Blog // HealthSmart Blog // March 2020

COVID-19 Information from HealthSmart

3/12/2020 1:27:58 PM

COVID-19 Information from HealthSmart

by Tom Mafale, EVP, Chief Sales & Client Officer

Each day, we are seeing more developments and news coverage related to COVID-19. Our team of clinicians and industry experts is monitoring this situation very closely. As expected, more cases of the COVID-19 coronavirus are being diagnosed, and we anticipate this number to rise in the coming days and weeks.

We want to assure our broker partners, clients and members that we are committed and prepared to support those we serve throughout this situation. As part of this commitment, we are sharing information about COVID-19 and details about member access to medical care. We also want to provide you with insight into our business continuity planning, which provides appropriate, proactive measures to minimize any possibility of disruption to our service delivery and business operations.

What We Know Right Now About COVID-19
  • The most commonly reported symptoms included fever, dry cough, and shortness of breath.
  • It is important to know that most patients (80%) experienced mild illness. Approximately 14% experienced severe disease and 5% were critically ill. Early reports suggest that illness severity is associated with age (>60 years old) and patients who already have a chronic underlying health condition.[1] 
  • The disease can spread from person to person through small droplets from the nose or mouth which are spread when a person with COVID-19 coughs or exhales.[2]
  • More cases of COVID-19 are likely to be identified in the United States in the coming days, including more instances of community spread. It’s likely that at some point, widespread transmission of COVID-19 in the United States will occur.[3]
  • Widespread transmission of COVID-19 would translate into large numbers of people needing medical care at the same time. For this reason, we recommend seeking advice from your doctor first before visiting a hospital or ER.
  • At this time, there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions would be the most important response strategy.[4]
  • Protection from and prevention of spreading COVID-109
    • Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water.
    • Maintain at least 1 meter (3 feet) distance between yourself and anyone who is coughing or sneezing.
    • Avoid touching eyes, nose and mouth. [5]
HealthSmart Member Access to Medical Care
  • For members who develop symptoms and have been in close contact with a person known to have COVID-19 or have recently traveled from an area with widespread or ongoing community spread of COVID-19, we encourage you to immediately call your physician for advice.
  • To find a network provider or inquire about benefits and coverage limits, members should visit their member portal at or call the member services number on their member ID card.
  • For HealthSmart clients who offer Teladoc as part of their member benefits package, their members can conduct a virtual visit with a physician, either by phone or through the Teladoc app.
    • NOTE: If your health plan provides access to Teladoc, the cost will be determined by each individual plan. Plan sponsors can contact their Client Service Executive to add Teladoc services to their benefit plan.
HealthSmart Operational Readiness
  • Business continuity planning – We are actively reviewing and refining our disaster recovery and business continuity plans to ensure proper process and controls are defined and followed if this situation escalates. This includes procedures to ensure our ability to continue business operations if our primary physical spaces become unavailable – including enabling staff to work from home or shifting workload between physical locations. 
  • Testing the program – Testing allows us to validate the effectiveness of the business continuity and recovery procedures, and our readiness to respond to changing circumstances – including, but not limited to, office closures and quarantines, as well as public transportation and critical service provider disruptions.
  • Operational preparedness – We have processes available for our mass communication tools to ensure we can quickly and efficiently engage with internal and external stakeholders in the event we need to reach out with important information and updates.
  • Employee awareness & prevention – We have launched an internal education program to ensure our employees understand risks and take proper precautions – from using hand sanitizer, to washing hands frequently, to proper cough/sneezing etiquette, to sending sick employees home.
  • Employee travel – We are continuing to monitor travel restrictions and are prepared to conduct business with travel severely restricted. 
  • Management oversight and governance – The entire HealthSmart executive and management teams have been actively involved in business continuity and disaster recovery planning to ensure we're ready as this situation unfolds. 
How Will This Situation Affect HealthSmart’s Claim Processing and Call Handling?
HealthSmart does not anticipate a disruption in our ability to provide excellent service and support. With our business continuity plans in place, we expect to continue to process claims in timely manner. Likewise, we expect our call handling capabilities to remain at the same or similar levels.

We are continuously monitoring this situation and will take action based on guidance from both the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). In the meantime, it is business as usual, while practicing recommended precautions and continuing to prepare for scenarios that may arise. 

[1] World Health Organization, Coronavirus disease 2019 (COVID-19), Situation Report–4
[2] World Health Organization, Q&A on coronaviruses (COVID-19)
[3] Centers for Disease Control and Prevention, Coronavirus Disease 2019 (COVID-19) Situation Summary
[4] Centers for Disease Control and Prevention, Coronavirus Disease 2019 (COVID-19) Situation Summary
[5] World Health Organization, Q&A on coronaviruses (COVID-19)