Archive for the 'News Articles' Category

TakeCare files protest against GovGuam RFP

Thursday, April 19th, 2018

FOR IMMEDIATE RELEASE
Media Contact: Maria O. Hernandez
(671) 646-6956 ext. 7117
maria.hernandez@takecareasia.com
April 18, 2018

FOR IMMEDIATE RELEASE

TakeCare files protest against GovGuam RFP

Today TakeCare Insurance Company, Inc. (“TakeCare”) filed a protest at the Department of Administration (“DOA”) against the FY19 Request for Proposal for the Government of Guam Group Health Insurance Program (the “RFP”) to select health insurance for Government of Guam employees, retirees and foster children.

The protest became necessary because DOA and the Negotiating Team included a requirement in the RFP that in order to be a qualified participant in the procurement, the interested health insurance companies have to include Guam Regional Medical City (“GRMC”) in their provider networks.

Guam law only requires that prospective offerors include all government health care services, such as GMH. Requiring all Offerors’ proposals to include GRMC in their networks violates several Guam laws, including the recently passed Public Law 34-83.

Such a requirement is not in the best interest of the People of Guam. GRMC could simply refuse to contract with a prospective offeror, or only offer ridiculous or completely unreasonable terms to select prospective offerors, and thereby make it impossible for certain prospective offerors to participate in the RFP process. To give a private entity like GRMC so much power effectively removes the government’s control over the RFP, and puts GRMC in control of which insurers could and could not offer health care services to government employees.

Health care at GRMC is already substantially more expensive than at GMH. If a prospective offeror wants to include GRMC, or any other private provider in its network, that is a choice which should be left to the business judgment of the insurance company. However, the Government of Guam mandating that prospective offerors have to include GRMC, or any other private entity, in their networks is inappropriate, and will adversely affect the insurance company’s negotiating ability with such private entities ultimately resulting in substantially increase health care costs and premiums for the Government of Guam and its employees. Not only will the increased premiums affect Government of Guam and their members, but if GRMC unilaterally decides to increase their fees, Government of Guam members will also have to pay more out of pocket expenses given that the Government of Guam plans are co-insurance plans where members pay a percentage of the cost of services.

In addition to burdening government employees with increased health care costs, requiring prospective offerors to contract with GRMC also hurts GMH, the only public hospital on Guam. Every dollar spent at GRMC represents funds that could have been used to support GMH. Moreover, every dollar spent by the Government of Guam at  GRMC means more funds will most likely have to be appropriated by the Legislature as a subsidy to GMH from the General Fund to keep GMH afloat.

TakeCare’s Protest requests that the RFP be cancelled or revised to remove the requirement that GRMC be included in the offerors’ provider networks.

View the PDF file here


TakeCare Pays Up

Wednesday, August 16th, 2017

FOR IMMEDIATE RELEASE

 

August 16, 2017

TakeCare pays up

(Tamuning, GUAM) – For the past several weeks, TakeCare has been working closely with the Commonwealth Health Care Corporation (“CHCC”) in regards to claims from Fiscal Years 2012 – 2017.

As a measure of good-faith to assist CHCC with their operations, TakeCare has provided a $1-million-dollar good faith payment to allow both organizations time to reconcile outstanding claims.

Both organizations came to a mutual agreement that while claims are being reconciled there would be no disruption in services for TakeCare members.

We look forward to our continued relationship with CHCC as we work together to reconcile claims to ensure accuracy.

About TakeCare

TakeCare’s health plans effectively cover its 30,000-plus members’ needs with exceptional, member-patient focused services. With over 40 years in the industry, TakeCare continues to uphold the highest standards of excellence for accredited provider networks, patient management expertise, and end-to-end quality control processes.

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TakeCare Reaches Agreement with GMH

Tuesday, June 20th, 2017

FOR IMMEDIATE RELEASE

 

June 17, 2017

TakeCare Reaches Agreement with GMH

(Tamuning, GU) – TakeCare and the Guam Memorial Hospital (GMH) are both integral parts of the Guam community and have for decades worked together to provide healthcare solutions to the people Guam. Since May, TakeCare has been meeting with GMH administrators to discuss payment options and have finally come to an agreement.

“We value the services GMH provides to the island and recognize the diligent efforts of GMH and clinical staff at the hospital. Despite issues that arise from time to time, our long standing relationship has proven that we will always come to a resolution,” shares Alicia Iseke, TakeCare Health Plan Finance Administrator.

TakeCare would like to thank Peter John Camacho and Edward Birn for their cooperation. In addition, we would like to recognize our partnership with GMH to improve the submission of claims process to resolve any issues that might exist moving forward.

TakeCare Member’s access to services at GMH remain unaffected.

About TakeCare

TakeCare Insurance Company, Inc. offers comprehensive medical and dental insurance to its members in Guam, Saipan and Palau. TakeCare benefit plans provides members with access to the largest health network in Micronesia with over 120 medical providers, 40 dental providers, and 20 pharmacies in the region.

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Letter to Our Members – June 15, 2017

Thursday, June 15th, 2017

FOR IMMEDIATE RELEASE

Media Contact:

Kyla Aquino

(671) 646-6956

kyla.aquino@takecareasia.com

June 16, 2017

TakeCare responds to allegations of GRMC Claims

(Tamuning, GU) – TakeCare has released a letter to its members responding to GRMC’s allegations on outstanding claims. The content of the letter may be seen below.

“Dear TakeCare Member:

TakeCare is an insurance company with over 40 years of experience in facilitating quality medical care for its Members. As part of this process, TakeCare regularly enters into agreements with leading US and internationally accredited hospitals, including hospitals in Hawaii, the U.S. mainland and the Philippines, and always does its best to negotiate reasonable rates for its Members.

On Guam, TakeCare has a long-standing relationship with Guam Memorial Hospital (GMH). However, TakeCare does not have an agreement with Guam Regional Medical City (GRMC) because GRMC’s rates for services are substantially higher for equivalent services at GMH. For example, the daily room rate at GMH is approximately $600, while a daily GRMC rate is approximately $2,400. GRMC’s rates are an astounding 4 times higher than GMH!

If TakeCare agreed to pay GRMC’s excessive rates, the increased cost of care would simply be passed on to TakeCare Members by increased premiums. TakeCare, at the request of its employer groups, has offered to extend coverage for services at GRMC via a benefit rider with a corresponding additional premium adjustment. In the end, TakeCare’s customers have decided to forgo such GRMC coverage. In short, TakeCare’s customers clearly see no value in having access to GRMC and the resulting higher costs.

Recent media reports generated by GRMC falsely claim that TakeCare owes GRMC millions of dollars for care provided to TakeCare Members. This is simply not true. GRMC admits it does NOT even have an agreement with TakeCare. Without an agreement, GRMC is not a part of TakeCare’s provider network, and GRMC does not have the contractual right to bill TakeCare for services it provides to TakeCare Members. Therefore, it is impossible for TakeCare to owe money to GRMC.

Even though GRMC does not have an agreement with TakeCare, we have always reimbursed members at the same usual, customary rate paid to GMH for bona fide emergency services subject to the terms of its policies. TakeCare treats GRMC consistent with industry practices when bona fide emergency services are required, whether on- or off-island, at non-participating hospitals. Our research shows that only a small fraction of the alleged outstanding claims are for bona fide emergency services GRMC provided to TakeCare Members.

In addition to charging unreasonable rates, GRMC, through its own omission, has also failed to submit many bills for services to its patients, including TakeCare Members, in a timely manner as required by law. The Health Care Prompt Payment Act of 2000 (Title 10 Guam Code Annotated §§ 9901-9908), requires that GRMC submit accurate claims within 90 days from the date that health care services were provided. Under most circumstances, claims not submitted within 90 days from the date of services cannot be collected from either a patient or his/her insurer. Consequently, GRMC’s threat to send stale bills to TakeCare’s Members may be in violation of law, depending on when services were provided.

TakeCare has made several good faith efforts to settle disputed claims and to negotiate reasonable rates with GRMC so that it can be included in its provider network. To date, these efforts have not been successful because of the unreasonable positions taken by GRMC. GRMC’s misrepresentations about TakeCare in the media, and threats to TakeCare Members, are just the latest maneuvers designed to bully TakeCare into an unfair agreement which would not be in the best interest of its Members. TakeCare will continue to insist upon reasonable rates before any agreement can be reached with GRMC.

TakeCare recommends that any Member receiving a bill from GRMC to contact TakeCare Customer Service at 647-3526 for information and assistance. Customer Service will help explain Members’ rights and responsibilities under its health plans as well as help to review GRMC’s billings for accuracy. Members may also wish to consult with legal counsel regarding their rights against GRMC for trying to collect on untimely claims that may be barred by Guam law.”

To view the full letter, please click on the link below.

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TakeCare is a proud sponsor of MagPro Awards

Tuesday, May 2nd, 2017

(Tamuning, GU) – TakeCare is pleased to announce its support of the MagPRO Awards, a Government of Guam employee recognition program. “We are proud to partner with the MagPRO Awards,” said, Jeff Larsen, TakeCare’s President. “As a longtime partner of the Government of Guam, we strongly believe in celebrating the hard work and accomplishments of Government of Guam employees.”

About TakeCare

TakeCare’s health plans effectively cover its 30,000-plus members’ needs with exceptional, member-patient focused services. With over 40 years in the industry, TakeCare continues to uphold the highest standards of excellence for accredited provider networks, patient management expertise, and end-to-end quality control processes.

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Shown in the photo:

[Left to Right] Greg Kerrebrock, TakeCare Sales Manager; Joleen Santos, MagPRO Awards Chairperson of Nominations and Judging; Jeff Larsen, TakeCare President; Adonis Mendiola, MagPRO Awards Chairperson of Public Relations and Marketing; Al Almira, TakeCare Controller; and Peter Calvo, MagPro Awards Overall Chairperson.

 


FHP Health Center welcomes OB-GYN, Dr. Rachael JM Consoli

Tuesday, March 28th, 2017

(Tamuning, GU) – FHP is pleased to announce that Rachael JM Consoli, MD MPH FACOG, an award winning, published, and US Board Certified Obstetrician and Gynecology Surgeon, has joined the FHP Health Center.

With 15 years of clinical experience, Dr. Consoli has practiced in Massachusetts, Wisconsin, and North Dakota. Most recently she worked at North Shore Medical Center/Massachusetts General Hospital and Clinical Instructor in Obstetrics and Gynecology Surgery at Harvard Medical School/Massachusetts General Hospital.

Dr. Consoli has a wide range of experience in research, public service and teaching. Most recently, Dr. Consoli was the Volunteer Director of Safe Motherhood Projects in South Sudan Africa after being the Volunteer Medical Director for Project PX (Poverty Extinct) working in South East Asia ((India, Nepal, Indonesia, Thailand, Philippines, Malaysia, China, Mongolia) Eastern Europe, (Russia, Poland, Czech Republic, Austria) El Salvador, Mexico, Australia, and New Zealand.

She is a Fellow of the American College of Obstetrics and Gynecology, a Diplomate of the American Board of Obstetrics and Gynecology, Member of the Society for Laparoendoscopic Surgeons, the Academy for Health Services Research and Health Policy, the North American Primary Care Research Group (NAPCRG), a Delegate of the Massachusetts Medical Association and the American Medical Association.

As the newest member of FHP, Dr. Consoli joins 30 other providers in their commitment to providing continuing and comprehensive medical care for individuals and families of all ages and backgrounds.

Dr. Consoli is accepting new patients at the FHP OB/GYN Center. To make an appointment, please call 646-5825. To learn more, please visit www.takecareasia.com.

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FHP gives to the Sea Haven

Monday, February 13th, 2017

FHP recently donated two dental chairs to the Sea Haven to assist with their services.

Based in Pohnpei, the Sea Haven, a floating clinic, serves remote islands that have no harbors or airstrips. The Sea Haven provides routine and emergency medical services, primary health care, health education, disaster relief and logistical support to outer island dispensaries.

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TakeCare launches PAP Campaign

Tuesday, January 10th, 2017

FOR IMMEDIATE RELEASE

Nearly 13,000 women in the United States are diagnosed with cervical cancer each year, but the disease is virtually always preventable with vaccination and appropriate screening (Pap and HPV tests).

In support of Cervical Cancer Awareness month, TakeCare has launched the PAP (Prevention and Awareness Program) Campaign for Cervical Cancer. From January 9 to March 31, 2017, eligible TakeCare members will receive a free gift with the completion of their Cervical Cancer Screening at the FHP Health Center. Supplies are limited.

In addition, eligible TakeCare members are able to receive up to $75.00 in Wellness Incentives for completing their Annual Physical Exam as well as their Cervical Cancer Screening. TakeCare members should contact their HRO or TakeCare Customer Service to find out if they are eligible to receive Wellness Incentives.

TakeCare members may call FHP Health Center at 646-5825 to schedule an appointment using promo code “CSCC”.

 

 

 

 


TakeCare Achieve Accreditation

Tuesday, June 21st, 2016

Tamuning, Guam – TakeCare Insurance Company, Inc. (TakeCare) has achieved health plan accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC). Through AAAHC accreditation, health plans demonstrate their commitment to providing high quality patient care for their members.

“Accreditation means that we live up to the promises and commitments we make to our members in providing high quality, value added products and services,” said Jeff Larsen, President, TakeCare Insurance, “At TakeCare, our customers can be confident that we not only deliver quality health insurance, but we do it consistently as judged by a neutral third party.”

Health plans seeking accreditation by AAAHC undergo an extensive self-assessment and a rigorous on-site survey by AAAHC expert surveyors – physicians, nurses, and administrators who are actively involved in health care organizations. Characteristics that are indicative of an accreditable health plan include recognizing member rights and protections, a responsible governing body, quality-focused administration, provider network credentialing, network adequacy, case management and care coordination, health education and wellness promotion, accurate and accessible clinical records and health information, an environment of care and safety, and a program of quality management and improvement.

 “Accreditation is both a process and a status. The process ensures that we’ve met (or exceeded) a very specific set of standards as determined by objective industry experts. The status of a three-year accreditation term ensures that our customers can be confident we are delivering on their behalf by providing value added products and services. No other health plan on Guam or in the region has achieved accreditation status and we are pleased at the outcome,” shared Larsen.

 About TakeCare

TakeCare Insurance Company, based in Guam, U.S.A., offers health plans of optimal choice and easy access to the providers consumers want. TakeCare’s health plans effectively cover its 30,000-plus members’ needs with exceptional, member-patient focused services. With over 40 years in the industry, TakeCare continues to uphold the highest standards of excellence for credentialed provider networks, patient management expertise, wellness and health education programs, and end-to-end quality control processes.

About the Accreditation Association for Ambulatory Health Care

The Accreditation Association for Ambulatory Health Care, founded in 1979, has been actively involved in accrediting health plans since 1983 and is now recognized as an accrediting entity for Qualified Health Plans and FEHB plans under the Affordable Care Act.. AAAHC serves as an advocate for the provision of high-quality health care through the development of nationally recognized standards and through its survey and accreditation programs. AAAHC accreditation is recognized as a symbol of quality by third-party payers, medical organizations, insurance companies, state and federal agencies and the public.

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TakeCare announces new relationship with SPH Analytics

Sunday, June 5th, 2016

(Tamuning, GU) — TakeCare Insurance Company, Inc. (TakeCare) is pleased to announce it has entered into an agreement with SPH Analytics (SPHA).

TakeCare’s agreement with SPHA will allow the measurement of its population health goals, member, and provider experience while meeting regulatory requirements with easy-to-understand, actionable information.

About TakeCare

TakeCare Insurance Company, based in Guam, U.S.A., offers health plans of optimal choice and easy access to the providers consumers want. TakeCare’s health plans effectively cover its 30,000-plus members’ needs with exceptional, member-patient focused services. With over 40 years in the industry, TakeCare continues to uphold the highest standards of excellence for accredited provider networks, patient management expertise, wellness and health education programs, and end-to-end quality control processes.

About SPH Analytics

SPH Analytics (SPHA), headquartered in Alpharetta, Georgia, generates powerful and impactful healthcare analytics through its cutting-edge applications. SPHA solutions provide key decision makers valuable insights with deep drill-down capabilities. SPHA is a member of the $3B Symphony Technology Group.

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