PinnacleCare's FAQs

PinnacleCare defines a major condition as a serious diagnosis that will involve rigorous treatment, a choice of treatment options, or a prolonged recovery and can result in significant healthcare costs and/or time away from work. Examples include: cancer, cardiac surgery, back surgery, joint replacement surgery, transplants, and persistent diagnostic challenges.

For preexisting conditions, a change of treatment might entail a new drug or a recommendation for a surgical procedure, changing a previous prescription, or therapy. For example, a patient has received injections for back-related issues and a physician is now recommending surgery.

When an employee reaches out to PinnacleCare, our intake team will ensure medical privacy by asking a few questions to verify eligibility. A Connection Health Advisor will then gather the employee’s appropriate medical history and the details of their current diagnosis. The Advisor reviews the case and consults with our Medical Team to guide the employee to the appropriate course of action.

PinnacleCare will provide a confirmation of a diagnosis, recommendations on top specialists, facilitated appointments, and/or research on a diagnosis and appropriate treatment options. In certain cases, PinnacleCare will help to coordinate the gathering and forwarding of key medical records to a recommended specialist.

We consult with a wide range of sources to select specialists based on their education, experience, and other qualifications:

• PinnacleCare medical directors, physicians, and Ph.D. researchers
• Medical Advisory Board of nationally-acclaimed physician specialists
• Network of leading hospitals and medical centers

Each physician office that we recommend is interviewed by a member of the research team in order to confirm details about the practice and their specialty.

PinnacleCare Connection is contracted as a sponsored group benefit plan. In addition, PinnacleCare services can be contracted through a customized retainer program to include executive physicals and comprehensive memberships geared toward senior management.

PinnacleCare’s account management and implementation team will coordinate with your HR team and benefits provider to manage employee communications and administrative coordination, including eligibility and billing.