It is your responsibility to make sure that you utilize doctors, hospitals and other facilities that are currently network providers whenever possible and it is prudent for you to be aware of the additional out of pocket expense that you will be expected to pay to the medical provider (doctor or facility) if you do not.
Generally speaking, emergency services will be treated as in network no matter where you go so if you are experiencing an emergency medical situation, seek help at the nearest qualified facility or dial 911.
Please be careful and make sure you are looking at the provider listing that applies to your particular health insurance plan. It is also a good idea to verify with the provider that he or she has not recently dropped from a network or is considering dropping from a network before your treatment or procedure will be completed.
Referrals from an in network medical provider to another medical provider (ie your doctor orders a cat scan or sonogram and sends you to another facility) are not necessarily in network. It is your responsibility to request that your doctor help you stay in network and you should use caution and verify with the facility you are referred to that they are in network. It is also very important to ensure that all precertification and preapproval procedures are followed properly as this is ultimately the responsibility of the insured patient.
If you need my assistance, call my office at (478) 743-9191 and speak with Stephanie or myself or you may call my cell phone at (478) 390-6359.
