Participant Rights and Responsibilities
Contact Solera
How do I contact Solera?
If you have any questions, you can contact Solera by:
- Email at support@solera4me.com
- By phone at 877.486.0141
- Monday – Friday, 9am – 9pm Eastern Time
Diabetes Prevention Program (DPP)
Participant Rights and Responsibilities
Diabetes Prevention Program (DPP) participant’s rights
As a participant, you have the right to:
- Be treated fairly with respect and dignity, regardless of your race, color, religion, gender identity, ethnicity, age, disability, or national origin
- Maintain a confidential relationship with your DPP Provider and Lifestyle Coach, and to have your participation in DPP Services and other personal information kept private (except when laws or regulatory bodies permit or require disclosure)
- Be informed of the nature of the information that may be shared for the purposes of paying for your benefits
- Get services in a timely fashion
- A clear explanation of the reasons to participate in DPP services
- Receive DPP Services in a language that you can understand, and in a culturally sensitive way
- Receive information about your insurance/third party payer, DPP Providers and Lifestyle Coaches, the DPP services, and their role in the treatment process
- Know which DPP services are covered by your health plan, and how the DPP services will be provided
- File a complaint, grievance, or appeal and learn how to file them
- Receive information on your rights and responsibilities in the DPP process
- Expect reasonable accommodations for communication of health information
- Request a change in your DPP Providers and/or Lifestyle Coaches in accordance with DPP Provider Changes and payer allowances
DPP participant responsibilities
Your responsibilities as a DPP participant include:
- Adhere to the eligibility requirements to participate in the DPP
- Adhere to the participation requirements to continue your enrollment in the Diabetes Prevention Program (DPP) DPP participation requirements
- You must be found eligible to enroll in the Diabetes Prevention Program
- To be considered eligible, you must meet the CDC Diabetes Prevention Program requirements for Participant Eligibility
- You aren’t diagnosed with Type 1 or Type 2 Diabetes before attending your 1st Core Session
- You must meet the “Rules for active participation” listed below
Rules for active participation
- The “In-Person Program Attendance” requirement is considered met once you arrive at and participate in a DPP Session
- The “Virtual Program Attendance” requirement is considered met when you complete a minimum number of activities in the DPP that equal to a 60-minute session. Acceptable activities include:
- Interacting with your coach and/or with a group
- Recording your meals and/or physical activity
- Review of educational material as provided by the DPP Provider
Your program may have different requirements. Please contact Solera’s Participant Care Center at 877-486-0141 for more details on your health plan’s Active Participation Requirements.
Being un-enrolled from the program
You may be removed from DPP services if:
- You don’t meet the minimum participation requirements
- Your health insurance plan coverage ends
- Your service period ends, for example:
- You’ve completed the Core, Core Maintenance, and On-Going Maintenance Intervals of the DPP
- You or your designee requests removal or disenrollment from the DPP Supplier’s services
DPP provider changes
- At any time, and for any reason, you may submit a request to change your DPP Providers
- Provider change requests are subject to Solera and/or health insurance plan approval
- Any change to another DPP Provider requires that you re-start the Program
Program costs and billing
- Solera has agreed to rates for our services with contracted health insurance plans
- These rates are paid to Solera in the form of Milestone Payments
- These payments occur when you’ve reached a certain program performance goal as identified by your health plan
- Solera and our providers only get paid if these goals are reached
- Neither Solera, nor any of our DPP Providers, will directly bill you for any services or products as part of the Diabetes Prevention Program
How to submit a grievance, complaint, or other concern
You’re encouraged to submit your complaints, grievances, or other concerns about the services you receive under the Diabetes Prevention Program (DPP). Solera takes your concerns very seriously and looks at participant concerns as opportunities to improve our service delivery of the DPP for all participants.
"Grievance" means a written or oral expression of dissatisfaction including quality of care concerns. If Solera is unable to distinguish between a grievance and an inquiry, it shall be considered a grievance.
"Complaint" is the same as "grievance."
We encourage you to include your name and contact information, but we’ll accept complaints and grievances anonymously. However, anonymous grievances may limit Solera’s ability to respond to your concern.
You may submit your complaints and/or grievances:
- Directly to your DPP Provider, who will forward the complaint to us
- Directly to us by:
- Clicking the “Submit a Concern” link on the SoleraNetwork.com website, or
- Calling the Solera Complaints and Grievances Hotline at 602-257-9326
- Directly to your health insurance plan for investigation and response
Participant privacy rights
Solera reserves the right to routinely update our privacy policy. Should our privacy policy change, we will post a revised notice on the SoleraNetwork.com website and post the revised privacy policy in our offices. We will not use or disclose your health information without your authorization, except as described within our Notice of Privacy Practices.
Examples of Uses and Disclosures of Private Health Information
We will use and/or disclose your health information:
- For purposes of treatment, payment, and healthcare operations
- To your primary care physician or a subsequent health care provider with copies of various reports that should assist them in treating you
- To a family member, other relative, friend or any other person you identify, but only health information relevant to that person’s involvement in your care or payment related to your care
- As required by law, such as disclosures about victims of abuse, neglect, or domestic violence; disclosures for judicial proceedings; and disclosures for law enforcement purposes
- For purposes of evaluating and standardizing test instruments that may be published
- To researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information. DPP Participants involved in research at our practice would first read and sign an informed consent document.
- To our Business Associates, such as a DPP Provider, so that they can perform the job we have asked them to do
- To protect your health information, we require the Business Associate to appropriately safeguard your information
- To notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location and general condition
- To provide appointment reminders or information about treatment alternatives, or other health-related benefits and services
- To the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law
- As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability
For more information regarding Solera’s Privacy Practices please visit: https://soleranetwork.com/privacy-practices/
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