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Tips from Paula: Confirming Network Status

Posted on July 10, 2015

Most of us work very hard to get the most out of our benefits. That includes checking the network status of our physicians, hospitals, ancillary facilities, etc.   We have also become quite astute in using carrier websites to check those network statuses.   It’s important to never assume a physician who is part of a contracted, in-network hospital, is automatically contracted themselves.

For example, a hospital may show up on a carrier website as a participating provider. We may then make an appointment with a physician who is affiliated with that hospital, assuming they must be participating as well. This could result in a claim not being paid, or it may be paid at a much lower level of benefits.

Therefore, when checking online for a provider, always search for the individual provider’s name, not just the hospital they are affiliated with. If one is unsure, a quick phone call to the member services phone number on the back of their ID card will also provide a fast and accurate answer.

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