You have the right to refuse treatment. It is critical that the members eligibility be checked at each visit. If you are calling to verify your patient's benefits*, please have a copy Savings - Negotiated discounts that result in significant cost savings when you visit in-network providers,helping to maximize your benefits. The provider must agree to accept network rates for the defined period of time. Provide, to the extent possible, information providers need to render care. Provider. This would also include chronic ventilator care. It is important to sign this form and keep a copy at home. For plans where coverage applies, one routine eye exam per year covered at 100% after copayment (no referral required). ConnectiCare reserves the right to terminate coverage for members who repeatedly fail to make the required copayments, coinsurance or deductibles, subject to the terms outlined in the applicableMember Agreement, Evidence of Coverage, or other governing contract. Choose "Click here if you do not have an account" for self-registration options. If you need more information, please call our Member Services. Use the My Plan tab on the main website page to register for online access to your claims, plan document, EOBs and additional items. Performance Health at This information is not used in contracting or credentialing decisions or for any discriminatory purpose. Note: Presentation of a member ID card is not a guarantee of a member's eligibility. MedAvant, an online transaction system available to ConnectiCare participating providers, also offers a secure means for entering and verifying referrals. Your right to make complaints Members must meet an in-network Plan deductible that applies to most covered health services, including prescription drug coverage, before coverage of those benefits apply. Influenza and pneumococcal vaccinations If you have questions about your benefits or the status of claims, please call Group Benefit Services, Inc. My rep did an awesome job. What can you doif you think you have been treated unfairly or your rights arent being respected? All genetic testing requires preauthorization, with the exception of the following: Routine chromosomal analysis (e.g., peripheral blood, tissue culture, chorionic villous sampling, amniocentesis) - CPT 83890 - 83914, billed withModifier 8A or ICD-9 diagnosis codes V77.6 or V83.81, DNA testing for cystic fibrosis - CPT 88271 - 88275; 88291, billed withModifier 2A - 2Z or ICD-9 codes V10.6x or V10.7x, FISH (fluorescent in situ hybridization) for the diagnosis of lymphoma or leukemia - CPT 88230 - 88269; 88280 - 88289; 88291; 88299. You have the right to get your questions answered. PET scans What should I do if I get a bill from a healthcare provider? PHCS (Private Healthcare Systems, Inc.) - PPO - Sutter Health Be treated with respect and recognition of your dignity and right to privacy. New members may use a copy of the enrollment form as a temporary identification card until they receive their ID card.
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