the airway Inflammatory problems of the airway Nausea Nicotine addiction Seizures Vomiting   For more information for both parents and teens about quitting smoking or vaping, you can click here. Parents can also use this tip sheet from the U.S. Surgeon General to talk to their child about vaping. The Substance Abuse and Mental Health Services Administration free national helpline number is 1-800-662-4357 (HELP). It is available 24/7, 365 days a year offering confidential treatment referral and information (in English and Spanish). If you or someone you know is facing a substance (or mental health) problem, please reach out to them.

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    • Neurología
    • Rehabilitación física
    • Niños seguros

    Know Before You Go

    Grab your skis, goggles, coat – and don’t forget that helmet. Skiing and snowboarding are fun activities for all ages but come with the risk of injury. Read on for tips to make it a safe day on the mountain. Daydreaming about your next trip to the slopes? We talked to Jared Worchel, DO, about his top tips for gearing up. Get the Gear Before you head out to ski or snowboard, make sure you have all your gear ready and in good condition. Everything should fit correctly so that it keeps you as safe as possible. Wearing proper gear will also help keep you warm. Items to check on before you head out include: Boots Bindings Goggles Poles Helmet Outwear Gloves Pack water and snacks in case the drive takes longer than you except due to weather or traffic. You’ll also want to make sure that your cell phone is fully charged before you head out in case you need to contact friends of staff for help while on the mountain.  Helmet, Helmet, Helmet Having a helmet that fits correctly is the most important thing you can do to prepare for a safe day on the mountain. According to a National Ski Areas Association study, helmet use has increased over the last 15 years, with 80 percent of skiers and snowboarders using helmets. Schubert would like to see that number increase to 100 percent. “If you have a head injury it could take you out for the rest of your life,” Dr. Worchel said. “The most important things to think about when fitting a helmet are making sure that it really fits you appropriately. You want to go into a store and try on as many different helmets as they have available. I know it’s tempting to buy one online, but you’re never going to know if it fits correctly.” If you are in an accident, your helmet’s fit can help protect you. Dr. Worchel has some tips on fitting: A helmet should fit low and snug over the head. Make sure that the helmet doesn’t wiggle or feel loose. Look for a model that has adjustability in the back, which will help you make sure it fits snugly. F ind a helmet with a chin strap that will help it stay in place throughout the day.

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    • Salud del bebé
    • Lactancia
    • Niños seguros

    Top Safe Sleep Tips for Your Baby

    Becoming a parent for the first time means lots of new unknowns – from learning to breastfeed and swaddle to buckling your newborn into the car seat for the first time. But when it comes to putting them to bed safely, it’s important to remember it really can mean life or death. It’s something we’re taught before our little one is even here: the correct way to put your baby to bed safely. Sadly though, the number of infant deaths continues to climb. The main culprit of sleep-related infant death continues to be all the items parents leave in the crib with their babies. According to the Center for Disease Control and Prevention, there are about 3,500 sleep-related deaths among babies each year. “The best advice is ‘bare is best.’ Keep your infant’s sleep space clutter free – no blankets, bumpers, toys or pillows,” said Karen Wagner, Pediatric Nurse Practitioner. Follow the ABCs for Safe Sleep Remembering the ABCs is an easy way to remember how to put your little one to bed safely. A: Alone No blankets, toys or pillows. “We do recommend using a sleep sack as a blanket alternative,” said Karen. “It prevents the risk of suffocation and keeps your baby warm.” Keep in mind, the greatest risk for suffocation happens when babies are under 1 year of age, so it’s best to save the toys, blankets and pillows for their “big kid bed,” or around 18 months old. B: Back The slogan “back is best” is another good reminder. Keeping your baby on their back until they’re old enough to rollover helps reduce the risk of Sudden Infant Death Syndrome (SIDS). C: Crib It is best to have your baby sleep alone in their crib. While co-sleeping may be enticing, especially after a late-night feed, it increases the risks of possible suffocation. However, “having your child in your room, in their own crib or bassinet, is protective for SIDS,” Karen said. “In fact, we think co-rooming reduces SIDS risk by almost 50 percent.” Co-rooming allows parents to keep new babies in close reach and helps parents oversee their baby’s sleep, just in case something happens.

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