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Frequently Asked Questions

These frequently asked questions provide basic information regarding how the Compass SmartShopper program works in general for members. Specific information regarding how the program works for your employer can be found by logging in. Please refer to the FAQs that you receive from your employer or from Compass for full details about the program. If you have questions, give Compass a call and a Health Cost Adviser can answer any questions you may have.

Program
Does the program cost me anything?
No. The program is free, easy to use, hassle-free and completely voluntary.
Am I eligible and how do I sign-up?
All active employees currently enrolled in the health benefit plan and enrolled dependents are eligible for the Compass SmartShopper™ program. In addition, retirees and their dependents in the Under Sixty Five Retiree Health Plan (who are not Medicare eligible) are eligible to participate in the program. If you are eligible, you are automatically enrolled and can use the service at any time. There is no need to sign-up.
Does Compass SmartShopper™ offer medical advice?
Compass SmartShopper™ provides only cost information for procedures that your doctor has requested. Compass SmartShopper™ does not offer medical advice and contacting Compass SmartShopper™ is NOT a substitute for medical advice from your doctor.
Is the Compass SmartShopper™ program confidential?
Absolutely. Compass SmartShopper™ does not share employee or dependent claims information with your employer. Your consultation with Compass SmartShopper™ is completely confidential.

Incentives
How do I qualify to receive an incentive reward?
There are 2 steps…first call Compass SmartShopper™ (or go online) if you need a medical service or diagnostic test from the list of services. You will be provided with cost-effective facilities in your area that qualify for an incentive. Choose to seek care at one of the cost-effective facilities identified by Compass SmartShopper™ and you automatically qualify for an incentive reward. Only those eligible to participate in the program can qualify for incentives. Check out the eligibility FAQ for further details on who is able to participate.
How will the incentives be paid?
If you qualify, an incentive will be mailed to your home within 60 days of your claim being paid. To qualify, you must have contacted Compass SmartShopper™ at least 24 hours prior to receiving your care at a cost-effective facility identified by Compass SmartShopper™ . We compare the call records and web transactions against the claims information to determine if you qualify. Please note: incentives are considered taxable by the IRS. Compass SmartShopper™ will provide the appropriate tax information at year-end.
Is the incentive taxable?
Yes. The incentive that you earn is considered taxable income. If you reach the $600 threshold in a given year where a 1099 is required, Compass will work with your employer to provide you with the proper 1099 forms. For all other incentives, Compass will provide you with a year-end summary to report the income on your personal tax return.

Services
What services qualify for an incentive?
Compass SmartShopper™ only targets high-volume, elective procedures and diagnostic tests, such as mammograms and colonoscopies…procedures that are known well in advance and that are not considered high-risk. The Compass SmartShopper™ program will begin with a core set of services, but will expand over time to cover additional services.

Benefits
What if I have a question about my benefits, such as are certain procedures covered?
Contact Customer Service at the phone number listed on the back of your insurance card. If you have questions that arise during your conversation with a Health Cost Adviser, they will put you in touch with the appropriate member of the Customer Service team to get your benefit questions answered.

Doctor
Will I have to change my doctor?
In many instances, your doctor may have “admitting privileges” which means he/she is able to perform the service in a number of different facilities that have availability. You are able to ask your doctor to perform the service at the facility of your choice. There may be certain instances where your doctor may not be able to treat you in a different facility but it is important to discuss your options with your physician. Because the program is voluntary, you may decide you would rather not change doctors. The decision is yours and you are free to choose any doctor to receive your service.
What about quality?
Compass SmartShopper™ is a cost-based incentive program and does not provide information regarding quality simply because quality is difficult to measure for specific services such as an MRI. As is the case today, it is up to you to talk to your doctor or research online at anthem.com to determine your quality requirements. All facilities identified as cost-effective are well-known, fully licensed to provide services in New Hampshire and all meet the rigorous standards to be credentialed providers as part of the Anthem network.
What if my doctor has already scheduled me at another facility?
Call Compass SmartShopper™ and a Health Cost Adviser will determine if the service that your doctor recommends qualifies for an incentive. If you have a scheduled appointment already, Compass SmartShopper™ will help you to change your appointment to allow you to seek a cost-effective facility in your area so that you qualify for an incentive.