When you join RMHP, you're trusting us to help guide you on your healthcare journey - and we take pride in that. RMHP offers extra services and personalized assistance that can help you take steps in your journey to better health, no matter what plan you have. We hold accreditation status from the National Committee for Quality Assurance, so you know you're in good hands. Below, you’ll find information that will help you understand your health coverage.
Becoming an RMHP Member
When you enroll with RMHP, you’ll receive a Member ID card. There’s no activation required for this card; simply take it with you when you need medical or pharmacy services, and your provider’s office will take care of the rest.
When you join, we encourage you to select a Primary Care Provider, or PCP (some plans require you to make a PCP selection). If you need to find an in-network provider, simply use our convenient Online Provider Directory.
We also offer a variety of online tools and resources for you to make the most of your plan with RMHP. With MyRMHP, our secure Member portal, you can:
- Estimate medical costs of services with our online Cost Estimator tool.
- Save a tree and enroll in paperless documents
Claims, Billing, and Benefits
Health insurance plans can be complex, and we know you might have questions. We provide tools and resources that can help you find the answers you need. Looking to pay your premium? Our Online Premium Payment makes it easy to make secure, monthly payments online. MyRMHP, our secure Member portal, allows you to estimate your treatment costs and view information about your claims. You can also refer to your Coverage Schedule in the Schedule of Benefits, found in your Health Plan Guide. If you still have questions, our dedicated Customer Service team is here to help you navigate your plan.
Understanding Prior Authorization
At RMHP, some types of care, medications, and/or equipment must receive approval from us before that care or service can be provided. This is called prior authorization. Prior authorization helps to make sure you get the care that’s right for you and at the maximum level of coverage that your plan allows. Our goal at RMHP is to make the prior authorization process as easy as possible for our Members.
We Care By Being Here
We understand that each Member's health is different, so the RMHP Care Management team works with you and your doctors to make sure the health care you receive is high quality, cost-effective, and right for your situation. Our Care Management team includes physicians, registered nurses, care coordinator, and specialists in oncology, diabetes, asthma, and prenatal care.
We will also help you if you require hospitalization. During a hospital stay, an RMHP registered nurse will monitor your stay. Our nurses help to make sure that you are getting the quality care that you need. We also work with doctors and hospital staff to figure out what you need when you leave the hospital. You may need home health services, medical equipment, or other care and services.
We Help You Manage Your Health
Our Disease Management program provides the support you need to manage your diabetes and asthma. Our nurses are available to answer your questions and offer advice and care tips – at no cost. We will also help you work with your provider to follow your individual health care treatment plan. Members are enrolled in the Disease Management Program based on medical and pharmacy claims.
Case management services are free for RMHP Members. If you need help coordinating care, our nurses can help you. They will talk with your doctors to find the best care for you. They can help with day-to-day management of your condition or recovery. Also, if you need more help or information, our team will help you find it. Our nurses can offer support to you and your family. To reach the Case Management Team, call 970-248-8718 or 800-793-1339.
To make a self-referral to the Disease Management or Case Management programs, you can call 888-847-6466. You can also make a self-referral on our website.
It is your choice to be in these programs, and you may choose to be removed from a program at any time. If you do not want you or your child to take part in these programs, please call us at the number listed above.