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Sepsis happens when a person's body reacts too strongly to an infection. Usually, our bodies fight infections with help from our immune system. But with sepsis, the body fights too hard, and that can be dangerous. Dr. Julianne Wilke, Pediatrics and Critical Care Medicine, examines pediatric sepsis's causes, symptoms and treatments and provides tips on preventing this potentially fatal condition. Most Common Causes Pediatric sepsis is a particularly concerning form of sepsis that can occur in children and infants. Therefore, it is vital for parents and caregivers to be aware of the indications of pediatric sepsis and to understand the causes. Bacterial infections are the most common cause of pediatric sepsis, accounting for over 80% of cases. Common Bacterial Causes: Staphylococcus infections (including Methicillin Resistant Staphylococcus Aureas - MRSA) Streptococcal infections (including those causing pneumonia and group B strep) Escherichia coli, or more commonly; E. coli Klebsiella and Pseudomonas infections Viral Infection Causes: Respiratory syncytial virus (RSV) Influenza Parainfluenza Adenovirus Human metapneumovirus Coronaviruses (including COVID-19) Other Causes: Fungal infections (but are relatively rare) Parasites, such as Giardia lamblia Pediatric Sepsis Symptoms Parents and caregivers need to be observant of sepsis symptoms in children and can include: Fever Extremely fast heart rate Rapid breathing Lethargy Pale or discolored skin Low blood pressure Confusion Slurred speech Abdominal pain Diarrhea & Vomiting Decreased urination Difficulty breathing Use the acronym SEPSIS: S – Slurred speech and confusion E – Extreme shivering or muscle pain/fever P – Passing no urine all day S – Severe breathlessness I – “I feel like I might die.” S – Skin mottled or discolored If any of these symptoms are present, seeking immediate medical attention is imperative.

Read More About Pediatric Sepsis: Causes, Symptoms and Treatment

Respiratory syncytial virus, also known as RSV, is a common respiratory virus that impacts the lungs and breathing pathways. The virus can be dangerous for infants and young children and is also concerning for older adults. While most older kids and adults only experience cold-like systems and recover in a week or two, an estimated 58,000-80,000 children younger than 5 years old are hospitalized due to RSV each year, and in 2022 healthcare organizations across the country are experiencing higher infection rates than in years past.  "We are experiencing a strong RSV season and do not expect it to go away anytime soon," said Dr. Kris Wilson, Division Chief of Renown Children's Primary Care. "Infants who are infected with RSV almost always show symptoms of runny noses and cough. Call your healthcare provider immediately if your child is having difficulty breathing, is not drinking enough fluids, or is experiencing any worsening of these symptoms.” Symptoms of RSV: Runny nose  Decrease in appetite/inability to drink Dry diapers, an indication of dehydration  Cough, which may progress to wheezing or difficulty breathing Irritability (most common in very young infants) Decreased activity (most common in very young infants) Decreased appetite (most common in very young infants) Apnea, pauses in breathing for more than 10 seconds (most common in very young infants) What to do if you think your child has RSV: Call your pediatrician! If you suspect your child might have RSV, consulting their healthcare provider is the best first line of defense. From here they will help you build an appropriate treatment plan for child. Keep in mind that many pediatrician offices offer 24/7 call lines.  If your child is experiencing retracted breathing (when the area between the ribs and in the neck sinks in when a person attempts to inhale), dehydration (not drinking and decrease in wet diapers) or apnea (pauses in breathing for more than 10 seconds) please call 911 or go to the closest emergency room.

Read More About What You Need to Know About RSV

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 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.

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

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.

Read More About Copays vs. Coinsurance: Know the Difference

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

Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!  STI Testing  Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year.   Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you.  Prostate Exams  Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old.  These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened.  Pap Tests and Pelvic Exams  Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer.  Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings.  Mammograms and Breast Exams  People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual.  The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project.  Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.

Read More About 6 Healthcare Action Items for the LGBTQIA+ Community

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

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

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.

Read More About Understanding "In-Network" and "Out-of-Network" Providers

Do it for the patient. That’s the motto that each employee in the Customer Engagement Center (CEC) lives by every single day. This team spins all the existing stereotypical thoughts about call centers on their side by empowering and partnering with patients to achieve their best health. Being transferred around several times just isn’t in this team’s DNA – being a one-stop-shop for patient scheduling, referrals, insurance matters and more is how they proudly operate. Through elevating the customer engagement experience, the CEC closes care gaps to ensure patients get the right care at the right time. From employees who work from our home base in Reno, all the way to the southeastern corner of Florida, this primarily remote team stays firmly connected and collaborative to make patient care possible for all Renown Health patients and Hometown Health and Senior Care Plus members.  The “Make It Happen” Department  Back-to-back phone calls about a wide variety of patient needs? They make it happen. Referrals that need to go directly to the provider? They make it happen. Complex insurance questions that need to be resolved? They make it happen. The CEC is the keeper of all things customer service and all things patient satisfaction, leveraging technology to improve engagement and accessibility – and they wear that badge with pride.  “Patient care is our first priority,” said Cindy Arevalo, Supervisor of Customer Engagement. “Even though we aren’t face-to-face with them, we are always there to help them over the phone with whatever their needs are.”  The CEC has a lot of different sub-departments under its umbrella: scheduling, referrals, insurance, patient outreach, personal assistants, MyChart customer service and more. Each team handles calls for a different section of our health system, including the hospitals, imaging, primary care and specialty care. While their individual teams may be different, one aspect of their jobs remains the same: they care. Deeply.  “We advocate for the patient, especially when they can’t advocate for themselves,” said Amanda Ishii, Referral Specialist.  “We are the first people that patients speak to, and we all have empathy to listen to them, help them solve their problems and take as much time as they need to care for their needs,” added Susana Arroyo Garcia, Supervisor of Customer Engagement.  Customer loyalty is key to the CEC. Every CEC team member builds strong relationships with patients and members. Whether they manage patient outreach or manage back-to-back inbound calls, each employee feels a special connection to the helpful work they do to solve a variety of patient concerns.  “As Senior Care Plus Personal Assistants, for instance, we help guide our members through complex situations, and we eliminate the process of transferring them to different departments, becoming a ‘one-stop-shop' for them,” said Stephanie Perez Campbell, Senior Care Plus (SCP) Health Coordinator. “While every day is different, we are constantly learning new things and helping members navigate through the health system."  With the 4.5 million calls the CEC handles per year, the nature of their jobs is undoubtedly fast paced. However, this does not intimidate the CEC team members; instead, it inspires them to continue reaching new milestones, helping thousands of patients and members every year by handling all the scheduling and referral work on the backend so that they can receive the care needed.  “I never find myself sitting around asking, ‘what should I do next,’” said Gina Briles, Supervisor of Customer Engagement. “We always support each other to stay on top of it all in order to take care of our patients.”  By wearing a lot of hats and managing many different work queues all while staying engaged with each patient, the CEC is full of natural problem-solvers, helping our healthcare network run smoothly.  “The Engagement Center is the front door for the community; serving as the voice of the customer, we ensure patients do not fall through the cracks of the complex healthcare system and are able to easily access the right care at the right time through an exceptional experience,” said Candace Dietrich, Director of Customer Engagement.   Consistently Connected  With thousands of referrals to process and millions of calls to field, the ways the CEC stays connected to patients and members as well as each other can be related closely to magic. No concern goes unnoticed, and no problem is too complicated.  “The sheer volume of patients we engage with is incredible,” said Rene Jacinto, Manager of Customer Engagement. “We processed nearly 200,000 referrals and authorizations last year.”  “We expect a steady increase of calls year-over-year. My team processed 1,259 referrals in one day alone recently,” added Arielle Gomes, Referral Specialist.  A superpower that every CEC team member holds is the ability to listen. According to this department, active listening is key when problem-solving with every patient and member, as that skill helps them anticipate patient needs and resolve their issues quickly and efficiently.  “I’ll always listen,” said Alex Gomez, Customer Engagement Representative. “I want them to know that they are in good hands, especially when they are feeling scared or frustrated.”  Team members like Alex help carefully guide customers through the Hometown Health and Senior Care Plus enrollment process, increasing membership and engaging patients to find the perfect plan for them.  One of the largest challenges the CEC faces is the departures and arrivals of providers. The ebbs and flows of all hospital systems include provider departures and shifting provider availabilities. Despite this challenge, the CEC staff work hard to ensure communication with all patients regarding provider changes is consistent and that all patients are scheduled in a slot that works for both their schedule and the provider’s schedule.  “It’s important for us to be flexible, because things can change at a moment’s notice,” said Gina Briles. “This is more than just a job – we are here for our patients. What we are doing impacts everyone.”  Throughout all times of transition, the CEC builds robust relationships with both patients and providers within our organization and community, a skill that this team emphasizes as “fundamentally important.” For example, SCP Personal Assistants like Stephanie Perez Campbell will coordinate care with community resources and offices, giving members one less call to make and one less hurdle to cross in order to get the care they need.  On top of it all, even though this team has the ability to work from all 50 states (and many of them work outside of Nevada!), every employee feels connected to their colleagues and their work.  “This is the best group of people I’ve ever worked with,” said Riley Petro, Manager of Customer Engagement – Imaging. “I am super lucky for this job and am so thankful for these people.”  Proud and Powerful  The proof is in the pudding – or rather, the proof is in the numbers. Within the 4.5 million calls they successfully field every year, approximately 1.6 million of those calls route through the private branch exchange (PBX) team – the team that oversees the main operator lines – under the guidance of Jess Nater, Supervisor of Customer Engagement. The CEC is also on track to handle nearly 300,000 referrals this year alone. Additionally, the Hometown Health CEC team was recognized nationally this year with a five-star rating from Medicare.  “We all have the initiative to grow, and because of this, we are always learning something new,” said Cindy Arevalo. “Our leaders also support our growth, especially if we want to skill-build or advance in our careers.”  The CEC is frequently the first stop on the career ladder for many employees as they start their journey in healthcare, and CEC leadership is committed to the growth and development of their teams to reach their career goals at Renown.  The secret formula for all this success can be in part attributed to the pride each CEC employee has for their team, their work and Renown.  “We have a very supportive team,” said Holly Coffey, Supervisor of Customer Engagement. “I’ve seen our leaders support their teams tremendously.”  “We rely on each other,” added Ashleigh Carty, Customer Engagement Representative. "I love the relationships we create with one another.”  Employees in the CEC come from many walks of life, choosing to work at Renown and Hometown Health for a variety of different reasons, many related to the positive power our health system holds. Team members in this department hold a myriad of different career backgrounds, including pharmacy technicians, medical assistants, population health professionals, community health workers and more.  Some team members, like Nikki Clifford, Customer Engagement Representative Lead, heard wonderful things about Renown from her mother, who also works for Renown. According to Nikki, “seeing how happy my mom has been in her career made me want to join too. I’ve loved it here ever since.”   Katie Lunau, Supervisor of Customer Engagement, also grew up in a family involved in healthcare, and she wanted to follow in their footsteps. Choosing Renown as the place to follow her family path was a simple one, because “Renown stood out as the company that was actively involved in the community helping others.”  For other team members, like Susana Arroyo Garcia, Ashleigh Carty and Stephanie Perez Campbell, Renown and Hometown Health’s impact on the local healthcare landscape was their primary driver for choosing a career here and in the CEC specifically.  “Renown is very well-known in the area,” said Stephanie Perez Campbell. “I went to school in Reno for public health, so Renown came up all the time in my schooling. I knew Renown had a lot of different opportunities available for career growth, and with the friendly environment I always experienced here, it was an easy decision.”  “Once I went through the interview process and joined the team, I immediately realized that there are outstanding managers, support systems and communication skills here. People genuinely care,” added Ashleigh Carty.  Ashleigh is exactly right. As emphasized by every team member, employees in the CEC care. Their heightened levels of care and empathy set the bar high for all at Renown and Hometown Health, and their impact will be felt for years to come.

Read More About Department Spotlight: Customer Engagement Center

Senior Care Plus was Nevada’s first Medicare Advantage Plan and is still providing healthcare coverage to qualifying members in Washoe, Carson City, Clark & Nye Counties. Senior Care Plus is administered by Hometown Health, the insurance division of Renown Health. That relationship means Senior Care Plus is the only Medicare Advantage Plan supported and accepted at Renown. This preferred access to Renown is a great benefit for northern Nevadans. When it comes to healthcare coverage, there are three key factors to keep in mind. Here’s why a Senior Care Plus Medicare Advantage Plan is your best choice. 1. Cost Cost matters when searching for the right insurance plan. Of the four Senior Care Plus plans available to residents of Washoe County and Carson City, three offer a zero-dollar monthly premium and all of them offer zero-dollar primary care office visits. That means no out-of-pocket costs for you. Additionally, all Senior Care Plus plans have an annual out-of-pocket maximum. This means when you reach this amount, that’s all you will pay. Senior Care Plus pays all other covered medical benefits for the rest of the year. That’s the beauty of a Senior Care Plus Medicare Advantage Plan. 2. Size of Provider Network and Accessibility Although saving money is important, it’s more important to be able to see a doctor when and where you need to. Senior Care Plus members enjoy the most comprehensive healthcare provider network in the region. Thousands of providers, including many hard-to-find specialists, are in the Senior Care Plus network. Since Senior Care Plus is part of the Renown Health family, you get priority access to all that Renown has to offer, which you won’t find with any other Medicare Advantage Plan. 3. Coverage Medical coverage needs are personal and unique to every member. Understanding a plan’s benefits is essential when picking the best coverage for you. Of course, the important benefits you associate with a healthcare plan are included in all Senior Care Plus plans: urgent care visits, specialists’ visits, lab services, imaging — all with reasonable copays. What sets Senior Care Plus apart from the rest are the additional benefits for preventive health. For example, Senior Care Plus offers plans with a comprehensive dental benefit with first-dollar coverage, meaning you pay nothing until the benefit limit is reached.  Senior Care Plus Medicare Advantage Plans also have a vision benefit allowing you to get a new pair of eyeglasses every year. In addition, these plans offer a fitness benefit, so you can join a local gym because Senior Care Plus wants to keep you healthy. Another interesting benefit is the over-the-counter benefit. If you choose the Renown Preferred Plan, you can select $50 worth of over-the-counter products such as: cold medicine, dental products, diabetic supplies, and digestive aides. Remember, that’s $50 worth of over-the-counter products four times per year. All on a plan that doesn’t cost a thing. Senior Care Plus Medicare Advantage Plans offer many added benefits tailored to Nevadans.

Read More About 3 Reasons to Choose a Senior Care Plus Health Plan