01
Employee needs help
Start with the question.
SHIELD CARE 360
Your Personal Healthcare Concierge.
Your employees shouldn’t have to figure out healthcare alone. Shield Care 360 helps employees understand, access, and use their benefits.
SHIELD CARE 360
01
Understand
Make sense of benefits, claims, and bills.
02
Connect
Find the appropriate care or administrative resource.
03
Follow through
Stay involved where appropriate.
Connected by Shield
One team to help connect the dots.
We don’t just provide benefits. We help employees use them.
Benefits navigation
Understand what benefits you have, where to find ID cards, where to go for care, and which program may fit your needs.
Find care
Help locating available healthcare resources and participating providers.
Appointment assistance
Navigate provider resources and the process of connecting with appropriate care.
Pharmacy support
Questions about prescriptions, participating pharmacies, pricing resources, and prior authorization or specialty navigation when supported.
Claims assistance
Understand claims, EOBs, denials, missing information, responsible parties, and next steps.
Medical bill advocacy
Help understanding bills and navigating available financial-assistance resources. Assistance and eligibility vary; bill reduction or forgiveness is not guaranteed.
Mental-health navigation
Connect with mental-health benefits available through your plan.
Dental & vision navigation
Understand available benefits and find participating resources.
Follow-up
Stay involved where appropriate until the employee understands the next step or the issue has reached the appropriate resource.
Don’t know where to start? Start with Shield.
Call, text, or chat using the support details supplied with your benefits. Follow your program’s member access instructions for available digital services.
02
Call • Text • Chat
Use your member support details.
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Shield Care 360
Your point of contact.
04
Understand
Clarify the need.
05
Navigate
Identify available benefits.
06
Connect
Reach the right resource.
07
Resolve
Work toward a next step; outcomes depend on the responsible parties.
08
Follow up
Stay involved where appropriate.
Your question belongs here.
Coverage and services depend on your selected plan.
Product Guide
A real starting point for healthcare questions
Shield Care 360 focuses on non-clinical navigation support: helping members understand benefits, next steps, and available resources. It does not guarantee issue resolution in every case, and it is not a replacement for emergency or clinical care.
Example situation
Members are covered but uncertain about where to start after receiving multiple care options. Navigation support can clarify sequence and benefit implications.
When this matters
- Your support queues show repeated confusion about claims, referrals, and eligibility pathways.
- Members need administrative guidance coordinating providers, plans, and documents.
- You want a consistent non-clinical escalation framework across teams.
What to review before you decide
- Define scope boundaries between navigation support and licensed clinical services.
- Establish response-time expectations and escalation criteria for unresolved cases.
- Align communication scripts to avoid overpromising guaranteed outcomes.
- Integrate with plan documents so guidance remains accurate and auditable.
- Train teams on privacy-safe communication and channel usage.
Step 1
Map: identify top member confusion scenarios and decision points.
Step 2
Deploy: launch standardized navigation playbooks for common situations.
Step 3
Improve: review case patterns monthly and refine support workflows.
Frequently asked questions
Is Shield Care 360 clinical care?
No. It is non-clinical navigation support and does not replace licensed medical treatment.
Can it guarantee every issue is resolved?
No. Resolution depends on plan terms, third-party processes, and case specifics.
Should members use it for emergencies?
No. Emergencies require emergency services.
What privacy guidance should we give members?
Direct members to secure support channels and avoid sharing personal medical details in public forms.
Let’s find your next step.
Get Member SupportIf you need support, use secure support channels. For privacy, do not submit sensitive personal medical details through public forms.