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What should I do before I need medical care or services?
Review your UNYHEALTH Plan directory to determine
if your health care provider is a member of our network.
Review the list of UNYHEALTH hospitals so you
know which ones are in the network.
Review your health benefit plan to be aware of
your coverage.
What should I do when I need care?
Call your UNYHEALTH physician for an appointment;
be sure to identify yourself with the information
provided on your member ID.
What should I do when I go to a UNYHEALTH
doctor's office?
Present your I.D. card that displays the
UNYHEALTH logo and give the staff the name of the
insured's employer.
Confirm that you are going to see a UNYHEALTH
physician. Pay
any co-payments that apply the day you receive service.
Do I have to file claims?
If you use a UNYHEALTH provider, the provider's
office will file claims for you.
What if I have a scheduled admission to the
hospital?
Your UNYHEALTH physician will handle your
admission to the hospital.
The physician office may also handle
pre-certification requirements.
However, please remember the responsibility for
ensuring pre-certification remains with the member so
verify that the physician office has done this prior to
your date of admission.
What if I have an emergency?
In the case of a life-threatening emergency, go
to the nearest hospital, and then notify your doctor.
For emergency admissions, you or your physician
must call the 800 # on the back of your I.D. card within
48 hours or on the first business day following the
admission if the emergency occurs on a weekend or
holiday.
What happens if I use a non-UNYHEALTH Plan
provider?
If you are using a non-UNYHEALTH provider, you
may be asked to pay full charges at the time of service.
You may also have to file your own claims.
Charges may be higher and your benefits lower
than if you use a UNYHEALTH provider.
Therefore, you may be responsible for higher
out-of-pocket expenses.
Refer to your health benefit plan for further
information or using out of network providers.
What are the benefits of using a UNYHEALTH
network professional?
Your health benefit plan provides additional
coverage for using a UNYHEALTH professional
since they are covered under the “in-network”
benefit level. The cost to both you
and your health plan are lower and your
out-of-pocket costs are reduced. In
addition, UNYHEALTH professionals will handle
claims submissions so there is less paperwork
for you and your family.
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