Out-of-Network Referrals: How it Works
Posted on December 20, 2012
When you need medical services, Health New England helps you. We have a robust, comprehensive network of providers that includes three tertiary provider hospitals and their networks:
- Baystate Health Systems
- UMass Medical Center
- Lahey Clinic
A tertiary hospital has personnel and facilities for advanced medical treatment. If you have an urgent situation, we may be able to assist you by making arrangements through our contacts in these networks. We know that sometimes our network cannot provide the care you need. If that happens and your provider recommends out-of-network treatment, our clinical staff considers your unique circumstances by examining the necessary clinical information. If we determine that we can provide the service in-network, we will redirect you to a specific provider or provider category. If we determine that we cannot provide the service in-network, we will either redirect you to a preferred provider or approve the original provider requested, depending on the type of service.
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