MyMedicalRewards Configuration

Configure and manage the MyMedicalRewards™ program to incentivize cost-effective healthcare decisions. This comprehensive guide covers reward parameters, processing workflows, and best practices for maximizing member engagement and employer savings.

MyMedicalRewards™ provides financial incentives to members who make cost-effective healthcare decisions, creating a win-win scenario for both members and employers.

What is MyMedicalRewards™?

MyMedicalRewards™ is a comprehensive incentive program that provides financial rewards to members who make cost-effective healthcare decisions. By comparing prices and choosing lower-cost, high-quality providers, members earn rewards that can be processed through employer payroll or HSA contributions.

How MyMedicalRewards Works

Rewards Process Flow
1
Member Shops
Member uses MyMedicalShopper™ to compare prices and finds a lower-cost provider for their needed procedure
2
Service Received
Member receives healthcare service from the chosen provider and the claim is processed
3
Savings Calculated
System calculates the savings compared to average market rates or highest-cost alternatives
4
Reward Earned
Member receives a percentage of the savings as a financial reward based on configuration

Configuration Parameters

The rewards system offers flexible configuration options to align with each employer's benefit strategy and budget requirements:

Savings Threshold
Minimum dollar amount of savings required before a member becomes eligible for a reward.
  • Prevents small reward amounts
  • Reduces administrative overhead
  • Typical range: $50 - $200
  • Lower thresholds = higher participation
Reward Percentage
Percentage of savings shared with the member as their reward amount.
  • Balances member incentive with employer savings
  • Higher percentages drive more engagement
  • Typical range: 15% - 50%
  • Can vary by procedure type
Maximum Cap
Upper limit on individual reward amounts to control budget exposure.
  • Prevents unexpectedly high payouts
  • Enables budget predictability
  • Typical range: $200 - $1,000
  • Higher caps for major procedures
Eligible Procedures
Specific healthcare procedures and services included in the rewards program.
  • Focus on high-impact procedures
  • Target areas with significant price variation
  • Common: imaging, surgery, lab work
  • Can expand over time

Configuration Best Practice

Start with conservative settings and gradually adjust based on actual engagement data and budget impact. Most successful programs begin with moderate thresholds and percentages, then optimize after 3-6 months of data collection.

Accessing Configuration

To configure rewards settings for an employer group:

  1. Navigate to Employers: Go to the Employers section in the main navigation
  2. Select Employer Group: Choose the specific employer group from the list
  3. Open Actions Menu: Click the Actions dropdown for the selected group
  4. Select Configuration: Choose "MyMedicalRewards Configuration" from the menu
  5. Adjust Parameters: Modify the threshold, percentage, cap, and eligible procedures
  6. Save Changes: Apply the new configuration settings

Important Note

Configuration changes typically take effect for new claims processed after the modification date. Existing pending rewards maintain their original configuration parameters. Always communicate configuration changes to employer group administrators.

Tracking and Management

The MyMedicalRewards table provides comprehensive tracking of all rewards earned, processed, and pending:

ColumnDescriptionPurpose
EmployerEmployer group assigned to employeeGroup identification and filtering
EmployeeEmployee name (First Last)Member identification for inquiries
Reward ReasonHealthcare procedure or serviceUnderstanding reward context
Reward AmountDollar amount of earned rewardFinancial tracking and budgeting
StatusProcessing stage of rewardWorkflow management
Reward Earned DateDate when reward was earnedTimeline tracking and reporting

Available Actions

The MyMedicalRewards™ interface provides several management actions:

  • Export Rewards File: Generate detailed reports of rewards for payroll processing or financial analysis
  • Update Processing Status: Manually update the status of rewards that have been processed externally
  • Filter and Search: Find specific rewards by employee name, status, or employer group
  • Bulk Operations: Process multiple rewards simultaneously for efficiency

Data Export Considerations

When exporting rewards files, apply appropriate filters to avoid processing large datasets unnecessarily. By default, all rewards entries export, which could lead to significant data volume. Use status and date filters to export only relevant records.

Implementation Best Practices

Strategic Configuration Approach

  • Conservative Launch: Begin with moderate parameters and adjust based on actual usage patterns
  • Budget Alignment: Ensure reward configuration aligns with employer budget constraints and savings goals
  • Communication Plan: Develop clear member communication about how rewards work and when they're earned
  • Regular Review: Schedule quarterly reviews to assess program performance and adjust parameters

Operational Excellence

  • Processing Schedule: Establish regular reward processing cycles aligned with employer payroll schedules
  • Member Support: Train support staff on reward inquiries and status explanations
  • Data Monitoring: Track key metrics like participation rates, average reward amounts, and total program costs
  • Compliance Documentation: Maintain records of configuration changes and processing activities