How can I get help finding a friendly provider?

Care Navigation

Our Members have access to Care Navigation, a service which helps you find any providers near you that work well with us. You can call Care Navigation at (470) 719-8067, and they will be able to provide you a list of providers for whatever service you need. For certain procedures, they are even able to schedule your visits for you, and take all of the stress out of scheduling for you!

If we have any Preferred Providers in your area, they will be able to help direct you to them. Preferred Providers are providers that have agreed to bill us directly, and have agreed to bill fair prices prices for our Members. Going to these providers is the best experience for our Members, as the billing process is much smoother and oftentimes much quicker. Otherwise, the care navigator will direct you towards providers that are friendly with our Reference Based Repricing model, and are likely to bill us directly. 

 

Care Connex Scheduling

For certain procedures, the Care Navigation team is able to schedule services on your behalf with providers who they have agreements with. Some of the services that are eligible for this service are:

  • Imaging
    • MRIs
    • CT Scans
    • PET Scans
  • Orthopedics
    • Hip Arthroscopy
    • Total Hip Replacement
    • Knee Arthroscopy
    • Total Knee Arthroplasty
    • Ankle Repair
    • Total Ankle Repair
    • Bunionectomy
    • Arthroscopic/Open Rotator Cuff Repair
    • Shoulder Arthroscopy
    • Total Shoulder Replacement
  • Other Category Examples
    • GI (i.e. Colonoscopies)
    • General Surgery
    • Bariatrics
    • Spine
    • Urology
    • Women's Health/GYN
    • ENT

The procedures listed above are examples. Eligibility for these procedures are determined by several factors, including location, time, provider availability, and Member health. Keep in mind - travel may be required. Depending on health history and pain level, this service may not be a fit. This list is a starting point, and the Care Navigation team will still need to verify the eligibility of each specific procedure for each Member.

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