PHYSICIAN VISIT
• With the Physician
Visit Network, you and your family can save 10% to 30% or
more at over 336,000
participating physician offices
nationwide.
•
The Network includes both primary care physicians and
specialists.
•
Members can also
access savings at over 40,000 ancillary facilities, which
includes medical clinics, labs,
diagnostics, out-patient
surgery centers and more…
•
Anyone can receive
the negotiated savings.
The Galaxy Health
Network Physician Visit program is valid at participating
network providers,
including but not limited to:p>
| PRIMARY CARE
PHYSICIANSd>
| CHIROPRACTIC |
COUNSELING |
| SPECIALISTS |
LABS/DIAGNOSTICS |
RADIOLOGY |
| PEDIATRICS |
ALTERNATIVE
MEDICINE |
REHAB |
| OB/GYN |
SKILLED NURSING |
HOME HEALTH |
| OUT-PATIENT
SURGERY CENTERS |
MEDICAL CLINICS |
And more… |
How it works…
1. Members select a
local participating provider by calling 800-975-3322 and asking
for the
"Medical Savings Card" department, or by accessing online at
www.galaxyhealth.net
2. Members must show ID
card at the time of their visit in order to receive a discount.
3. Provider will follow
instructions on the back of the card to "re-price" the bill by
applying the predetermined savings according to the negotiated
contract.
4. Member is
responsible for paying remaining balance due to provider at the
time of service. If member has any additional medical coverage,
that amount will be applied to the bill according to the medical
plan or policy in place.
HOSPITAL
Members have access
to almost 2,700 acute-care hospitals nationwide for
in-patient confinement,
with savings of 5% - 30% or more.
How it works…
1. Pre-Planned
Services: members call 800-975-3322 (Option 4) to receive
savings for preplanned/non-emergency services; available only
with the required pre-certification and referral number. The
negotiated estimate payment portion amount needs to be secured
prior to member receiving any services. Network will confirm
payment ability and provide a referral number.
2. Emergency Visits:
members must notify network and receive a referral number within
forty-eight (48) hours of an Emergency Visit by calling
800-975-3322 (Option 4).
PATIENT ADVOCACY
To ensure members have a positive experience when using their
medical savings card, network representatives are ready to help.
Network will confirm that provider is in network and accepting
new patients, confirm provider is aware of how the medical
savings card works, and verify the discount will be honored at
the time of service.
Members simply need to
contact a Patient Advocacy representative at 800-975-3322
(Option 4) prior to making their appointment to take advantage
of these services. *Patient Advocacy is not available in
California.
With over 336,000
doctors and over 2,700 hospitals in the United States
participating in this Referral program, you could save from 5% -
30% on your medical bills. As a minimum, you will receive a 20%
savings on your actual bill from the doctor's office.
Additionally, our
Patient Advocacy Program will help you select a participating
provider.
Savings are available on
the following type of services:
Inpatient
• Hospital Room
• Operating Room
• X-Rays
• Lab Services
• Electrocardiograms
• Surgeon's Fees
• Many Others |
Outpatient
• Office Visits
• Pathology
• X-Rays
• Sonograms
• Chemotherapy
• Many Others |
Physicians
Our patient advocacy representatives will work with members to
locate specific
providers, confirm the provider's acceptance of new patients and
provide the member
with a listing of several different providers in their immediate
area that will meet the
member's specific needs.
Hospitals
For assistance with hospitals, patient advocacy representatives
will work with members
to locate a participating hospital. The member will be
responsible for any applicable
financial guarantees required by the hospital, prior to
admission.
This is a discount program only. Galaxy Health Network (GHN) has
no liability for
providing or guaranteeing service or for the quality of service
rendered.
How to use your
Physician And Facility Patient Advocacy Service
This service is
included with purchase of physician/facility discount access
network.
*Patient Advocacy is not available in California.
Galaxy Health Network
(GHN) offers a Patient Advocacy Service for all
Physician/Facility service visits through participating
providers in the Galaxy Medical
Savings Network.
How the Galaxy Health Network Patient Advocacy
Department works:
1. Members call Galaxy Health Network Medical Savings Card (MSC)
Department at 1-800-975-3322 (Option 4) to locate a
participating provider in your area.
2. Member identifies
their location, zip code and the type of doctors or facility
being requested, and provides a telephone number, fax number or
e-mail address so that the a Patient Advocacy representative can
provide specific information back to the member.
3. The GHN Patient
Advocacy Department will contact providers specific to the
member’s zip code and specialty, verify that the provider is
accepting new patients, pre-certify that the physician/facility
understands that they are part of Galaxy Health Network and that
they will accept the Medical Savings Card product, confirms the
provider’s office understands how to re-price the bill, and
perform any unique pre-certification that may be required.
4.The Patient Advocacy
Department contacts the member via telephone, fax or e-mail and
provides member with 2 to 3 different provider options for the
member’s selection purposes.
5. Member will make
their own appointment and visit one of the 336,000 physicians or
40,000 facilities within Galaxy Health Network.
6. Provider will utilize
the IVR repricing line or web-based system for immediate
repricing of the procedure. Members will receive 5 to 30%
savings or more, and the provider will receive payment for the
services provided (based on their contract with Galaxy Health
Network) at the time of service.
How to use the Hospital Patient Advocacy Program
This service is included with purchase of Hospital discount
access network.
*Patient Advocacy is not available in California.
Members have access to
the Galaxy Health Network (GHN) Patient Advocacy representatives
to pre-certify and obtain a referral number for all
hospital/facility needs. MSC representatives will coordinate
hospital in-patient as well as out-patient needs.
Members call
1-800-975-3322 (Option 4) to receive assistance in and let us
initiate the process of negotiating their hospital services on
their behalf. To make it simple members only need to make one
point of contact, as our patient advocacy representatives will
do the rest.
Members will be
asked to provide the following information:
- Patient Name
- Member
- Card Number or Group ID Number
- Illness or Injury
- Treatment required or requested
|
- Referring Physicians and Phone Number
- Facility Requested
- Insurance Carrier (if applicable)
- Medical Savings Account Sponsor Name
|
After making the
necessary arrangements we will contact the member with the
details regarding
their procedure. We will obtain a good faith estimate of the
cost involved for treatment, contact
the insurance carrier if applicable to verify benefits and
eligibility, apply the GHN network
discount to the total billed charges, and then apply the
insurance benefit amounts. We will inform
the member of the estimate amount they will be responsible for
payment. *This amount needs to
be secured prior to the member receiving any services as
providers will expect the remaining
balance due at the time of service.
Members have the option to secure payment using the following
methods or any combination
thereof: Cash, Check, Credit Card, Insurance Payment or Medical
Savings Account Funds or
other Certified Funds. The FACILITY and/or PROVIDER, in advance
of services being
performed, must agree upon any needed payment arrangement. If
payment arrangements are not
pre-approved or payment is not made in a timely manner, the
contracted SAVINGS could be in
jeopardy. If members need assistance negotiating such a payment
arrangement, member can
contact GHN Patient Advocacy department at 1-800-975-3322
(Option 4).
Members will receive 5% - 30% savings or more, and the provider
will receive payment for the
services provided (based on their contract with Galaxy Health
Network) at the time of service.
MEMBERS must process their Hospital service through the GHN
Patient Advocacy department
in order to guarantee the network savings. MEMBERS ARE NOT
ELIGIBLE FOR SAVINGS
THROUGH GHN IF THEY ASK A PROVIDER/FACILITY TO FILE AN INSURANCE
CLAIM FOR THEM and do not contact GHN first, as the provider
will then balance bill the
patient for any payment portions not covered by insurance. If a
member fails to obtain precertification
or referral number from GHN and a bill is received, the bill
will be returned to the
member as "SELF-PAY" resulting in the member being responsible
for billed services in full.
In the event of an "Emergency Room Visit", members must notify
GHNH at 1-800-975-3322 and
receive a referral number within forty-eight (48) hours of said
visit or GHNH is not responsible
to negotiate discounts.
If a member selects an Out-Of-Network Provider, savings are more
difficult, and possibly
unavailable. However, GHN will utilize its resources to
coordinate negotiations with the Facility
and/or Physician to obtain the best possible savings – even if a
provider is not participating with
Galaxy Health Network.
Click to Read GALAXY HEALTH NETWORK MEDICAL SAVINGS CARD
HOSPITAL TERMS AND CONDITIONS
THIS THIS MEMBERSHIP IS NOT HEALTH INSURANCE NOR IS IT INTENDED TO
REPLACE HEALTH INSURANCE.
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