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Managed Care

Managed Care Affiliations and Insurance Plans:

2019 Managed Care Affiliations and Insurance Plans

Your Role:

“Managed care” means that your health insurance company may direct you to a specific doctor or doctors’ group for the diagnosis and treatment of your cancer. You are responsible for knowing and following the guidelines of your managed care plan.

You should read your insurance benefits book carefully. Inside, you will find instructions on how to get medical treatment in agreement with the insurance plan. Know what services require prior approval from your Primary Care Physician (PCP) or pre-certification from your insurance company.

You are responsible for paying any deductible, copays or coinsurance.

If you want information about estimated professional fees, please ask to speak with a financial counselor.


Our Role:

Our Role- If required by your plan, as a service to you, we will request a referral from your primary care provider. A referral is confirmation your primary doctor approves your visit to see us. It is your responsibility to schedule a visit with your primary doctor prior to scheduling a visit with our providers. You may receive a bill if a referral is not obtained.

Prior authorization may be required by your plan for services provided by our doctors. We will request and work with your plan to obtain approval for service.

Most treatments for cancer and blood disorders require insurance company certification for payment before therapy is given. Unfortunately, prior authorization does not guarantee insurance will pay for services.

When this happens, you may be personally required by your insurance company to pay for your services.

 

 

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