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SOME EMPLOYER GROUPS USE A TRIPLE RATING SYSTEM TO SHOW THE COST SAVINGS TO YOU AND YOUR PLAN THIS RATING DETERMINES THE BENEFIT LEVEL OF THE CLAIM
If you see a provider listed as TIER 2, this provider IS PARTICIPATING with your health plan. If your benefit plan has a Tiered benefit then the TIER 2 benefits apply.
If you see a provider listed as TIER 1, this provider has agreed to accept our special rates and so the copay or out of pocket is lower.
If you do not have a Tiered benefit plan, this provider is still in-network.
If you see a provider listed as TIER 3, this means that benefits are substantially reduced because the provider has very high billed amounts and will not accept contracted rates that are appropriate .
Finding a participating provider on this provider search is NOT a guarantee of benefits or payment. Contact the customer service phone number listed on the member identification card for eligibility & benefits. Some providers such as Labs, Radiologists, Pathologists, Anesthesiologists and Emergency Room Physicians may not be participating even though the facility where they work or the referring provider is part of our network. It is your responsibility to verify that your provider is participating at the time of service. Labs performed at Laboratory Corporation of America (LABCORP) and Quest Laboratory Services may offer you the best benefit. It is your responsibility to verify this before seeking lab services.