You are strongly encouraged to contact us to verify the status of the providers involved in your care including, for example, the anesthesiologist, radiologist, pathologist, facility, clinic, or laboratory, when scheduling appointments or elective procedures to determine whether each provider is an in-network or out-of-network provider. Such information may assist in your selection of provider(s) and will likely affect the level of copayment, deductible, and amount of coinsurance applicable to the care you receive. The information contained in this directory may change during your plan year. Please contact (608) 643-2491 or (800) 362-3310 to learn more about the in-network providers and the implications, including financial, if you decide to receive your care from out-of-network providers.
Notice: Limited benefits will be paid when out-of-network providers are used.
You should be aware that when you elect to utilize the services of an out-of-network provider for a covered service, benefit payments to the out-of-network provider are not based upon the amount billed. For POS and PPO plans, the basis of your benefit payment will be determined according to your policy's fee schedule, usual and customary charge (which is determined by comparing charges for similar services adjusted to the geographical area where the services are performed), or other methods as defined by the policy.
You risk paying more than the coinsurance, deductible, and copayment amount defined in the policy after the plan has paid its required portion.
Out-of-network providers may bill enrollees for any amount up to the billed charge after the plan has paid its portion of the bill. In-network providers have agreed to accept discounted payment for covered services with no additional billing to the enrollee other than the copayment, coinsurance, and deductible amounts.
You may obtain further information about the network status of professional providers and information on out-of-pocket expenses by calling (608) 643-2491 or (800) 362-3310.