A network is the group of providers doctors, hospitals, and other clinicians who are part of your insurance plan. To get the most from your benefits, see providers that participate in your network. To make sure your provider is in your network, present your ID card when receiving care. If you get services from a provider that isn't on your plan, you may be responsible for excess charges (this is called balance billing), and they may bill you directly for charges that are not covered by your plan. Learn more about Network Providers. Show Your Primary Care DoctorWe encourage you to find a primary care provider. These doctors can help you get preventive care and manage your overall health. Conditions treated and services provided include:
Provider SearchLooking for a new doctor or specialist? Use our provider search or call Member Advocates at 800-515-2220. Many providers also offer telehealth services for common needs. When searching for the right provider, use these ratings to help you pick the right doctor for you. The patient rating score is an average of all patient responses to a Press Ganey Medical Practice Survey for a particular provider. The survey is conducted by Intermountain Healthcare® on behalf of SelectHealth. Patients receive the survey to complete within 6 weeks after their visit to a provider. Responses are measured on a scale of 1 to 5, with 5 being the best score. You may not find star ratings for non-Intermountain providers. This doesn’t mean they have worse reviews than others—it just means we don’t have data to publish for them. To learn more about these reviews, please visit: intermountainhealthcare.org/website-information/provider-ratings/ (Available for family and internal medicine, women’s health, and pediatric specialties only.) The Quality Ratings are intended to provide you with more transparency about the quality of providers. We measure quality so you can find excellent, high-quality healthcare. The Ribbon Ratings show you how invested providers are in our members’ health and the preventive care they are encouraged to perform based on national best practices. These ratings are assigned to providers with 30 or more patients in our quality metrics (effective, safe, efficient, patient-centered, equitable, and timely care) and are obtained through our quality programs. Each score is compared to national benchmarks from the Healthcare Effectiveness Data and Information Set (HEDIS*), which are measured by the National Committee for Quality Assurance (NCQA**) on all health plans nationwide. *HEDIS is a registered trademark of the **NCQA and is designed to measure performance on important dimensions of care and services. Nurse LineA phone call could save you money and an emergency room visit. Instead of relying on the internet for self-diagnosis, pick up the phone and talk to a registered nurse. This free, 24/7 service is available to our members through Intermountain Health Answers, which is staffed by registered nurses. Get help determining how and where to get the best care. Utah and Nevada Call 844-501-6600 Idaho Call 844-265-7648 Intermountain Connect CareIntermountain Connect Care is a fast, convenient way to talk to a provider—virtually! Use your smartphone, tablet, or computer to connect to a provider within minutes. Conditions treated include:
Note: Connect Care is not intended for treatment of emergency medical problems. Urgent CareUrgent conditions require care within 24 hours. Visit an in-network urgent care clinic when you can't wait for an appointment. If you plan to visit an Intermountain InstaCare® or Intermountain KidsCare®, use our mobile app to find the shortest wait and get in line ahead of time. Walk-ins are welcome. Conditions treated and services provided include:
EmergenciesIf you have an emergency, call 911 or go to the nearest emergency department - we’ve got you covered. Conditions treated include:
After Hours Access to CareAll outpatient providers that are contracted with SelectHealth, provide SelectHealth members with 24 hour phone coverage. When members call their provider after hours they will either be connected with the contracted provider or a covering provider of same or similar specialty. Working Remotely or Traveling?SelectHealth commercial plans (non-Medicare/Medicaid/CHIP) offer several medical networks that provide access across the country. Your primary network is listed on the front of your ID card. You may also have access to other networks depending on your plan—they will be listed on the back of your card. Networks by state:
To search for providers on the UnitedHealthcare Options PPO, MultiPlan, PHCS, or Beech Street networks, please visit their website. Note: Coverage may vary. Please refer to your member materials and ID card to determine your benefits. Getting Care Outside of the U.S.If you are outside of the country and need urgent or emergency care, visit the nearest doctor or hospital. You may need to pay for the treatment upfront and submit a claim for reimbursement. Questions?Call SelectHealth Member Services at 800-538-5038 weekdays, from 7:00 a.m. to 8:00 p.m., and Saturday, from 9:00 a.m. to 2:00 p.m.
We DO NOT accept Anthem Blue Cross High Performance
*Medicaid is not accepted by Dr. Douglas Jones as primary or secondary insurance. *Medicaid is not accepted by Dr. Ben Van Leeuwen as a primary or secondary insurance. *New Medicaid patients must live in Layton, Clearfield, Clinton, West Point, Sunset, Syracuse, Kaysville, Fruit Heights, Farmington, Roy, Uintah, Hooper or West Haven. Healthy U Medicaid Molina Medicaid SelectHealth Community Care Steward Health Choice Utah
All Medicare and Medicare Advantage plans are accepted.
*The following providers do NOT accept ANY SelectHealth plans: Gary Alexander, MD (Pulmonology, Sleep Medicine), Brady Tucker, PA (Pulmonology, Sleep Medicine), Bob Svagr, MD (Orthopedics), York Yates, MD (Plastic Surgery)
*Tricare Prime must have a referral from Primary Care Manager.
*Except the Preferred Plan
This list is for reference purposes only and is subject to change. Cleveland Clinic may participate in some — but not all — products offered by a health plan. Coverage limitations are dependent on individual group contracts. Check with your health plan to confirm that Cleveland Clinic is covered. Please contact your insurance company directly to confirm which procedures and providers are covered at Cleveland Clinic Nevada: Cleveland Clinic Lou Ruvo Center for Brain Health - Las Vegas 888 W. Bonneville Avenue Las Vegas, NV 89106 702.483.6000 |
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