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    • Administrative Support Workers

    Insurance and Claims Specialist

    Full Time - Eligible for Benefits
    100621 Professional Billing Services
    Day
  • University Health Accepted Insurance

    Accepted Insurance Plans   If your plan is not listed below, you may also verify your insurance in-network benefit eligibility with our providers. Don't hesitate to contact your insurance company and provide them with Med School Associates North and Tax ID # 86-0881749 or Group NPI # 1992842660.   University Health accepts most major insurance plans operating in our region, including:  Aetna Aetna - Medicare Access to Healthcare Allwell - Medicare Ambetter Anthem Blue Cross Blue Shield Anthem - Medicaid Anthem - Medicare Behavioral Healthcare Options (BHO) Benefit Plan Administrators, Inc. (BPA) - Trust Funds NV. Bureau of Vocational Rehabilitation Programs Cigna Cigna Behavioral Health Coventry Healthcare Custom Ink Group Health Plan Electrical Workers Health & Welfare Plan for Northern Nevada Hometown Health Plan (Premier HMO Excluded) Health Plan of Nevada Health Plan of Nevada - Medicaid HMC Healthworks (Behavioral Health only) Humana Humana - Medicare Health Smart Preferred Medicaid Medicare Northern Nevada Health Network Northern Nevada Laborers Health & Welfare Trust Fund Northern Nevada Operating Engineers Health & Welfare Trust Fund Optum Care PacifiCare PPO Prominence Health Plan Prominence - Medicare Senior Care Plus Silver State ACO SilverSummit Health Plan - Medicaid Specialty Health MCO Three Rivers Provider Network (Terminating 5/2/23) Tricare - Health Net Federal Services Tricare Behavioral Health Tricare for Life Triwest - Veterans Affairs Community Care Network U.A. Local 350 Health, Welfare & Vacation Trust Fund United Healthcare United Healthcare - Medicare Yerington Paiute Tribal Health 6 Degrees Health, Inc. (Terminating 6/1/23) Please note that many insurance networks operate under a variety of names and agreements. Therefore, the best way to verify your insurance benefits with our providers is to call your insurance company and provide the name Med School Associates North with the Tax ID: 86-0881749 or Group NPI: 1992842660.

    Read More About University Health Accepted Insurance

    • Health Insurance and Coverage

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

    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 and Coverage

    3 Ways to Enroll in a Hometown Health Insurance Plan

    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

    • Renown Health
    • Health Insurance and Coverage

    Health Insurance Terms Explained: HMO, EPO and PPO Plans

    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

    • Wednesday, Jul 15, 2020

    Locally Owned Not-For-Profit Insurance Company, Hometown Health, Welcomes New CEO

    David Hansen, MBA, joins Hometown Health to continue to serve future generations and improve the health and well-being of Nevadans Renown Health and Hometown Health are excited to announce David Hansen, MBA, is joining Hometown Health as its Chief Executive Officer (CEO). In his role as CEO, Hansen will oversee Hometown Health, contributing to its growth to ensure the not-for-profit company is here for generations to come and to assist Renown in developing new care models that will deliver healthcare that is both accessible and affordable. “We are pleased to welcome such an experienced and talented leader like David to our organization and to northern Nevada,” said Tony Slonim, MD, D.Ph., President and CEO, Renown Health. “As CEO of Hometown Health, David will continue to foster a culture of caring and excellence, while ensuring wide-ranging medical coverage and great customer service to Hometown Health’s more than 138,000 members statewide.” Hansen has spent the previous twenty years of his career working for UnitedHealthcare, a health insurance company based out of Minnetonka, Minnesota. During his time at UnitedHealthcare, Hansen held various roles including chief financial officer of clinical & network services, west region president of network & provider services, chief executive officer of the California Health Plan and chief executive officer of the Pacific Northwest Health Plan. He has also served in executive roles with PacifiCare and TransAmerica Occidental Life and began his career in the audit and management consulting practice of Deloitte & Touche. “Choosing healthcare coverage is one of the most important decisions people make. I am excited to begin my work with Hometown Health and Renown to help our members receive the quality coverage to enhance their health and well-being,” said Hansen. “Hometown Health is such a community-focused organization and I look forward to being a part of a team that gives back to improve the health and wellbeing of the communities we serve. ”David has an MBA in Finance and Business Policy from the University of Chicago, and a BA in Economics and Business from the University of California, Los Angeles.     About Hometown Health Established in 1988, Hometown Health is the insurance division of Renown Health and is Northern Nevada’s largest locally-owned, not-for-profit health insurance company. Providing wide-ranging medical coverage and great service to members, Hometown Health represents a philosophy of health care that emphasizes active partnerships between members and physicians. For more information, call 775-982-3000 or visit www.hometownhealth.com. About Renown Health Renown Health is the region’s largest, locally owned and governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. Renown’s institute model addresses social determinants of health and includes: Child Health, Behavioral Health & Addiction, Healthy Aging and Health Innovation. Clinical institutes include: Cancer, Heart and Vascular Heath, Neurosciences and Robotic Surgery. Renown is currently enrolling participants in the world’s largest community-based genetic population health study, the Healthy Nevada Project®. For more information, visit renown.org.

    Read More About Locally Owned Not-For-Profit Insurance Company, Hometown Health, Welcomes New CEO

    • Professionals

    Insurance Statutory Reporting Analyst

    Full Time - Eligible for Benefits
    500602 Finance
    Day
    • Health Insurance and Coverage

    Copays vs. Coinsurance: Know the Difference

    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

    • Health Insurance and Coverage

    Understanding "In-Network" and "Out-of-Network" Providers

    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

    • Thursday, Dec 16, 2021

    Hometown Health Enters Affordable Care Act Marketplace

    Softheon and Hometown Health, Nevada's largest not-for-profit insurance company, have formed a partnership to serve Nevadans enrolling through Nevada Health Link state-based ACA marketplace. Nevada's largest not-for-profit health insurance company, Hometown Health, has entered the Affordable Care Act (ACA) marketplace and has expanded their health plan offerings through a partnership with Softheon, a leading cloud-based health insurance exchange and service provider. Softheon's innovative platform is helping bring quality health care to Nevada residents enrolling in Hometown Health insurance through Nevada Health Link. “Softheon’s expert knowledge of the ACA marketplace coupled with their leading enrollment and billing technology has made them the perfect partner during Hometown Health’s first open enrollment period on the exchange,” said David Hansen, Hometown Health CEO. “Today, more than 100,000 people in Nevada choose Hometown Health for their insurance needs. Thanks to Softheon, we look forward to expanding insurance coverage options, in a way that is simple and convenient, to our friends and families who use Nevada Health Link.” Since the beginning of the 2021 open enrollment period, over 800 new members have seamlessly enrolled in Hometown Health’s insurance thanks to Softheon’s cutting-edge software. The partnership with Softheon will improve member enrollment, billing and communications, enabling Hometown Health to remain focused on their core mission of providing excellent healthcare to Nevada residents. As the health insurance division of Renown Health, northern Nevada’s leading healthcare provider, Hometown Health offers members competitive rates and the largest network of providers in the region. Renown Health provides advanced medical services including Renown Regional Medical Center, an 808-bed full service regional hospital, Renown South Meadows Medical Center, a 76-bed acute care community hospital, Renown Children’s Hospital, the region’s only children’s hospital with 83 beds, and Renown Rehabilitation Hospital, a 62-bed rehabilitation hospital. These facilities provide quality healthcare for Renown's primary service area, Washoe County and the secondary service areas of northern Nevada and northern California. Renown Health has more than 7,000 employees and serves northern Nevada, Lake Tahoe and northeast California with a total population in excess of 2 million. In addition to hospitals, Renown also has 110 medical group practice sites, urgent care and outpatient imaging sites. Renown Health and Hometown Health offer advanced care for patients and embrace their role in improving the health and well-being of the people and communities. “The continued growth of the Affordable Care Act marketplace is welcome news for consumers who are seeking more options for accessing health coverage,” said Eugene Sayan, CEO and founder of Softheon. "We are excited to partner with Hometown Health on their entrance into the ACA marketplace to create seamless experiences for their members and connect more individuals in Nevada with quality health care.” Along with improving member enrollment, billing and communications, Softheon helps Hometown Health continue to ensure accuracy through monthly Advanced Premium Tax Credits premium reconciliation. The turnkey solution provided by Softheon has guided Hometown Health in handling all regulatory and operational requirements required of insurers in the ACA marketplace. The partnership has given Hometown Health the opportunity for expanded reach while making a bigger impact on communities across the state. To learn more about Softheon, visit www.softheon.com. To learn more about Hometown Health, visit www.hometownhealth.com.     About Softheon Founded in 2000, Softheon’s Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) solutions solve complex challenges for health plans and government health agencies. Currently, Softheon’s solutions serve 8 State agencies and over 90 health plans. Issuers and consumers utilizing Medicaid, Medicare, and the ACA Marketplace benefit from Softheon’s innovative technology that reduces administrative overhead and enhances user-experiences. Softheon is an Agent, Broker, and Merchant of Record that facilitates health insurance enrollment, billing, and renewal.   About Hometown Health Established in 1988, Hometown Health is the insurance division of Renown Health and is northern Nevada's largest local, not-for-profit health insurance company. Providing wide-ranging medical coverage and great service to members, Hometown Health represents a philosophy of health care that emphasizes active partnerships between members and physicians. For more information, call 775-982-3000 or visit www.hometownhealth.com.

    Read More About Hometown Health Enters Affordable Care Act Marketplace

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