Tivity Health - Silver Sneakers/Prime Insurance Guide

Liftbrands IT Admin -

This guide will cover eligibility verification, basic program summary, membership details, and how to sign up the member in Fitware. For further information contact Danielle Svobodny. dsvobodny@liftbrands.com

Please note the Prime program is similar to Silver Sneakers program, with the exception that it targeted towards non-seniors.


 

Eligibility Verification

Before signing up the member it is recommended you verify the member's eligibility by accessing the Healthways Fitness Provider Portal. You can access the site by going to the Snap Fitness Owners portal then under Supplies and Services click Healthways Fitness Portal. Use the members 16 digit ID to check for eligibility, if they do not have their ID you can use the members first and last name along with there date of birth.

Note: If you use the eligibility icon you must enter their full name as it appears on their health insurance card to generate accurate information.

Program Summary

Silver Sneakers is the nation’s leading exercise program designed exclusively for older adults, offering physical activity, health education and social events for people who are Medicare-eligible and Group Retiree members. Provided by Healthways, this program helps reduce health care costs by reducing the physical and mental effects of ageing and reducing the number of hospital visits for older adults.

Prime is a similar benefit to Silver Sneakers for the non-senior population. All new U.S. Snap Fitness clubs will be included in the Prime program, allowing eligible individuals to take advantage of our clubs while generating revenue for you on a pay-per-visit basis.

Membership Details

Silver Sneakers

  • Silver Sneakers members should be given a Single-Reciprocal membership at no cost.
  • Snap Fitness wavies the dues, enrollment fee, and access card fee.
  • Tivity Health agrees to pay $2.85 per visit with an 8 visit monthly cap of $22.80 for eligible and properly enrolled individuals at your club. Please note that once we hit a certain number of Healthways visits submitted among all Snap Fitness clubs in the US, the rate per visit drops.
  • Whether married or single and living in the same home, each Silver Sneakers member must be enrolled separately as a single membership. The program does not pay for family memberships. 

Prime Program

  • Prime members should be given a Single-Reciprocal membership at no cost.
  • Snap Fitness wavies the dues, enrollment fee, and access card fee.
  • Tivity Health agrees to pay $2.75 per visit with a 12-visit monthly cap of $33.00 for eligible and properly enrolled individuals at your club. Please note that once we hit a certain number of Healthways visits submitted among all Snap Fitness clubs in the US, the rate per visit drops.
  • Whether married or single and living in the same home, each Prime member must be enrolled separately as a single membership. The program does not pay for family memberships.

Reimbursement details

 

  • Snap Corporate will deposit your monthly reimbursement from Healthways into your account. This happens around the 15th of each month and is combined with any other reimbursement you receive from other programs such as Silver&Fit, People’s Health, Union Pacific or At Your Best.
  • You are reimbursed monthly for the club usage your SilverSneakers/Prime members had 2 months prior. For example, in March of 2016 you will be reimbursed for your SilverSneaker’s member’s usage from January of 2016. Your reimbursement will follow in this pattern.
  • Snap Corporate is responsible for providing Healthways the monthly attendance report. You do not have to submit anything.
  • If a member does not use a club for a given month, you are NOT reimbursed for that membership that month but the member remains active in our database as long as he is a SilverSneakers or Prime participant. Please note that we recommend terminating or freezing Healthways members if they have not visited the club in 3+ months. That way if they do decide to visit again, they will contact you regarding their access card not working and you can change their status back to OK. This will cut down on having Healthways members in your system and appearing on reports that are not actively using the club.
  • Tip: Maximize your potential for reimbursement by contacting SilverSneakers/Prime members who have not used your facility in awhile and invite them back in. Also, there are “We miss you forms” that are available in the portal for you to mail letters to these members if they have not been in your club recently. These forms are only to be used for SilverSneakers members at this time.
  • Your club is charged $35 monthly for this service but only if you have members enrolled in the program. Additionally, if you have members enrolled in another insurance reimbursement program, then you will not be charged a second service fee.

Fitware Sign Up Instructions

You have to enter anyone who is under an insurance group that pays for their entire membership as a Single-Reciprocal member with dues of $34.95 and form of payment Statement

Please see image below as to how to properly enter the member's insurance information into Fitware. Note, it is important to fill in all the fields listed below (including the group field) so that your member is billed properly.

 

Silver Sneakers

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Prime Program

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