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Provider Network
Before obtaining services you should always verify the Network status of a provider. A provider's status may
change. You can verify the provider's status by calling Customer Service. A directory of providers is available
online on our website or by calling Customer Service at the telephone number on your ID card to request a copy.
It is possible that you might not be able to obtain services from a particular Network provider. The Network of
providers is subject to change. Or you might find that a particular Network provider may not be accepting new
patients. If a provider leaves the Network or is otherwise not available to you, you must choose another Network
provider to get Network Benefits.
We do not guarantee that any Network provider will continue to be part of the Network. We do not guarantee that
our contract with the Network will stay in effect.
Termination of a Network Provider from the Network, or termination of the Network contract, is made without prior
approval from the Employer or from you.
When a Network provider terminates from a Network or a Network contract terminates, we will make reasonable
efforts to replace the terminated contract with a new Network contract. However, we do not guarantee that this will
happen.
If you are currently undergoing a course of treatment utilizing an Out-of-Network Physician or health care facility,
you may be eligible to receive Transition of Care Benefits. This transition period is available for specific medical
services and for limited periods of time. If you have questions regarding this transition of care reimbursement
policy or would like help determining whether you are eligible for Transition of Care Benefits, please contact us at
the telephone number on your ID card.
Do not assume that a Network provider's agreement includes all Covered Health Care Services. Some Network
providers contract with us to provide only certain Covered Health Care Services, but not all Covered Health Care
Services. Some Network providers choose to be a Network provider for only some of our products. Contact us for
assistance.
Page 17 Section 4 - Schedule of Benefits
PPO - 2017
