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
MDPP PARTICIPANT’S RIGHTS
Participants have the right to:
- Be treated fairly with respect and dignity, regardless of race, color, religion, gender identity, ethnicity, age, disability, or national origin.
- Maintain a confidential relationship with their DPP Provider and Lifestyle Coach, and to have their 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 disclosed for the purposes of paying benefits.
- Easily access services in a timely fashion.
- A clear explanation of the reasons to participate in DPP Services.
- Receive DPP Services in a language that they can understand, and in a culturally sensitive way.
- Receive information about their 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 their health plan, and how the DPP services will be provided.
- Freely file a complaint, grievance, or appeal, and to receive knowledge on how to do so.
- Receive information on their rights and responsibilities in the DPP process.
- Expect reasonable accommodations for communication of health information.
- Request a change in DPP Providers and/or Lifestyle Coaches in accordance with DPP Provider Changes and payer allowances.
MDPP PARTICIPANT RESPONSIBILITIES
Participants have the responsibility to:
- Adhere to the eligibility requirements to participate in the DPP.
- Adhere to the participation requirements to continue their enrollment in the Medicare Diabetes Prevention Program.
MDPP PARTICIPATION and ELIGIBILITY REQUIREMENTS
To enroll in the MDPP program, all participants must meet the following requirements:
- Are enrolled in Medicare Part B
- Have a body mass index (BMI) of at least 25, or at least 23 if self-identified as Asian
- Meet 1 of the following 3 blood test requirements within the 12 months of the first core
- session:
- A hemoglobin A1c test with a value between 5.7 and 6.4%, or
- A fasting plasma glucose of 110-125 mg/dL, or
- A 2-hour plasma glucose of 140-199 mg/dL (oral glucose tolerance test)
- Have no previous diagnosis of type 1 or type 2 diabetes (other than gestational diabetes)
- Do not have end-stage renal disease (ESRD)
- If a participant attempts to enroll at a MDPP provider location and does not meet all the requirements listed above, the participant will not be permitted to enroll in the program in accordance with CMS/CDC requirements.
- Once enrolled, participants must notify their MDPP coach if diagnosed with end-stage renal disease.
- Participants must work diligently to lose at least 5% of starting body weight.
- Participants must attend all scheduled classes.
- To be eligible to participate in ongoing maintenance sessions during months thirteen (13) through twenty-four (24), the MDPP Participant must completed all of the following steps:
- Achieved weight loss of at least 5% from baseline weight,
- Attended at least one in-person core maintenance session in interval #2 (months 10 through 12),
- Achieved or maintained at least five percent (5%) weight loss as measured during interval #2.
- To maintain eligibility for ongoing maintenance sessions, participants must:
- Attend at least 2 ongoing maintenance sessions during the previous 3-month session interval, and
- Maintain at least five percent (5%) weight loss at least once during the previous interval.
Diabetes Prevention Program Disenrollment – MDPP participants will be disenrolled (removed) from MDPP services if the participant experiences any of the following:
- Participant fails to meet the minimum participation requirements (for example, loses Medicare coverage, develops ESRD).
- Participant health plan coverage ends.
- Participant requests removal / disenrollment from the MDPP Supplier’s services.
Submitting a Grievance, Complaint, or other Concern
MDPP Participants are encouraged to submit their complaints, grievances, or other concerns about the services they are receiving under the MDPP. Solera takes participant concerns very seriously and looks at these concerns raised as opportunities to improve the MDPP service delivery. Participants are encouraged to include their name and contact information when submitting a complaint or grievance but are permitted to submit their issues anonymously.
Participants may submit their complaints and grievances in the following ways:
- Directly to their MDPP Provider, who will forward the complaint or grievance to Solera.
- Directly to Solera utilizing the following methods:
- Click the “Submit a Concern” link on the SoleraNetwork.com website.
- Call the Solera Complaints and Grievances Hotline at 602-257-9326.
- Directly to the participant’s health plan for investigation and response.
Participant Privacy Rights
We reserve the right to change 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 below. We will also discontinue using or disclosing your health information after we have received a written revocation of authorization.
Examples of Permitted 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 in treating you.
- Subject to your grant of permission to any other identified party.
- 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 result in publication.
- 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. MDPP participants involved in research would first read and sign an informed consent document.
- To our Business Associates, such as a medical laboratory, so that they can perform healthcare operations such as billing for services rendered. To protect your health information, however, we require the Business Associate to appropriately safeguard your information.
- To provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
- To the extent authorized by and necessary to comply with laws relating to workers compensation or other similar programs.
- 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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