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How Primecare Works for Insurers


PrimeCare Online (PCO) will provide coverage for catastrophic injuries, but unlike existing policies, it will include an innovative set of primary care services.

The online system will use the full-service patient management system, the PrimeCareâ„¢ System, to help the medical staff efficiently gather appropriate patient information and facilitate the delivery of needed medical care.
The health insurer will establish a Medical Services Triage Desk staffed by physicians, physician assistants and registered nurses. The medical staff will be online 24 hours a day/7 days a week. The PCO enrollment agreement will require that all PCO enrollees use the online system to request medical care.
At the time of enrollment an annual exam and general medical history questionnaire will be completed by each patient.
PCO patients will not be required to have traditional relationships with primary care physicians. When a PCO enrollee has a health concern, he or she will speak online to a member of the PCO medical staff and request services. The responding medical staff member will triage the patient and ask the patient to complete one or more of PrimeCare's 280 plus medical questionnaires. Depending on the complexity of the complaint, the patient will complete the assigned medical questionnaire(s) by logging onto the PrimeCare System via secure access from any Internet browser-enabled computer.
All information is secure and compliant with HIPAA guidelines for electronic medical records. After the patient completes and submits the questionnaire online, staff members will determine the next proper medical steps that should be taken to complete the patient’s online visit. The medical staff will decide the course of action and may:

Prescribe prescription or over-the-counter medications


Send acutely ill patients to the nearest approved hospital


Dispatch an ambulance from a nearby emergency medical facility


Request that the patient go to an approved laboratory for medical tests


Make an appointment for the patient with an approved network physician or specialist for follow-up care


Provide the patient with a recommendation to monitor their symptoms and to call back or resume the online visit if their symptoms worsen.


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