•How
do I know if the doctor I want to see is in the QHP Network?
For the most up to date information on the QHP Network of providers,
we recommend that you: First – Check our website. From the home page
click on, Physicians, Hospitals, or Ancillary. You are able to search for
providers by Specialty or City. Second -Call your Third Party Administrator
(TPA) or your insurance company. (See your health I.D. card for your TPA
or insurance company’s phone number) Keep in mind that your TPA,
insurance company and our website are updated weekly.
•What
is a PCP (Primary Care Physician)?
Primary Care Physicians (PCP’s) include doctors who specialize
in Family Practice, General Practice, Internal Medicine and Pediatrics/Adolescent
Medicine. You can search by Specialty under Physicians on our home
page to find a provider under these specialties.
•What are my insurance benefits?
Your best source of information concerning your health benefits is either
your Human Resources Representative at your place of employment or
your TPA/insurance company.
•What happens if I use a doctor that is
not in QHP?
This depends on the specifics of your health benefit plan. You would
need to contact your human resources representative at your place of
employment or your TPA/insurance company for the answer to this question.
•Do I need a referral to see a specialist?
If you are covered under a Point of Service (POS) Plan or an Exclusive
Provider Organization (EPO), you must obtain a referral from your Primary
Care Physician (PCP) before you see a specialist. You should contact
your TPA or insurance company to find out their policy on referrals.
•Are there any dentists in the network?
The QHP network is designed to provide services for your medical benefits
not dental benefits. Contact either your Human Resources Department
or insurance company to find out more information about a dentist in
your network, if your company has a dental plan.
•Are
there any optometrists in the network?
We do not have any Optometrists in the QHP network. However; we have negotiated
discounts with several optometrists in the Columbus area who offer discounts to our members. They can be found
by clicking on Ancillary on the home page, then selecting Vision Care
under Specialty. You may go to any of these facilities and show your
health insurance card with the QHP logo and receive a discount on services.
Contact your Human Resources Department to inquire if you have a separate
Vision Care plan other than the QHP vision discounts.
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