WTC Health Program LHI Coronavirus Update

WTC Health Program Coronavirus Update by the national provider network (outside of New York and New Jersey), which is administered by Logistic Healths Incorporated (“LHI”):

The well-being of our Members is our top priority at the World Trade Center (WTC) Health Program Nationwide Provider Network (NPN). In light of the COVID-19 pandemic, it is important for our Members to consider the following:

Teladoc Telemedicine Services

In response to the COVID-19 pandemic, the WTC Health Program NPN has partnered with Teladoc telemedicine service to ensure that you have access to care for your certified conditions during this time. You may have received a communication recently from Teladoc welcoming you into the program. That communication was a generic overview of the service. The instructions below are specific to WTC Health Program Members. To ensure proper utilization of the Teladoc services, please follow the additional guidance below:

• If you are unable to access care with your current Provider or are certified but have not yet established care with a Provider, we encourage you to reach out to your case manager to discuss this option.
• The Program will cover Teladoc services related to your WTC-related conditions at no cost to you.
• For any other non-covered/certified conditions, you will need to follow up with your regular Provider.

Do you have enough medication?

The most convenient method for ensuring that you continue to receive medication for your certified conditions is to sign up for home delivery.

To receive more information on home delivery or to enroll, please call Optum’s WTC Health Program Pharmacy Benefit Services line at (855) 640-0005 and choose Option 2. You can also visit https://wtchomedelivery.optum.com/ and select ‘Click to Enroll’ to have a customer service representative contact you.

The Program is also allowing you to receive early refills of medications on an as-needed basis. You can contact your local pharmacy to have your prescriptions filled as usual.

Do you have any upcoming tests, treatments or appointments? 

We encourage you to contact your Provider to discuss any upcoming appointments and, if possible, use the telehealth services they may have available. The Program has approved telehealth services during this public health emergency. However, each Provider may differ in the services they offer. Contact your provider for more information. If your Provider does not have telehealth services available, contact our case management team at 877-498-2911, ext. 89960 to discuss if Teladoc would be an option for your certified conditions.

Is your medical equipment (oxygen, CPAP, nebulizers, etc.) working properly? Do you have enough supplies?

Ensuring that you have the correct equipment and supplies will be essential over the coming weeks/months. We encourage you to have a 30-day supply on hand. If you need supplies, reach out to your Durable Medical Equipment (DME) Provider or contact us so we can help.

You can visit http://www.cdc.gov/wtc/covid19.html for more Program information on COVID-19. For CDC information on COVID-19 prevention tips, symptoms and what to do if you get sick, visit www.cdc.gov/coronavirus.

We’ve also enclosed some Frequently Asked Questions (FAQs) to address some of the inquiries we’ve received from Members related to COVID-19.

We are here to support your health and safety. As the situation evolves and guidance changes, we will continue to provide updates. If you have any question or concerns, call us at 877-498-2911, ext. 89960.

Sincerely,

Theodore L. Aquino, DO, MBA, MSPH, FACOEM
World Trade Center Health Program Nationwide Provider Network

Frequently Asked Questions

Will the Program pay for COVID-19 testing?

Current guidance is that the Centers for Disease Control and Prevention (CDC) is covering the cost of testing for people who meet the CDC criteria for testing.

Will the Program pay for treatment of COVID-19?

This will be reviewed on an individual basis. It requires criteria be met, along with approval from the Program. If you have been evaluated by your Provider and tested positive for COVID-19, please contact the NPN, and you will be scheduled to speak with a RN Case Manager.

Should I be tested for COVID-19?

Your Provider will let you know if you should be tested for COVID-19. Please call your Provider prior to showing up to a clinic to avoid unnecessary exposure to and spread of disease.

What are the symptoms of COVID-19?

Symptoms include fever, cough, flu-like symptoms and/or shortness of breath.

Should I cancel my monitoring appointments?

You should contact the Provider’s office to see if they are canceling their appointments for routine or non-essential visits. If the Provider is still completing these visits, reschedule your appointment if, in the past 14 days, you have traveled to a high-risk area; had close contact (been within approximately six feet) with someone who has traveled to a high-risk area; had close contact (been within approximately six feet) with someone who has a confirmed case of COVID-19; or if you have any of the following symptoms: fever, cough, flu-like symptoms or shortness of breath.

Should I cancel my diagnostic appointments?

You should reschedule your appointment if, in the last 14 days, you have traveled to a high-risk area; had close contact (been within approximately six feet) with someone who has traveled to a high-risk area; had close contact (been within approximately six feet) with someone who has a confirmed case of COVID-19; or have any of the following symptoms: fever, cough, flu-like symptoms or shortness of breath. The new appointment should be more than 14 days after symptom onset or exposure date.

You should also contact the Provider’s office to see if they are canceling their appointments for routine or non-essential visits. If you have any concerns regarding this appointment, please contact the NPN, and you will be scheduled for a call with a RN Case Manager.

Should I cancel my appointments for certified conditions?

You should contact your Provider’s office to see what their policy is related to scheduled appointments during this time. Some Providers have been canceling appointments that are considered routine or non-essential. If you need your routine visit to renew medication, make sure to communicate this to the Provider’s office.

The Program has been approved to cover telehealth services during this public health emergency; however, each Provider may differ in the services they offer. Contact your Provider for the services they are able to provide. If your Provider does not have telehealth services available, reach out to our case management team to discuss if Teladoc would be an option for your certified conditions.

Will the Program be paying for masks or sending masks out to Members? 

The Program is not allowed to provide disinfectant supplies or protective equipment (rubbing alcohol, other disinfectants, gloves, masks, etc). If you feel you are in need of these supplies, please contact your Provider or your local COVID-19 resource helpline. Please follow CDC guidelines for prevention, including social distancing and washing your hands.

Does this mean my certification requests are on hold?

No, the WTC Health Program NPN certification specialists are continuing to work on all requests in the order that they are received. The WTC Health Program reviewers are still reviewing all requests that are sent to them.

I have not completed my Initial Health Exam for Survivors, and my appointment was canceled. Can my certifications be processed before this exam is completed?

We will work with you to address your acute treatment needs and make sure we are taking steps to get you the care you need. Having access to your medical records will help expedite the process of certifying your health conditions. We encourage you to submit your medical records and/or provide authorization forms so we can obtain them on your behalf.

How can I obtain more medications?

Optum is allowing for early refills. Please contact your pharmacy for a refill. If you need authorization or have any difficulty obtaining medications, please have your pharmacy contact the number on the health program card. Mail-order medications are also an option and provide a 90-day supply mailed to your home.

Does the Program cover telehealth services?

The Program has been approved to cover telehealth services during this public health emergency; however, each Provider may differ in the services they offer. Contact your provider for the services they are able to provide. If your Provider does not have telehealth services available, reach out to our case management team to discuss if Teladoc would be an option for your certified conditions.