Your benefits will be paid at a lower percentage if the provider is out of network. Make sure all doctor and facilities involved in any procedure are in the QualChoice network — including all specialists (such as anesthesiologists), medical equipment and lab or xray testing. Specialty lab work is expensive, but most can be done by our network partners! Certain genetic tests require Pre-Authorization.
Know beforehand which medical procedures require pre-authorization by checking the Medical Policies section of QualChoice.com, or calling Customer Service. Your claim could be denied if pre-authorization was required and you didn't get it.
3See a Primary Care Physician Instead of a Specialist
Visit your Primary Care Physician first for most medical needs; your doctor knows you and your medical history, and can take care of most problems without the cost of specialty care.
4Use Generic Drugs
Ask your doctor if a less expensive generic form of a drug will work as well as a name brand for you.
5Take Advantage of Your Preventive Care Benefits and Health & Wellness Programs
Use the preventive care benefits in your plan, such as free annual pap tests, mammograms, health checkups, flu shots and more. Or enroll in our tobacco cessation program, get healthy lifestyle coaching or the support of a nurse care manager for chronic or serious health issues. It could help you avoid a problem later.