FastCard - Information for Providers
As a service organization, Sagicor Life Jamaica Limited is continuously seeking to improve the efficiency of our administrative systems and the quality of service we provide to our health care partners.
We believe that our introduction of an electronic claims adjudication system will help us to achieve this goal.
Since January 2003, Sagicor has began to gradually reduce the benefits available on the customary paper health cards, thus encouraging our members to use the re-branded FastCard to access health services.
We have now begun to integrate, for payment purposes, on-line (or electronic) claims with paper claim transactions for the Dental, Optical and Prescription Drug benefits.
As we continue our business of enrolling new groups of subscribers and renewing our existing business, all new paper cards will have the notation “Use FastCard” printed alongside the Dental, Optical and Prescription Drug benefit entries only. This means that eligibility entitlement for these services must be accessed electronically.
The newly formatted paper cards will continue to be used to access those customary benefits such as: Doctor’s Office and Hospital Visits and all other benefits stipulated on each member’s paper health card.
We hope our providers will realise the obvious benefit of this latest initiative where it matters most, yes, the bottom line.
We think you will agree that our only concern is truly you!
Q. What Is The FastCard?
A. The FastCard is the recently introduced plastic health card with a magnetic stripe on the back. This card is often referred to as the “electronic” or “swipe card”.
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Q. How Will The FastCard Work?
A. All subscribers and dependents will receive the FastCard. In addition, the subscriber and in some instances, their dependents will also receive a paper health card. The paper health card will clearly direct you to ask for and use the FastCard to access Dental, Optical and Prescription Drug benefits. This means access to these three benefits will no longer be available on presentation of the paper card only.
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Q. What are Full-house Benefits?
A. Some health cards, particularly those for members of government health plans will have “Use FastCard“ for the Full-house benefits. The Full-house benefits refer only to the combination of the following services:
- Dental
- Optical
- Prescription Drugs.
On some health plans these are indicated as single benefit lines.
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Q. What Should I Do If I Have The Provider Access System?
A. The Provider Access System (PAS) is the application used to electronically adjudicate health care claims. Dental, Optical and Prescription Drug providers who are using this system will continue to operate as normal:
- Obtain the FastCard from each patient who is a Sagicor member.
- Swipe the FastCard to access PAS, confirm the member’s eligibility for the service requested and submit an electronic claim;
- The system will then print a duplicate receipt. Please obtain the member’s signature on the receipt and ensure that it matches the signature on the back of the card.
If the cardholder is a minor, an authorised adult can sign on the cardholder’s behalf.
If you have any doubt about the customer’s identity, please decline the service or advise the cardholder to pay for the service and submit a claim to Sagicor for reimbursement
- Hand a copy of the signed receipt to the cardholder and retain the original for your records. Sagicor will need access to your copy of the receipt for audit purposes when necessary.
- Within seven (7) working days of your electronic claim submission, Sagicor will print your cheque for despatch or collection.
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Q. I am a PAS Provider who does not provide Dental, Optical or Prescription Drug services. What should I do?
A. Providers who have access to the Provider Access System should continue to accept the FastCard for their specialized area of health service.
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Q. I Do Not Have The Provider Access System (PAS). What Should I Do?
A. Sagicor® Participating Providers who do not have the Provider Access System (PAS) should:
- Accept the FastCard.
- Call the toll free Provider Voice Response (PVR) system at telephone no. 1-888-3425-225 to verify the member’s eligibility for service; or
- Call the PAS Help Desk at 927-6811, 927-6839,
946-2266, 927-3134, 946-9716.
The Provider Voice Response (PVR) system will be able to verify the member’s benefit amount and issue an authorization number which the provider must enter on the paper claim form submitted to Sagicor to validate the provider’s claim for payment.
The PAS Help Desk will facilitate verification of the member’s eligibility and authorize the service by the provider.
However, the provider must note the name of the authorizing Help Desk officer on the paper claim form.
The Provider Voice Response (PVR) system and the Help Desk verification are not an alternative to PAS.
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Q. What if telephone service is not available?
A. In circumstances where participating providers of Dental, Optical and Prescription Drug services cannot access telephone service, they are advised to continue to submit a paper claim with the additional inclusion of the FastCard member number , e.g. 0123456 001 and group number, e.g. 7350
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Q. What if the sagicor member does not present the FastCard?
A. Every effort has been made to ensure that our members are in receipt of their FastCards. In cases where members have the paper health cards only you are allowed to accept the paper card and call the Provider Voice Response System or the PAS Help Desk to confirm eligibility for service.
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Q. How will I know the member’s FastCard balance?
A. Providers will not have direct access to the member’s balance. Sagicor members may access information on current balances by calling the Sagicor Subscribers’ Voice Response System.
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Q. I am a participating provider but not a PAS provider, how do I enroll?
A. Providers who are not PAS providers may contact the Provider Services office to
inform the manager of their intention to enroll. The follow-up will be done by
AIS.
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