I want to go to an out-of-network provider because I feel he can provide the best care for my condition. What are the costs going to be for me?
Obtaining care from out of network provider will result higher out of pocket costs than using network providers. You will have to satisfy an annual deductible; pay a copayment of 25% or 40% of the allowable charge for the service, depending on your plan; and be responsible for any amount above allowable that the provider charges. And you are required to obtain preauthorization from Southern Health for Out-Of-Network services, such as for DME or procedures and tests, or entire claims can be denied. Preventive visits to an Out-Of-Network provider are not covered at all by your health plan. Be aware that some Southern Health Out-Of-Network allowable amounts are substantially lower than out of network provider charges. You may ask Southern Health for the specific allowable amounts for specific procedure codes obtained from your doctor to be well informed of potential costs for your situation. For example the current Out of Network inpatient hospital allowable is $2,500 per day rate regardl
Related Questions
- I suspect the rectifiers (diodes) are going bad in my alternator, what is the best way to check for this condition before removing from the airplane?
- I want to go to an out-of-network provider because I feel he can provide the best care for my condition. What are the costs going to be for me?
- How can I get the best mix of covered services, provider choice and costs?
