<p class="blog-p">Optum brings together trusted providers and wellness services to help people live healthier lives. We focus on making care personalized and easy to access. Members can enjoy all our featured services through their UnitedHealthcare or Humana Medicare Advantage plans.</p>
<h2 class="blog-h2"><strong>In-person, In-home and virtual care options</strong></h2>
<ul class="blog-ul">
<li><strong>Southwest Medical Associates (SMA) clinics</strong> – 27 owned clinics across with 450 employed primary and specialty providers.</li>
<li><strong>Independent Practice Associations (IPA) clinics</strong> – 210+ clinics statewide with 3300+ contracted primary and specialty care providers.</li>
<li><strong>Urgent care</strong> – 5 state-of-the-art clinics offering lab results in 15 minutes. The Rancho clinic is open 24/7 with a 23-hour observation unit.</li>
<li><strong>NowClinic</strong> – video visits with doctors 24/7 from a phone computer or tablet with records kept up to date in EPIC.</li>
<li><strong>In-home visits</strong> – Same-day care at home from DispatchHealth® and Doctoroo® from 7 a.m. to midnight, 365 days a year.</li>
<li><strong>Close Observation Unit (COU)</strong> – staffed 24/7 by a doctor, nurse and medical assistant providing transfusions, monitoring and more.</li>
</ul>
<h2 class="blog-h2"><strong>Featured specialties</strong></h2>
<ul class="blog-ul">
<li><strong>Optum Cancer Center</strong> – advanced cancer and blood disease care with clinical trials and leading technology all in one place. Optum Breast Cancer is Nevada’s only Certified Breast Center of Excellence.</li>
<li><strong>SMA medical surgery centers</strong> – high-quality and lower cost care without a hospital stay. Two centers named America’s Best Ambulatory Surgery Centers by Newsweek.</li>
<li><strong>SMA specialty care</strong> – 18 specialty departments including cardiology, urology, pain management, pediatrics and more. SMA has been serving the valley for over 50 years.</li>
</ul>
<h2 class="blog-h2"><strong>Featured services </strong></h2>
<ul class="blog-ul">
<li><strong>Telephone advice nurse line</strong> – guidance, answers to questions and appointment scheduling from registered nurses 24/7—even on holidays.</li>
<li><strong>SMA pharmacy and home medical equipment facility</strong> – daily delivery of medications and equipment to clinics and patients.</li>
<li><strong>Transportation services</strong> – rides for patients to and from appointments through Modivcare.</li>
<li><strong>Optum RX</strong> – home delivery of prescriptions with up to a 100-day supply so patients have their medications.</li>
<li><strong>Medicine on the move (MOM)</strong> – two 50-foot mobile medical center trucks offering mammograms, annual wellness visits, immunizations, diabetic exams and more.</li>
<li><strong>Community centers</strong> – two locations, East and West that are open to all seniors 55+. Free classes like Chair Yoga, Zumba, Tai Chi, Brain Trainers, Meditation and more offered.</li>
</ul>
<h2 class="blog-h2"><strong>Featured technology</strong></h2>
<ul class="blog-ul">
<li><strong>EPIC</strong> – electronic medical record (EMR) system that streamlines patient care from charts, x-rays, medical records and more.</li>
<li><strong>MyChart</strong> – online patient portal that makes it easier for patients to stay on top of their health. Patients can schedule appointments, get test results and send a refill request.</li>
</ul>
<p class="blog-p">If you have any questions about the network, please call one of our <a class="blog-a" href="https://optumbrokerportal.com/nevada/"><strong>broker market contacts</strong></a><strong>.</strong></p>


Optum – Nevada Network at a glance

<p class='blog-p'>
    MyChart offers a quick and easy way to manage your health and stay in touch with your care team. Over the past few years, MyChart has also become another way to seek medical advice. Sending MyChart messages can be a convenient way to get answers to health questions without scheduling an appointment for every care need. It’s important to us to be responsive to patient needs and provide a wide range of options for care. As a result, however, our providers receive more MyChart messages than ever before—and often about complex conditions.
</p>
<p class='blog-p'>
    To account for the time and medical expertise sometimes provided in MyChart, we will begin billing for messages that require medical advice and complex care decisions.
</p>
<h2 class='blog-h2'>Most MyChart messages will not be billed. </h2>
<p class='blog-p'>
    It’s important to keep in mind that this change will only impact a small percentage of total MyChart messages. Messages that will not be billed include:</p>
<ul>
<li>Scheduling appointments</li>
<li>Requesting prescription refills when refills remain available</li>
<li>Requesting a pharmacy change</li>
<li>Questions that result in an appointment within 7 days for the same health concern</li>
<li>Questions related to a visit you had in the last 7 days or recent surgery (within 90 days)</li>
<li>Questions about lab or imaging results related to a recent or upcoming visit</li>
<li>Questions about billing</li>
<li>Messages giving a quick update on your health</li>
</ul>
<h2 class='blog-h2'>Some MyChart messages can be billed. Messages that require medical advice and complex care decisions can be billed, as we do for other medical services. Types of messages that can be billed include:</h2>
<p class='blog-p'>
<ul>
<li>Requesting new medications or medication changes</li>
<li>Checking-in about chronic conditions or reporting changes in chronic conditions</li>
<li>Questions about new symptoms or problems</li>
<li>Requesting new referrals to services, testing, or imaging</li>
<li>Requesting other complex medical advice</li>
</ul>
<h2 class='blog-h2'>When will this change happen?</h2>
<p class='blog-p'>Providers will begin to submit billable charges for MyChart medical advice messages beginning March 27, 2024.</p>
<h2 class='blog-h2'>What will a medical advice message cost?</h2>
<p class='blog-p'>Most commercial insurance and Medicare plans cover medical advice portal messaging at little-to-no out-of-pocket cost after standard co-pays and deductibles are met. If we bill for MyChart medical advice, we will submit the charge to your insurance plan on file or send to you directly if you do not have health insurance. After insurance pays its portion, you may receive a bill for any remaining co-pay, co-insurance, or charges applied against your deductible – the same as with other kinds of care. Contact your insurance plan to confirm your coverage for medical advice portal messages.<br />
    *MyChart medical advice cannot be conducted for conditions covered by the Washington Department of Labor and Industry, Worker’s Compensation and Medicaid.</p>
<h2 class='blog-h2'>Why are we billing for MyChart messages?</h2>
<p class='blog-p'>
    We will bill for medical advice portal messages to acknowledge the time and medical expertise provided by our clinicians. While the vast majority of MyChart messages are handled quickly and will not be billed, those that require more time, clinical evaluation and expertise are a form of virtual care. These medical advice messages will be billed as we do for other virtual care services.
</p>
<h2 class='blog-h2'>Will I be billed if my clinician sends me a MyChart message on a new topic (and not a response to a message I sent)?</h2>
<p class='blog-p'>
    No, you will only be billed for messages you initiate that require your provider’s medical expertise and complex care decisions to answer. If your clinician initiates a message to you asking for information or giving you an update on a topic you didn’t initiate, you will not be billed.
</p>
<h2 class='blog-h2'>Will I be billed if I request a referral for services related to my existing treatment plan?</h2>
<p class='blog-p'>No, requests for referrals to support services related to an existing treatment plan, such as ongoing cancer treatment, will not be billed. This is not considered a “new” issue.
</p>
<h2 class='blog-h2'>What is the likelihood that my MyChart message will be billed?</h2>
<p class='blog-p'>We anticipate only a small percentage of messages will meet the criteria for billing. The care provided must be through a patient-initiated MyChart message you send to your care team, require clinical decision making and expertise, and be unrelated to any recent or upcoming visits.
</p>
<h2 class='blog-h2'>How will I know if am billed for MyChart messages?</h2>
<p class='blog-p'>Submitting a MyChart message means you agree to a possible charge for the message. You will be notified if your clinician responds to the message with an assessment or care plan, and documents time spent in the notes for the MyChart message visit. Any charges will be visible in the Billing Summary section in MyChart.
</p>
<h2 class='blog-h2'>Will messages about mental health care be billed?</h2>
<p class='blog-p'>No, questions about mental health services and care will not be billed.
</p>
<h2 class='blog-h2'>Will messages from pediatric patients be billed?</h2>
<p class='blog-p'>No, direct messages between a pediatric patient and clinician will not be billed. Messages concerning pediatric patients may only be billed if a parent or legal guardian age 18 or older initiates a MyChart message on behalf of the child and it meets the criteria noted above.
</p>
<h2 class='blog-h2'>Why are we making this change?</h2>
<p class='blog-p'>Digital health services and electronic communication with your care team continue to grow and evolve. We offer these enhanced services as they provide patients with greater ease and convenience and help increase access to care. This practice enables us to deliver better virtual care and dedicate time to review your questions and concerns, while delivering care in a way that best meets your needs. If you have any questions, please ask your care team.</p>


Together, we can keep your clients happier and healthier