• Introduction
• Family Doctor
• Care Management
• Hospital Access
• Management and Reporting
• Banking and Underwriting

Pick Your Own Physician
The family doctor/patient relationship is the cornerstone of DocFirst. Employees are asked to chose a family physician and see that physician for all his or her medical needs. If specialty care is required, you work with your family doctor to select the best course of care for you or your family. There are generally no restrictions on what specialist and facilities are utilized as long as the member works with the family doctor to seek specialty care.

Family Doctor
All members of DocFirst are asked to choose a family doctor and communicate with that doctor whenever they have healthcare needs. Employees can use any family doctor as long as they are:

• A Family Practitioner
• A General Pediatrician
• An Internist
• A General Practitioner

Employees consult their family doctor before seeking specialty care. Once the family doctor is consulted, the appropriate specialist can be seen.

Care Management
DocFirst’s sophisticated care management system, administered by Future Health, is integrated into the plan. It concentrates resources on the five percent of plan members that generate 60 percent of healthcare costs. By identifying these high risk members in the early stages of an illness DocFirst can help contain the severity of health care costs and deliver optimum outcomes. Integrated components make up DocFirst’s Care Management System. These typically include:

• Future Health's RiskScreen®
• Future Health's HealthModels™
• Traditional Utilization Review
• Proactive Health Risk Assessments
• Nurse Advice Line

Hospital Access
DocFirst has access to discounted pricing arrangements which help to manage the cost of health care. These arrangements do not impact the decisions that you and your physician make about your specialty care selections.

Management and Reporting
DocFirst provides detailed management and reporting for all employers. This reporting is available through a secure website via a data warehouse. Some sample reports include:

• Claims and Enrollment tracking
• Budget Projections vs. Actual Costs
• Stoploss
• Provider Listing
• Plan Utilization Detail

Banking and Underwriting Services
DocFirst’s underwriting department handles cost projections, prices out benefit options, places stop loss insurance and provides quarterly and annual reports.

Banking services include the funding of claims payments, monthly bank reconciliation’s benefit statements and the payment of premiums and claims.