Accolade Health Care Advocate FAQs

Can I opt out of using Accolade and talk directly with the Anthem reps? I've found it was much easier to get care with Anthem reps.

Accolade is your new member services resource and first point of contact. 

Accolade replaced Anthem Health Guide starting January 1, 2023, and we are now fully supporting all UC Care, UC Health Savings Plan and CORE plan members.

Is it free to receive advice and help navigating health care issues through Accolade?

Yes, Accolade is a free service for UC Care, UC Health Savings Plan, and CORE plan members.

Who should I call first: A UC health care facilitator or Accolade?

You still have access to your dedicated campus health care facilitators, but your first call should be to Accolade. Accolade works closely with the UC health care facilitators to help curate a comprehensive support model for you and your families.

Can I choose not to use Accolade?

Accolade is your first point of contact for all your health care needs. We work closely with your UC health care facilitators, providers and Anthem to ensure your health care needs are met.

Does Accolade have wellness resources, such as smoking cessation, health coaching and for weight loss?

Accolade is not a well-being platform. However, all the Anthem wellness resources continue to be available. An Accolade Care Advocates can direct you to these resources.

Do I need three different accounts to use all the provided services? 

No. Plan members can register with member.accolade.com, which directly links to Anthem and Navitus member portals via a single sign-on.

You’ll need to register for Accolade services — virtual Accolade Care and expert medical opinion, 2nd.MD.

When would I contact my own primary care doctor versus an Accolade Care Advocate?

Accolade is your point of contact for all providers. The first time you contact Accolade, you will be assigned your own dedicated Care Advocate and you'll be provided their direct extension. For ongoing care needs, you have your own Care Advocate who you can reach through the app or the portal, or you can call them directly.

Who would I contact to escalate an issue with Accolade?

Contact your campus health care facilitator if you’re unable to resolve an issue by contacting Accolade at (866) 406-1182.

Are all the Care Advocates dedicated to the UC account?

Yes, your Accolade Care Advocate is dedicated to your needs. If you have any specific questions about your clinical programs, you can reach out to the UC dedicated number and speak to your Care Advocate.

Can I get a primary care on my own? Do I need Accolade to find one?

You can look for a provider on your own, but with Accolade, we can do the work for you. We can even help schedule the appointment if you prefer.

How do I get a referral to see specialist?

The UC PPO plans don’t require a referral to see a specialist. But if you need help finding a specialist in the Anthem network, you can find one by using the Accolade mobile app (download for free from the App Store or Google Play), by visiting the Accolade member portal or by calling Accolade at (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT) to speak with a Care Advocate.

Do the Care Advocates have access to providers outside the United States?

No. This is not a global offering, so our providers are only located in the United States.

If a prior authorization and pre-certification is needed, does the doctor contact Accolade or Anthem?

Accolade is now owning prior authorizations and pre-certification. They have a dedicated utilization management department that reviews the medical necessity of any procedures that require prior authorization.

To talk to Accolade about prior authorizations and pre-certification, call the number on the back of your insurance card.

If I can’t reach our doctor in a timely manner for a Paxlovid prescription after testing positive for COVID-19, is there a nurse triage option?

Our nurses can't prescribe medications, but our doctors at Accolade Care, your virtual care service, can examine your and write a prescription for Paxlovid for you.

Most pharmacies and doctors listed are in California, I work remotely in Maryland. How can Accolade assist me?

Accolade providers are available in every state, so you can receive treatment wherever you are. Our primary care doctors are able to address and treat a variety of conditions, and after the appointment, they can send prescriptions to your preferred pharmacy. They can also write any orders, including lab work, if you need any diagnostic testing. They can also write orders for physical therapy or occupational therapy.

If I sustain a minor injury, should I contact Accolade first rather than going directly to urgent care or the emergency room?

Yes, via Accolade Care, you can speak with a board-certified primary care doctor or mental health therapist from your phone, tablet or computer — day or night. Accolade Care providers can help you receive care for urgent medical issues (excluding true emergencies), ongoing and chronic conditions, mental health, preventive care, prescriptions and more. Accolade Care doctors can also be assigned as your primary care physician, so you see the same doctor for each virtual visit, making it easier to manage ongoing conditions and creating a trusting relationship with a doctor and care team who are easy to reach. Learn more at Accolade Care.

How do Accolade Care Advocates search for in-network providers?

Accolade has a provider search tool within their system. Care Advocates can help members find providers through that tool or members can search through member.accolade.com or uchealthplans.com.

How can Accolade help if in-network providers are not able to treat a specific mental health issue, and the provider has told them they cannot treat their condition?

An Accolade Care Advocate can help you find an in-network provider who can treat a specific condition. If your Care Advocate cannot find a provider with an opening within 10 days and 30 miles or less in distance who can meet your needs, an out-of-network provider can be considered under the gap exception.

Is there a charge for the virtual care through Accolade Care?

Each family member gets 12 no-cost primary care and mental health therapy (age 18 and older) visits each calendar year (between January 1 and December 31). This includes annual wellness checks and preventive care. After 12 visits, the cost is $115 per visit. You can submit this charge to Anthem for reimbursement. (Your reimbursement is based on your plan’s coverage.)

Can I use Accolade Care for an annual physical checkup?

Yes, Accolade providers can also be your resource for annual wellness checks and preventive care.

After my 12 free visits, are virtual care visits billed directly to Anthem?

No. You’ll have to submit a claim with Anthem for reimbursement, either through the Anthem portal at anthem.com/ca or through the Sydney mobile app. You’ll receive a receipt for each visit to include with your claim. Your reimbursement is based on the coverage by your plan.

If you don't use all 12 free visits during the calendar year, does the balance carry over to the next year?

No.

How do I connect with Accolade Care?

You have several options:

• Connect through the Accolade member portal or mobile app or portal (download for free from the App Store or Google Play). Select the Accolade Care tile and it will take you to the Accolade Care website. On your first visit, you’ll be asked to register set up a user ID and password for Accolade Care.
• Call Accolade at (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT) and select prompt one to be connected to an Accolade health coach.
• Call your Care Advocate and ask to be connected to Accolade Care. 

Can I access virtual primary care and mental health providers through Accolade?

You have full access to virtual therapy visits through Accolade Care.

Can the telehealth providers prescribe medications?

Accolade’s mental health therapists are licensed counselors, not psychiatrists, so they can’t write prescriptions. However, if your therapist thinks that a medication regimen is needed, they can collaborate with your primary care doctor through Accolade Care to share the suggestion.

Is there a charge for any Accolade services?

The only thing that would require any out-of-pocket payment from you as the plan member is Accolade Care after you've exhausted your 12 free visits.

How long is the wait time for getting a virtual care appointment?

Oftentimes, there is same or next day availability to speak to our primary care doctors.

Appointment with mental health providers may take longer due to the increased need for mental health but we will strive to get you connected to a therapist as soon as possible.

Is Accolade Care considered in-network?

Your 12 free visits do not go through your Anthem insurance coverage. Once you've exhausted your 12 free visits, Accolade works with Anthem to ensure that all those providers are in-network. And for the UC Care plan members, the Accolade Care doctors will be billed at a tier one level.

Are counseling services provided by licensed therapists or psychologists?

Accolade Care has licensed therapists on its panel, employed by Accolade Care. Currently, there are no psychiatrists on t panel.

Can I talk to an Accolade Care provider outside of California?

Yes. Accolade Care providers are located in all 50 states.

Do you have any bilingual therapists?

Yes. Contact your Care Advocate for help locating one.

Are Accolade physicians UCSD physicians?

No, Accolade providers are employed by Accolade.

Does the Accolade Care primary care doctor replace our primary care doctor?

No, Accolade does not replace your in-person doctor. Oftentimes, Accolade’s primary care doctor will work alongside your regular primary care doctor. However, you have the option to use the Accolade Care virtual primary care doctor as your first primary care doctor resource.

Are the Physicians employees by UC?

No, Accolade providers are employed by Accolade.

Can 2nd.MD be used more than once?

Yes. You can get a second opinion from a 2nd.MD specialist, take that recommendation to your doctor, and re-connect with your specialist to ask any follow up questions about your doctor’s treatment plan.

Why would I use Accolade for a second opinion?

2nd.MD specialists provide no-cost, unbiased recommendations to help ensure that you're receiving the best care and being the best advocate for yourself. They can weigh in on a new or existing diagnosis, or on your current treatment plan. For example, members may want advice about a recommended surgery. The specialist can advise if that surgery is necessary or if it's the best surgery for you. They can also review your medication regimen and address any chronic conditions tied to a new or existing diagnosis.

How deep is the bench for 2nd.MD?

The 2nd.MD panel includes over 900 specialists who can weigh in on almost any medical diagnosis or condition.

Is 2nd.MD free for UC CORE members?

Yes, 2nd MD is free for UC Care, UC Health Savings Plan and UC CORE plan members.

How do I access 2nd.MD?

You have several options:

• Connect through the Accolade member portal or mobile app or portal (download from the App Store or Google Play). Select the Accolade Care tile and it will take you to the Accolade Care website. On your first visit, you’ll be asked to register set up a user ID and password for Accolade Care. 
• Call Accolade at (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT) and ask to be connected to the 2nd.MD care team.
• Call your Care Advocate and ask to be connected to Accolade 2nd.MD.

By Phone: (866) 406-1182. Care Advocates are available Monday–Friday, 5 a.m.–8 p.m. PT.

• Hold times: We recognize that hold times are long and are working quickly and diligently with our executive operational leaders to get this resolved as quickly as possible.

Through the Accolade member portal. 

Through the Accolade mobile app. Note that the mobile app is not intended to be instant messaging. Accolade strives to answer mobile messages within an hour. Allow notifications from the app so you’ll be alerted when the Care Advocate responds. If you are experiencing long delays, please provide that feedback to your UC team.

Where can I get information about coverage for transplants?

Call Accolade (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT) and ask to speak to a transplant nurse.

How does HIPAA come into play with Accolade?

Our services and our platform are fully HIPAA-compliant, and we take your privacy very seriously. After that initial conversation with our nurse, we will generate an electronic release of information to your doctor, but your information is always confidential.

How is my accolade information shared with my outside primary care physician?

Accolade Care Advocates will review your medical and behavioral health prior authorizations and pre-certification and work directly with your health care providers to ensure your needs are met.

Are all billing questions answered thru Accolade instead of Anthem?

Yes. If you have a billing question, you can reach out to an Accolade Care Advocate, and they'll be able to support you from there.