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Frequently Asked Questions

WHEN YOU VISIT THE PHYSICIAN'S OFFICE

The physician's staff may ask you to sign a form to "assign benefits" the first time you visit the office. This is a simple procedure that allows the physician to collect his or her fee directly It also helps ensure that you will not receive a bill for any balance due except for your share of coinsurance or deductibles (if any) for certain covered services.

Following these easy steps when you first arrive at the provider's office will help the physician's staff verify your eligibility, ensure that they bill your visit correctly and that you receive panel level benefits for covered services.
WHEN YOU ARE REFERRED TO A SPECIALIST
To ensure that you receive panel benefits for covered services, it is your responsibility to make certain your physician refers you to specialists and other healthcare providers a participate in PHS. The same is true if your physician admits you to the hospital or refers you to a specialty facility.

Before the referral is made, ask your physician to check the current directory of PHS panel providers. You can call PHS to make certain the referral physician, hospital or specialty facility is a PHS panel provider (see below for further details).

When you call to make your appointment, make sure the physician's staff or facility knows you are a PHS subscriber. Also, be sure to show your PHS card when you arrive for your appointment.

If your physician refers you to tertiary providers in the PHS network, a referral by PHS is required. It is important to obtain the appropriate referral by calling (814) 946-7793 or 1-800-422-8929.

  WHAT TO DO ABOUT...

LOST ID CARDS
It is easy to get a new identification card if you lose yours. Just contact your employer's benefit office or PHS for help in getting a replacement.

QUESTIONS ABOUT ELIGIBILITY OR COVERAGE
Call your employer's benefits office or the number listed on your ID card to resolve questions about eligibility and specific coverage under your plan.

QUESTIONS ABOUT CLAIMS OR BENEFITS
Call the telephone number listed on your ID card for answers regarding specific claims or benefits provided by your employer's health plan.

QUESTIONS ABOUT HEALTHCARE PROVIDERS
Call PHS for information about healthcare providers. The status of each PHS provider can change throughout the year. Therefore, before you make an appointment with a provider, call PHS at 814-317-5063. to determine if they are a panel provider or if your physician has recently joined the network.








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