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In order to obtain the most value from your health insurance coverage, you should use participating providers and pharmacies whenever possible. The following pages contain contact information for the various PPO Networks contracted with your employer's plan. These websites have search tools and/or lists of participants, enabling you to find a participating provider that meets your needs. Waterstone provides this information as a service to you and does not guarantee the validity of the information provided on these sites.
It is very important that you call the provider you select prior to your visit to assure that they are still participants in your network. It is your responsibility to make sure the provider has not changed their participation at the time you see them.
Seeing a participating provider has distinct advantages over visiting a non-participating provider:
- Participating providers have agreed to accept a pre-established amount as payment in full for service.
- Your out-of-pocket cost is normally lower, with a co-pay (if any) specified in your health plan (most plans also have an annual deductible amount).
Non-participating providers, on the other hand, set their own fee. You are responsible for the difference between the reasonable and customary amount and the non-participating provider’s total fee. Some non-participating providers will file a claim for you, while others require payment in full from you. You are then responsible for submitting receipts to Waterstone for reimbursement of the approved amount.
For complete details about your coverage, including the name of the appropriate network for your plan, please refer to your ID card or call Waterstone.
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| Copyright ©2010 Waterstone Benefit Administrators | 4013 Northwest Expressway, Suite 575 Oklahoma City, OK 73116-2605 | |
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