Page 11 - Benefits Book Tanner Manor 2020

How It Works

Your plan pays providers based on a multiple of the Medicare

reimbursement rate for each service you receive. There is no network ,
2
1
Get to Know Your Core Value Plan
so you can go to any provider you want. Here’s how it works:

1 2 3

Seek Care Receive Your EOB Review Your Bill

You can go to any doctor or You will receive an Explanation of Your provider will send you a bill

hospital ; simply show your Benefits (EOB) showing your Patient for any amounts due to them. This
2
Medical ID card to the provider. Responsibility. This includes copays, bill should not exceed the Patient

If they have any questions, they coinsurance, charges for non-covered Responsibility as shown on your EOB.

can call the Customer Service services, and deductible amounts.

number on the back of your card.
4 5 The Member Advocacy Program 3

(MAP) is here to:

• Answer questions about billing.

• Clarify your EOB.

• Find providers.

• Help you understand your benefits
When to Call The Team Gets to Work
and how to use your plan.

If your bill shows an amount that MAP will work with your provider

exceeds the Patient Responsibility to resolve any inconsistencies on Call at 888-306-0905
on your EOB, call the MAP Team your bill. Afterward, you’ll receive

immediately. a letter explaining the resolution.

888-306-0905 1 Or a derived equivalent of the Medicare reimbursement rate.
2 Pharmacy benefits and transplants still rely on the use of network providers.
3 Non-covered services and certain other charges are not eligible for the program.

Stop-loss insurance for the National General Benefits Solutions Self-Funded Program is underwritten by National Health Insurance
Company, Integon National Insurance Company, and Integon Indemnity Corporation. ®2019 National Health Insurance Company. All
rights reserved. NGBS-COREVALUE-EEKIT-HOWITWORKS (08/2019)