Members’ Frequently Asked Questions

How do I find a provider that accepts this insurance?

You can use the “Find Provider” link to access your network’s website to perform a provider search. From there, just enter a physician or facility’s name or select a specialty to search the network’s participating providers.

Okay, I found a provider on the network’s website, but the provider says they don’t take this insurance. Now what?

Call us! We’re happy to reach out to providers to explain how the networks work and clarify their participating network status.

How much should I expect to pay for a certain service?

That depends on a few things. Depending on the benefits outlined in your chosen plan, some services simply have a copay while others could apply to your deductible. Additionally, some providers could give you a cost estimate if you ask.

My insurance ID card says “precertification is required.” What does this mean?

This means some services require the provider to call and obtain precertification (also known as prior authorization) before the services are rendered. Each group’s plan has a different listing of services that require precertification, so if you’re curious or concerned, feel free to call us and ask.

I received a bill. What should I do with it?

First things first: did you receive an explanation of benefits (EOB) from us that matches the service referenced on the bill?  If so, then look at the total member responsibility on the EOB and the balance due on the bill. If those numbers match, go ahead and pay the bill.  If those numbers don’t match, or if you’ve never received an EOB for that claim, call us!

Can I look up my claims online? How do I do that?

You certainly can! Click on the “View Claims” link to visit our online portal. From there, you can register to view your claims, print out EOBs, and request a new ID card. If you have any questions about your claims, you can always call us, too.

I paid for some services that didn’t process through insurance. Could I still get credit for them?

Depending on the services rendered and the benefits in your plan, you might. Please fill out the “Member Claim Submission Form” and send it in with an itemized copy of your receipt, then we’ll review the claim for consideration.

Have a question that isn’t answered here? Reach out to us!

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