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3223 S. Loop 289, Suite 312Lubbock, Texas 79423(806) 795-5959www.team-choice.com

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Va l u e - d r i v e n . Q u a l i t y A s s u r e d .September / October 2008 Volume I, Issue V

a p u b l i c a t i o n o f

Follow the ‘4 P’s’ to Intelligent Health Plan DesignIn today’s increasingly expensive Health Insurance Marketplace, everyone is looking forways to cut costs while keeping benefits rich andcomprehensive. Understanding how health insurance works is the best way to get the mostvalue for your healthcare dollar, and can be simplified by breaking the insurance plan into 4 categories, or, the ‘4 P’s’:

Premium: This is what health insurance costs,and is typically the ‘P’ that everyone is most concerned with. Adjusting each of the 3 other P’s will impact Premium.

Plan: This ‘P’ refers to the plan, or plan design. Deductibles, Rx and Doctor co-pays, andCo-insurance are all facets of plan design. This ‘P’ultimately determines what you pay in the event ofa medical incident, so this is effectively the most important determinant of the ‘P’ above, Premium.

Panel: This ‘P’ stands for panel, or the PPO network. Specifically, this is the group of doctors,hospitals, and facilities who have agreed to discount your rates if you obtain services throughtheir network. The better the negotiated discounts through the Panel, the lower your Premium will be!

Performance: This ‘P’ relates to how the healthinsurance plan performs, or better, the service you

get from your insurance company. Is your healthinsurance financially rated by AM Best? Are claimspaid accurately and timely? Is there an actual person answering your calls to address your concerns? For the high cost of insurance these days, service should be top-notch!

Each of the ‘4 P’s” above are critical componentsof your Small Group and Individual MedicalHealth Insurance plans – understanding which arethe most important to YOU will help you design aplan that will meet your family’s needs and keep costs low for years to come.

new providers new providers

Motheral, Lesley, MD . . . . . . . . . . . . . . . . . . . . . . .PediatricsHudgins, Amanda S., MD . . . . . . . . . . . . . . . . . . .PediatricsDuncan, Diana, CRNA . . . . . . . . . . . . . . . . . .AnesthesiologyZhang, Yan, AC/PhD . . . . . . . . . . . . . . . . . . . .AccupunctureRobinson, Kirsten, MD . . . . . . . . . . . . . . . . . . . . . .PediatricsWright, Nannette, CNP . . . . . . . . . . . . . . . . . . .OrthopedicsOommen, Kalarickal J., MD . . . . . . . . . . . . . . . . .NeurologyKadiyala, SrinivasP., MD . . . . . . . . . . . . . .Pulmonary DiseaseWertz, Rodney A., MD . . . . . . . . . . . . . . .Pulmonary DiseaseJohnson, Mark W., MD . . . . . . . . . . . . . . .Pulmonary DiseaseSmith, Gary, MD . . . . . . . . . . . . . . . . . . .Pulmonary DiseaseCobb, Elizabeth, MD . . . . . . . . . . . . . . . . .Internal MedicineSeay, Gaylon, MD . . . . . . . . . . . . . . . . . . . . . . .OrthopedicWinter, Mark, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ENTScovell III, John F., MD . . . . . . . . . . . . . . . . . . . .OrthopedicsSettle, Donald W., PA . . . . . . . . . . . . . . . . . . . . . .PsychiatryRobertson, Jared Y., CRNA . . . . . . . . . . . . . . .Anesthesiology

Haynes III, Allan L., MD . . . . . . . . . . . . . . . . . . . . . .SurgeryAbshire, Sabrina R., CRNA . . . . . . . . . . . . . . .AnesthesiologyKosik, Edward S., DO . . . . . . . . . . . . . . . . . .AnesthesiologyJimenez, Vivian, FNP . . . . . . . . . . . . . . . . . . .Family PracticeSmith, Cynthia K., MD . . . . . . . . . . . . . . . . . . . . . . .UrologyEisenbaum, Allan M., MD . . . . . . . . . . . . . . .OphthalmologyMaly, David W., CRNA . . . . . . . . . . . . . . . . .AnesthesiologyCoppock, Steven F., CRNA . . . . . . . . . . . . . . .AnesthesiologyYeomans, Edward R., MD . . . . . . . . . . . . . . . . . . .OB/GYNBruce, Kellie E., NP . . . . . . . . . . . . . . . . . . . . . . . . . . . .FNPPerez-Verdia, Alejandro, MD . . . . . . . . . . . .Internal MedicineHicks, Rodney W., NP . . . . . . . . . . . . . . . . . .Family PracticeThe Ranch at Dove Tree . . . . . . . . . . . . . . . .Substance AbuseKindstar, Inc. dba Accolade Home Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Home Health Care & Hospice

Hall, David S., MD . . . . . . . . . . . . . . . . . . .Bariatric Surgery

To verify that a new provider/facility participates with your specific employee health plan, please call (800) 683-3596.

Not all providers participate with all TeamChoice groups.

AGENTS:Are you aware Assurant

is offering a $1,000 bonus plan?

Call your Assurant representative or

TeamChoice for details at (806) 795-5959.

Five primary and specialty care pediatricians have joined the staffof Texas Tech Physicians – pediatrics. Three generalistsand two specialists now complement a staff of 19 providers.

SpecialistsAdaobi Kanu, M.D.,

a pediatric pulmonologist, treatspatients with asthma, cystic fibrosis, chronic lung disease and ventilator dependency. She received her undergraduate degree from Johns Hopkins University, Baltimore, MD, and her medical degree from the University of Connecticut School of Medicine, Farmington, CT. She completed her residency at State University of New York, Children’s Hospital in Buffalo, NY, and her fellowship in pediatric pulmonology atBaylor College of Medicine, Texas Children’s Hospital, Houston. She is board certified by the AmericanBoard of Pediatrics in general pediatrics and pediatric pulmonology. Her office is in the Texas Tech Physicians Medical Pavilion.

Vasum Peiris, M.D. M.P.H., is a pediatric cardiologist. He earned his medical degree from theUniversity of Vermont College of Medicine and completed his residency in pediatrics at Yale-New HavenHospital, Yale School of Medicine. He then completed a fellowship in pediatric cardiology and cardiovascular research at Children’s Hospital, Boston. He sees patients in the Texas Tech Physicians Medical Pavilion.

Elizabeth Goldwater, M.D., practices general pediatrics at Texas Tech Physicians -Southwest Pediatrics. She is a graduate of Abilene Christian University where she was named valedictorian. She earned her medical degree and completed her residency in pediatrics at TTUHSC School of Medicine.

Lesley Motheral, M.D., is a general pediatrician with offices in the Texas Tech Physicians Medical Pavilion. She earned her undergraduate degree in biology from Texas Tech University. She earned

her medical degree and completed her residency at TTUHSC School of Medicine.

Nancy Valdez, M.D., sees patients at Texas Tech Physicians – Southwest Pediatrics. She earned her un-dergraduate degree in cell and molecular biology from Texas Tech University and her medical degree from TTUHSC

School of Medicine. She completed her pediatric residency at TTUHSC School of Medicine. She is board certified in pediatrics by the American Board of Pediatrics. She is bilingual in Spanish and English.

The Texas Tech Physicians Medical Pavilion is at 4th and Indiana and the phone number is 743-7337. The SouthwestPediatrics office is at 6630 Quaker Avenue, Suite C and the phone number is 743-7800.

Texas Tech Physicians Welcomes New Pediatric Staff Members

from left: Lesley Motheral, M.D., Adaobi Kanu, M.D.,Elisabeth Goldwater, M.D., Nancy Valdez, M.D., Varum Peiris, M.D.

Flu Vaccines Now Available Through Physician Network Services

UMC Physician Network Services (PNS) practices h ave theirflu vaccine available now. The Centers for Disease Controland Prevention (CDC) recommended that the flu shot begiven beginning in September. Normally Oct 1st is the recommended day. The shots are normally effective for a year, but some chronically ill patients receive a booster.

All PNS practices will bill your insurance for the flu vaccine.You will be responsible for your co-payment at the time ofyour visit. If you do not have insurance, the cash paymentfor a flu vaccination is $25. Medicare will pay for one vaccine during the flu season which is considered Septem-ber through March. The charge for the booster is a cash payment of $25.

The CDC notes that flu season most often peaks in Januaryor February, so people who are unable to get their influenza vaccine in the fall may still find it beneficial to get their vaccination in December or January.

Research indicates which flu vaccine is the one most likelyto impact the country. The CDC’s research shows three main influenza virus strains which are predicted to cause the mostillness during the flu season. Those three strains are included in this year’s flu vaccine. CDC recommends the following people for vaccination during the 2008-09 flu season:

• Children ages 6 months up to their 19th birthday • Pregnant women • People 50 years of age and older • People of any age with chronic medical conditions • People who live in nursing homes and other long-term

care facilities

People who live with or care for those at high risk for complications from flu, including: • Health care workers• Household contacts of persons at high risk for

complications from the flu • Household contacts and out of home caregivers of

children less than 6 months of age (these children are too young to be vaccinated)

Taken from Centers for Disease Control and Prevention Website

Many Lubbock doctors are trying to hold off until October1st to reduce the possibility of needing the booster. Callyour physician to set up an appointment to get your flu vaccination right away. For the PNS clinic closest to you, call 761-0333. Remember, the flu is nothing to sneeze at.

Va l u e - d r i v e n . Q u a l i t y A s s u r e d .