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What You Need to Know About Referrals and Pre-authorization
While QualChoice does not require referrals, some services require pre-authorization (pre-approval). Find out ahead of time if the services you need call for a pre-auth. Your claim could be denied if pre-authorization was needed and you didn’t get it before you received care.
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Outpatient Surgery? Consider an ASC
There are more options available today to get quality health care at a lower cost. If you need outpatient surgery, an Ambulatory Surgery Center (ASC) may be an option to consider.
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Health Insurance How-To: Avoid Balance Billing
If you use an out-of-network provider, you might end up with a much larger bill than you expected. This is because of a practice called balance billing.
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Making the Most of Your Benefits
Healthcare can be confusing — and costly. Here are some ways you can make the most of your health insurance benefits. Master these points to stay healthy and save on your healthcare costs!
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Progress in Primary Care Delivery Models
The CPC+* and PCMH** value-based care programs were designed to test improved provider payment and service delivery models. The goals are better care for patients, smarter spending and healthier communities.
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Understanding Your Explanation of Benefits (EOB)
As a QualChoice member, you will receive an EOB every 14 days if you have had any claims during that time. Review the EOB closely and compare it to the receipt or statement from your doctor.* Keep it for your records, along with your medical bills..
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Value-Based Care Program Updates
Thank you to our CPC+ and PCMH program participating providers for helping us improve healthcare! Please review these updates to the programs.
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Value-Based Care Program Reminders
Thank you to our CPC+ and PCMH program participating providers for helping us improve healthcare! To complete our 2018 programs, please remember these points.
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Improving Healthcare with PCMH
At QualChoice, our goal is to make health insurance simple and to make healthcare better. We’re working with providers, payers and state and federal groups to move from volume-based to value-based care.
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Beware of Balance Billing!
Balance billing by out-of-network providers can be a nasty surprise. But what does it mean exactly?
