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QUESTIONS & ANSWERS about
PPO Coverage
What is a
Preferred Provider (PPO)
plan?
The PPO being offered to you through
OSF HealthPlans is a plan that lowers your out-of-pocket costs if you
use OSF HealthPlans contracted providers. You may still use providers
outside the preferred list, but you will pay more to do so.
Will I need to file my
own claims?
No. If you use a participating OSFHP
PPO provider, they will file claims for you. All you need to do is
present your ID card at the time of your visit. However, you may be
responsible for filing your own claims if you use a non-participating
provider.
Can physicians bill me
for costs above your reimbursement level?
Not if you use an OSF HealthPlans
participating physician or provider. A participating physician will
always accept OSFHP reimbursement for covered services as payment in
full after you pay any applicable copayment, deductible or
coinsurance. You will be responsible if you are billed for services
that are over our reimbursement level by any non-participating
physician or provider no listed in our directory.
Who do I call when I
have questions about my PPO coverage?
Our Member Service Department is
available if you have a question regarding your coverage. Simply call
309-677-8222 or 800-673-5222.
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