Building Philadelphia, PA 19106-9111 Network providers are the doctors and other health Benefit Package Warning: Remember to look out care professionals, medical groups, hospitals, and for a request for an member’s HMO/Referrals (How it Works) other health care facilities that have an agreement Organization Determination. with us to accept our payment and any plan Include the POS section if the as payment in full. We have arranged for plan has Out of Network benefits. these providers to deliver covered services to members in our plan. It is important to know which providers are part of our network because, with limited exceptions, while you are a member of our plan you may be required to use network providers to get your medical care and services. The providers in <plan name> are grouped by <Local Physician Organizations (LPOs)/Participating Provider Organization (PPG)> , which are headed by Primary Care Physicians (PCPs). A choice of PCP will determine member’s which (PPG)> > providers are in their <LPO’s )/ referral network. The exceptions to using network providers are emergencies, urgently needed services when the network is not available (generally, when
Building Philadelphia, PA 19106-9111 HMO/Referrals (How it Works) Network providers are the doctors and other health care professionals, medical groups, hospitals, and other health care facilities that have an agreement with us to accept our payment and any plan as payment in full. We have arranged for these providers to deliver covered services to members in our plan. It is important to know which providers are part of our network because, with limited exceptions, while you are a member of our plan you may be required to use network providers to get your medical care and services. The providers in <plan name> are grouped by <Local Physician Organizations (LPOs)/Participating Provider Organization (PPG)> , which are headed by Primary Care Physicians (PCPs). A member’s choice of PCP will determine which <LPO’s )/ (PPG)> > providers are in their referral network. The exceptions to using network providers are emergencies, urgently needed services when the network is not available (generally, when Benefit Package Warning: Remember to look out for a member’s request for an Organization Determination. Include the POS section if the plan has Out of Network benefits.