Riverside introduced the Riverside Care Advocate program, offered through Health Advocate, in January 2012. Riverside Care Advocate will be extended to all health plan participants at no additional cost. (Eligibility was previously limited to PPO plan participants with a designated RMG Primary Provider.) The Riverside CareAdvocate program provides personalized assistance to help you and your eligible family members resolve healthcare issues to save time and money. Eligible family members include your spouse, dependent children, parents and parents-in-law even if they are not enrolled in the health plan.

Riverside will continue to offer Wellness Coaching services to health plan participants in 2013. This service is provided by Health Advocate to Riverside's health plan participants at no additional cost. Services include personalized wellness coaching, wellness workshops, online meal and exercise planning tools as well as health trackers and logs, authoritative health information, and MedChoice Support™ which is a comparative tool designed to help users consider medical care options.

Getting started with the CareAdvocate and Wellness Coaching programs is easy. Visit the web site at HealthAdvocate.com/riverside or call Health Advocate at 866-799-2643.

Riverside Care Advocate Program Services

Personal Health Advocate
The Personal Health Advocate (PHA) is a trained professional, typically a registered nurse or a person experienced in benefits and administrative issues, who can handle claims, benefits, grievances, paper work and other issues. As soon as you contact Riverside Care Advocate, a PHA establishes a relationship with you and stays with you through the resolution of your problem.

Care Coordination
Your PHA can help you coordinate care among physicians and medical institutions. This may include:

• helping you understand tests, treatments, and medications,
• assisting you through complex medical conditions
• arranging for home-care services and equipment

Claims Assistance
Your PHA may help you sort out and solve claims and related paperwork problems and assist you with coverage and benefits issues.

Grievance Advice
As appropriate, your PHA can provide advice and/or assistance to you when filing a complaint or grievance with your health insurer.

Coverage Advantage^TM
Your PHA may help you through the coverage review process and, when necessary, may also assist in identifying alternative coverage options.
 
RxAdvocate^TM
Your PHA may assist you with prescription drug issues including formulary and benefit questions.

Health Cost Estimator^TM
Your Health Cost Estimator (HCE) provides you with zip-code based estimates for common medical services and procedures. Your PHA may provide you with personalized and easy-to-understand reports highlighting a range of comparative cost estimates for the service in question, and will help answer any questions you may have.

Health Advocate CareQuest
This service can help locate resources and make arrangements for you if you need special services that fall outside the realm of traditional healthcare benefits. You will be responsible for payment for any services you use beyond those covered by the Riverside CareAdvantage PPO.