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This tool was designed to help you easily locate providers, hospitals and
other facilities participating in your health plan. While we take great care to
make the directory complete and accurate, the network listing of participating
providers may change without notice.
"Health Plan" is defined as a program of benefit coverage that you have
elected through your employer, insurance company, or other entity offering
coverage for health benefits. If you are using this site your company has
contracted with Coalition America to provide access to participating providers.
Before receiving services, you should always verify with the provider that he/she
is participating in your PPO or health plan when making an appointment.
Please know that actual coverage for the healthcare services you receive is
determined by your health plan.
To receive the highest level of coverage for services provided by a specialist,
some health plans may require you to obtain a referral from your primary care
physician before receiving services. Please review your enrollment material,
or call your plan's Customer Service numbers listed on your benefit ID card
for more information.
ABOUT YOUR PLAN's SERVICES:
The plan does not provide health services or practice medicine. Rather,
the plan arranges for providers of health services to participate in a
network. Network providers are independent contractors and are not
employees of the plan. The plan makes payment to network providers
through various types of contractual arrangements. These contractual
arrangements may include financial incentives (e.g., bonuses, capitation)
to promote the delivery of healthcare in a cost efficient and effective
manner. Such financial incentives are not intended to impact your
access to medically necessary health services. If you have questions
about whether there are any financial incentives in your doctor's
contract with the plan, please feel free to ask your doctor.
All of the above means that the physician patient relationship is between
you and your doctor. It means that:
- you are responsible for choosing your own doctor
- you must decide if any doctor treating you is right for you; this
includes network providers that you choose or to whom you have
been referred by the Plan
- you must decide with your doctor what care you
should receive
- your doctor is solely responsible for the quality
of the care you receive
The Plan makes decisions about benefit plan coverage. These decisions
are administrative decisions and are for payment purposes only. The
Plan is not liable for any omission of a provider of health services, nor any
act of a provider of health services.
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