An Accountable Care Organization (ACO) is the name given to a group of doctors and/or hospitals that agree to provide care to a defined population of patients (in this case, Qualcomm employees). ACOs are different than traditional medical groups, because participating providers agree to meet certain patient experience, quality and/or cost targets.
Yes. Health Maintenance Organizations (HMOs) are a type of managed care health plan. They use a “gatekeeper” strategy to lower utilization and costs. Patients in an HMO must choose a primary care physician (PCP) who must authorize access to specialists and other care. Services received outside the HMO network are not covered.
Qualcomm Premier Plans are not HMOs. Premier Plan members can self-refer to specialists and other providers without any authorization requirements, and can choose to pay higher deductibles or co-insurance and go out-of-network.
You'll select a personal physician who can help you coordinate care with different providers. However, your personal physician will have no ability to limit or deny you care with other providers.
Contracting directly with a health system allows Qualcomm to create, monitor and refine a different model of health care delivery. Qualcomm wants to provide employees a superior patient experience. And Qualcomm wants to develop better ways to improve health outcomes and reduce the costs of health care.
Scripps has deep roots in San Diego, having provided care here since 1924. Today they continue to demonstrate a high quality of care and a commitment to a superior patient experience. Scripps also has a strong physician network and broad geographic reach in San Diego.
Scripps is consistently recognized by third-party organizations for its safety, quality and clinical performance. For example:
- Scripps Memorial Hospital La Jolla was named one of the nation’s top Large Community Hospitals by IBM Watson Health
- Scripps is ranked among the best hospitals in San Diego and the nation by U.S. News & World Report 2020-22
- Scripps hospitals are recognized for their performance by the Centers for Medicare and Medicaid Services, The Joint Commission and California’s Office of Statewide Health Planning and Development
We encourage Qualcomm Premier Plan members to find a personal physician they can turn to for routine medical care. When you establish a relationship with a personal physician, you have a partner who understands your medical history and helps keep you healthy.
No, Qualcomm Premier Plan members do not have to wait 365 days between their annual preventive exams. The plan covers one preventive exam each plan year, even if the time between the exams is less than 365 days.
Learn more about what services are covered for annual preventive exams. Contact the Premier Plans concierge team for assistance and scheduling at 844-884-7266 (844-884-QCOM) or firstname.lastname@example.org.
Qualcomm Premier Plan members do not need a referral to see a specialist.* You can choose from any specialist in the Premier Plan network. You can also choose to use out-of-network doctors, but you will pay higher deductibles or co-insurance.
* Some specialists require that you visit a personal physician prior to scheduling an appointment with them. You may consult with the concierge team to determine if your preferred specialist requests a Personal Physician referral before booking an appointment.
Yes. The QHC is considered in-network under both Qualcomm Premier Plans for employees only.
If you or a family member needs care after normal business hours or on a weekend, you have several options. These include:
Walk-in clinic care
For minor illness and injuries, you may visit any of the Scripps HealthExpress same-day, walk-in clinics located throughout San Diego County. HealthExpress provides medical care when you need it the most, from early morning to late in the evening and weekends. For a complete list of locations, visit the locations page.
Nurse navigator phone support
Our nurse navigator line is staffed 24/7 by registered nurses who can evaluate your symptoms and recommend when and where to seek care. Call 844-884-7266.
Urgent and emergency care
In-network emergency rooms and urgent care centers are available across San Diego County.
For urgent care, we can shorten your wait time through our “fast-pass” program. Simply call our concierge team at 844-884-7266 for help selecting a Scripps urgent care center. We’ll call ahead to reserve your spot on the urgent care wait list.
Virtual care (also called telemedicine or telehealth) is offered through the MyScripps patient portal, including on-demand video visits. Learn about the types of virtual care available.
Expedited primary care
If you decide to wait until the next business day to seek care, plan members are guaranteed same-day or next-day appointments with a Premier Plan primary care provider for urgent medical needs.
You may choose to use providers outside the network for Premier Plans, however, a higher deductible, coinsurance and out-of-pocket maximum amounts apply to most services. You can use the provider search tool or call the concierge team to find an in-network specialist for you or your family members.
The Premier Plan network offers a comprehensive list of specialists. However, if you need specialized services and are unable to locate an in-network Premier Plan provider, a network exception process is available. In order to initiate a network exception request, please contact the Scripps concierge team at 844-884-7266. If your network exception request is approved, you will be able to access identified out-of-network providers, for example certain UCSD specialists for perinatology, burn injuries and orthopedic oncology, while receiving in-network coverage.
If you select a Qualcomm Premier Plan during Open Enrollment, you will be asked to identify dependents that reside outside of San Diego. They will be considered in-network as long as they use providers within UnitedHealthcare’s national Options network.
If you’re outside San Diego County, we’ll help you get the care you need, including connecting you to a local provider or urgent care center if necessary. We will then work with United Healthcare to ensure your claim is processed as in-network.
If you have an emergency claim while on business or personal travel, the claim will be paid at the in-network level. Should you need hospitalization while traveling, Scripps can facilitate a transfer to an in-network San Diego hospital once your condition is stable.
If you choose to seek non-emergency care outside of the network, you will be subject to out-of-network cost sharing.
Yes. Plan members who have a Scripps Clinic or Scripps Coastal Medical Center provider, will have online and mobile access to their personal health information through a secure portal called MyScripps. The portal allows you to perform a variety of functions. Through MyScripps, uses can now:
- View lab or imaging test results
- Schedule or cancel primary care appointments
- Pay your bill
- Request prescription refills
- Send messages to your doctor’s office
- Access your child's health record — if they are between 0-12 years of age — to manage appointments, message care providers and view select lab results
- Access or proxy access a teen patient’s chart — to message providers, review and refill medications** and track growth charts.
- Use eCheck-in for appointments, which allows you to pay visit co-pays, update medication allergies, current conditions and answer appointment questionnaires
This allows doctors or hospitals who treat you to see a more complete picture of your health, including medical conditions, current prescriptions and previous surgeries or other procedures.
For more information on accessing MyScripps for yourself or your teen patient, contact the concierge team.
Not all Scripps-affiliated providers may be using MyScripps. Please ask your provider's office if they use the MyScripps patient portal.
Under federal and California law, when minors reach age 12, they have a legal right to health information privacy. In compliance with these laws, we limit the information that a proxy can view in a teenager’s chart.
**Sensitive medications will be filtered from teen proxy view. At this time, proxy access for teens does not allow the viewing of test results, upcoming or past appointments or letters.
Plan members have access to a dedicated team of professionals who provide concierge-level service, including:
- Selecting a physician
- Scheduling appointments on your behalf
- Navigating Scripps programs, services and facilities
- Helping expedite your urgent care wait through our fast-pass program
- Helping you understand your benefits, including costs and eligibility
- Answering questions about your bill or claim
- Helping you resolve issues such as access to test results or assisting with prescription refills via MyScripps
Yes. The Qualcomm Premier Plan concierge team can help you find a personal physician who is a good match for you — based on your health goals, preferred location and preferred language. We can also schedule appointments with Premier Plan primary care physicians. Contact the concierge team at 844-884-7266 or email@example.com.
You and your dependents are guaranteed appointments within a specific time frame.* For example:
Wait times for primary care and OB-GYN include same-day or next-day appointments for urgent needs, five days for non-urgent needs and 10 days for preventive care.
Wait times for specialists are three days for urgent needs, 10 days for non-urgent issues and 15 days for Rady’s specialists.
*While expedited appointment scheduling grants you timely access to appropriate care, we cannot guarantee you will always have access to your own doctor or a specific doctor within these time frames.