Vida Health Member Services Enrollment Guide

This guide provides a step-by-step workflow for enrolling members into Vida Health programs, covering platform navigation, eligibility verification, the "Mini-Consult," and successful onboarding. For more visual details please review this training

1. Preparation and Platform Access

Before engaging with a member, ensure you are logged into the necessary platforms:

• Health Guide Platform: Log in to the enrollment system using a secure browser window. Clear cache and cookies regularly to maintain performance.

• B2B Portal: Log in via your identity provider to access member eligibility tools.

2. Eligibility Verification

Verifying eligibility is the first critical step to ensure the member can access benefits.

• Search Criteria: In the B2B portal, search using the Health Plan ID (recommended).Note that for some organizations, you may need to remove specific digits from the ID. Full name can be used if Health Plan ID is unable to be found. (You MUST verify w/ full name AND 2 PHI verification pieces before confirming eligibility.)

• Confirm Status: Verify the member's Date of Birth (DOB) and ensure their status reads "Active." If the status is "Terminated," they are not eligible. 

  • Note: Never communicate 'Terminated' status to members - this only means they were not on the file sent to us by their org and they should only be told 'you are currently not showing as eligible in our system'

• CVS/Caremark Members: If the member belongs to a CVS group or is listed under CVS, do not use the main search. Instead, use the specific CVS lookup tool with the member's PayOrg, Name, DOB, and Zip Code. 

  • Note: if you can access the member's Caremark ID, you can locate their eligibility in CVS lookup without including name, dob, etc.

3. Initiating the Interaction

Once eligibility is confirmed, begin the interaction using the appropriate script.

• Inbound Calls: Greet the member, ask for their name, and verify if they are currently enrolled.

  •  "Thank you for contacting Vida Health Member Services, This is <agent name> on a recorded line, may I have your first and last name? - I would be happy to assist you today, to ensure I have the right account pulled up and to comply with HIPAA, can you please provide your DOB and Zip Code."
    (verify 2 pieces of PHI)

• Outbound Calls: Introduce yourself and Vida Health, referencing the program offered through their employer or health plan. 

  • Read scripting presented on Outbound dialer.

• PHI Verification: To comply with HIPAA, you must verify two pieces of Personal Health Information (PHI) before discussing account details. Acceptable combinations include DOB (month/year) plus Zip Code, or Employee ID plus Zip Code.

4. Account Creation & The "Mini-Consult"

After verification, move into the enrollment phase on the Health Guide Platform.

1. Create/Search Profile: Search for the member's email. If they exist, resume onboarding; if not, select the option to add a new member.

2. Collect Demographics: Enter or confirm the member's name, gender, DOB, height, weight, ethnicity, and preferred language.

3. Conduct the Mini-Consult: This is a key engagement step where you assess the member's needs using Motivational Interviewing (MI) techniques.

   • Health Conditions: Confirm conditions such as Diabetes or High Cholesterol.

   • Program Selection: Select the option to manage conditions to let the system recommend the best program. If a specific program is recommended, select it and save.

   • Goal Setting: Ask the member what success looks like for them (e.g., "What are you hoping to achieve?"). Document their personal goals, motivators, and any social determinants of health (e.g., food insecurity) in the notes.

   • Nutrition: If a physical program, ask the member if they have any food allergies or dietary preferences they'd like the coach to know about. Document in the notes.

5. Coach Selection and Scheduling

Matching the member with the right coach increases engagement.

• Preferences: Ask for the member's preferred meeting times and any specific coach preferences. Attempt open availability for best coach options, if possible.

• Scheduling: View available coaches. If a coach's schedule matches the member's availability, select a time and confirm the appointment. 

• No Availability: If no specific times match, select the coach without a time and encourage the member to schedule later via chat.

6. App Setup and Login Support

Guiding the member to log in immediately is crucial for retention.

• Mobile App (Preferred): Send a text link to download the app.

  • Login: The username is their email. The password is created via the "Action needed" email sent earlier.

  • Troubleshooting: If the password setup fails, use the "Magic Login Link" feature to text or email a direct sign-in link.

• Web App: If they prefer a computer, direct them to the client portal (vida.com/login) or send a magic link via email.

• Tour: Briefly explain the app features, including the Home screen (to-do lists), Chat (communication with the coach), and Journey (progress tracking).

7. Next Steps & Closing

Before ending the call, ensure the member knows what is required before their first provider visit and receives the correct follow-up communication.

Program-Specific Reminders For members in GLP-1 or Prescribing Programs, remind them to:

1. Upload medical records (including name, DOB, medication history, and BMI).

2. Upload lab results from the last 12 months (CMP, A1C, TSH, Lipid Panel).

3. Complete the Member Contact Form in the app.

See How to Share Your Lab Results, Medical Records, or Documents With Vida for instructions.

Post-Onboarding Follow-Up Send the appropriate email macro based on the member's specific program and organization. Select one of the following:

• Lincoln/Mondelez Members: Use the macro Enrollment Support::Follow up email post-onboarding - Lincoln/Mondelez.

  • Usage: Only for paying organizations with specific engagement requirements.

• MWL Members: Use the macro Enrollment Support::Post Enrollment Email::MWL Post Onboarding.

  • Usage: Only for members enrolled in the Medical Weight Loss (MWL) program.

• Standard Enrollment/ All Other Members: Use the macro Enrollment Support::Post Enrollment Email::General Onboarding Follow Up Email.

  • Usage: General macro for all other paying organizations.

Final Actions Remind the member of the cancellation policy and support contact options. Finally, check the "Completed Mini-Consult" box in the platform to officially log the successful enrollment.