Support

Care Coordination

When you need to navigate labs, imaging, and major procedures, Care Coordination is here to help you find lower cost, high quality providers.
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Why we provide this service.

The fact of the matter is – healthcare is complicated, and plan specifics can be hard to understand. This makes finding care difficult to navigate, resulting in people making hasty decisions about when and where to access healthcare.

That’s why Frederick Fox has created the Care Coordination program – to help members understand the care they’re paying for, and get to the care they need.
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How you can use Care Coordination.

Find next steps after getting an unfavorable diagnosis
Identify affordable options if you need labs, imaging, or surgery
See a recommended provider and have out-of-pocket costs waived

We’re here to help you.

The Care Coordination team is here to assist you with your labs, imaging, and major procedures.

In addition to providing you with a support team, finding your treatments through Care Coordination means your patient responsibility can be waived.

Although we can’t fix the broken healthcare system, we can make sure members know that they aren’t alone. Care Coordination is a supporter alongside you, helping you navigate this space and understand each step.
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Frequently Asked Questions

When can I use Care Coordination?

Care Coordination access depends on the plan you have selected.

On ClearShare plans, you can use Care Coordination to find providers for labs, imaging tests, some surgeries, and other major procedures. In addition, Care Coordination can help you find local providers if the primary and secondary network doesn’t provide the coverage you need in your area .

On Major Medical Copay 3500, Copay 4500, and Copay 8000 plans, Care Coordination is embedded in the plan as a Tier 1 In-Network Preferred provider. Most services other than primary care and emergency services are eligible, but reference your plan documents for a complete list.

When Care Coordination is able to find a provider in your area that we recommend, your care is completely free. Our team will work diligently to find you a recommended provider, however there are instances where no provider is available. Care Coordination benefits are not guaranteed.

On Major Medical HSA 5000 and MVP plans, use of Care Coordination to access benefits or avoid penalty is required for most services. Reference your plan documents for a complete list.

How do I use Care Coordination?

When you need a service that is eligible for Care Coordination, we recommend contacting us at least 21 days before obtaining services. When you choose to see the provider we recommend, your care is completely free.

Our team will work diligently to find you a recommended provider, however there are instances where no provider is available. Care Coordination benefits are not guaranteed.

How do I know which providers are in the Care Coordination network?

Care Coordination does not have a doctor lookup. The providers we recommend depend on a variety of factors. 

Can I choose the doctor I want to see?

No, Care Coordination works to find and recommend you a fair-priced, high quality provider.

If you want to choose your own provider, you can use your plan’s applicable in-network or out-of-network services. 

Can I request a second opinion?

Yes, we can recommend providers for a second opinion.

Do I need to contact Care Coordination for every occurrence, repeat services, or if additional treatment is recommended?

Yes, Care Coordination must be contacted and a provider must be recommended for each service in order to be eligible for waived out-of-pocket costs.

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