{"id":391,"date":"2011-06-22T08:27:06","date_gmt":"2011-06-22T12:27:06","guid":{"rendered":"http:\/\/www.hnetalk.com\/Member\/?p=391"},"modified":"2011-06-22T08:27:06","modified_gmt":"2011-06-22T12:27:06","slug":"ask-member-services","status":"publish","type":"post","link":"https:\/\/hnetalk.com\/member\/ask-member-services\/","title":{"rendered":"Ask Member Services"},"content":{"rendered":"

\"\"How do I handle emergency or urgent medical visits when you are out of your HNE coverage area?<\/h2>\n

Everyone loves summer.<\/strong> As we all know, in the summer we may plan vacations or visits to family and friends outside of our health plan\u2019s coverage area. Summer also offers the perfect time to increase or change our daily routines \u2013 bike riding, sports, barbeques, and other activities. Along with the fun can come unforeseen accidents such as allergic reactions to bee stings, baseball injuries, swimmer\u2019s ear infections\u2014you name it, it can happen!<\/p>\n

To help eliminate any concerns our members may have when these mishaps occur, we would like to clarify our guidelines on Emergency Room visits, or Urgent Care visits, while you are out of your HNE coverage area. You can take simple steps to avoid receiving a denied claim or a direct bill:<\/p>\n

If you have a Health Maintenance Organization (HMO) plan, are out of the area, and have to use an Emergency Room:<\/strong><\/p>\n

    \n
  1. Pack your HNE ID card!<\/strong><\/li>\n
  2. Present your insurance card \t\tat the time of your visit.<\/strong> This \twill give the hospital the \t\tnecessary information to submit \t\tyour claim to HNE. If you have \t\tan Emergency Room copay, \t\tsome hospitals may ask for this \t\tpayment at the time of your ER \t\tvisit; others may bill you after \t\tthey have submitted your claim \t\tto HNE for processing. Our billing \t\tinformation is on the back of your \t\tHNE ID card. Emergency visits \t\tare processed according to \t\tyour plan benefit \u2013 your member \t\tresponsibility differs based on \t\tyour plan coverage.<\/li>\n
  3. If you need to go the \t\t\tEmergency Room, it is not \t\tnecessary to notify HNE of your \t\tvisit.<\/strong> Please note that usually \t\ta visit to the ER related to dental \t\tissues is not covered.<\/li>\n<\/ol>\n

    If you have an HMO plan, and are out of the area, and have to use an Urgent Care facility<\/strong>:<\/p>\n

    You may be in need of medical care, but feel you don\u2019t need the full hospital ER visit. In that case, HNE offers members the option to use either an Urgent Care facility, or, if available, to see an Out-of- Area provider.<\/p>\n

    Follow these easy steps, to get your Urgent Care visit<\/strong> covered according to your plan benefit coverage:<\/p>\n

      \n
    1. Pack your HNE ID card!<\/strong><\/li>\n
    2. Call us!<\/strong> If you are out of the \t\tarea, we want and need to \t\thear from you with the \tfollowing information:\n
        \n
      • Who are you seeing?<\/strong> \u2013 Doctor \t\tname, facility, address and \tphone number.<\/li>\n
      • Why are you being seen?<\/strong> Allergic Reaction? Stomach Pain?<\/li>\n
      • What is your date of service?<\/strong><\/li>\n<\/ul>\n<\/li>\n
      • HNE enters an authorization \t\tfor this service<\/strong>, and will cover \t\tyour visit in most cases with \t\tyour specialist copay. Your plan \t\tselection may differ; check your \t\tplan coverage to see if you may \t\tbe subject to a deductible, or if \t\tyou have a High Deductible plan.<\/li>\n
      • Present your HNE ID card at \tthe time of your visit, <\/strong>and \t\tgive the provider the authorization \t\tnumber you have obtained. \t\tIf you were not able to notify \t\tHNE prior to your urgent care \t\tvisit it is important to notify \t\tHNE as soon as possible so \t\tan authorization can be entered. \t\tUrgent Care covers your \t\t\tinitial date of service visit. Any \t\tadditional follow up care, while \t\tstill out of the area, has to be \t\tcoordinated through your \t\t\tprimary care provider (PCP) \tand needs prior approval \tthrough HNE.<\/li>\n<\/ol>\n

         <\/p>\n

        If you would like further clarification on your benefit coverage, feel free to call us. We are here to help!<\/p>\n

        Enjoy a safe, happy summer!<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

        How do I handle emergency or urgent medical visits when you are out of your HNE coverage area? Everyone loves summer. As we all know, in the summer we may plan vacations or visits to family and friends outside of our health plan\u2019s coverage area. Summer also offers the perfect time to increase or change […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[25],"tags":[],"class_list":["post-391","post","type-post","status-publish","format-standard","hentry","category-summer-2011"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZGa-6j","_links":{"self":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/391","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/comments?post=391"}],"version-history":[{"count":0,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/posts\/391\/revisions"}],"wp:attachment":[{"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/media?parent=391"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/categories?post=391"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hnetalk.com\/member\/wp-json\/wp\/v2\/tags?post=391"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}