ProHealth Care Self-funded Employee Health Benefit Plans
Frequently Asked Network Questions

Q. Which outpatient laboratories should I use to ensure that my claims are paid at an "in-network" benefit level?

A. To make sure that outpatient laboratory services are paid as "in-network", they need to be performed at:

• A network physician's office and sent to a network laboratory
• LabCorp at Moreland Medical
• Participating hospital laboratories

If your physician sends your lab work to other facilities than those listed above, your lab charges will be considered as "out of network". As the patient, you can request that your lab work be sent to one of the labs listed above. Please refer to your network directory for more information.

Q. Which durable Medical Equipment providers should I use to ensure that my claims are paid at an "in-network" benefit level?

A. All Durable Medical Equipment must be provided through the following vendors. The following vendors are all participating in the WIDS Network at the Tier 1 benefit level. If you choose not to use these vendors, there would be no coverage.

• Home Care Medical, Inc.
• Kinex Medical Company, Inc.
• Knueppel HealthCare Services, Inc.

Q. If I have a procedure done at a network hospital, should I assume that all of the hospital-based specialists (pathologists, radiologists, anesthesiologists, and emergency physicians) are in the network?

A. Please note that not all of the hospital-based physician groups have joined our network. You can confirm network membership by reviewing our Provider Directory.

Q. Have any new providers been added to the network since open enrollment?

A. For up-to-date participating physician information, you should access the on-line ProHealth Provider Directory just prior to scheduling an appointment. The on-line directory is routinely updated; however, changes can occur daily and may not yet be included in the directory. Therefore, it's best to check just prior to seeking services.