|ODS Travel Network offers members in-network coverage |
A new offering from ODS gives members better coverage when they travel. Effective April 1, the ODS Travel Network offers groups in-network benefits when members travel outside their primary service area.
The ODS Travel Network is an additional network tier. When a medical member seeks care outside his or her primary service area for any reason, emergency or non-emergent, we'll review the claim to see if the provider is part of the PHCS Healthy Directions network. If so, ODS will pay the claim at the in-network benefit level.
Members will be able to search for providers quickly and easily
by visiting www.phcs.com and selecting the Healthy Directions network. The PHCS Healthy Directions network boasts nearly 70,000 hospitals and medical facilities and 658,000 primary care physicians and specialists.
In addition, the ODS Travel Network can save money for members with dependents who live out of the area. Normally, these members may be subject to balance billing. However, if an out-of-area dependent seeks care from a PHCS Healthy Directions provider, ODS will pay at the in-network benefit level, providing better coverage and savings to the member.
The ODS Travel Network is available to members who are covered under a primary network inside and outside of Oregon, unless they're already covered by the PHCS network. Your group will most likely either gain automatic access to the ODS Travel Network or will have the option to enroll.
Insured groups (excluding minimum premium and refunding) will automatically have access to the ODS Travel Network upon renewal or initial enrollment. Twenty-five percent of total claim dollar savings will be applied to the group's claims experience.
ASO groups have the option to add the ODS Travel Network and will be charged 25 percent of total claim dollar savings.
Minimum premium and refunding groups have the option to add the ODS Travel Network, and 25 percent of total claim dollar savings will be applied to the group's claims experience.
The ODS Travel Network is not currently available for groups in Alaska, individual business groups in Oregon, Medicare Advantage groups or Medicaid members.
If your group is not automatically enrolled, the ODS Travel Network is worth the extra step. Members in your group will appreciate the convenience of having access to medical care away from home, and they'll love the savings from receiving care at in-network benefit levels.
Because the ODS Travel Network is not an alternative primary network, members should continue to seek care in their primary network whenever possible. Preauthorization is still required for inpatient services. Healthcare Services will direct members to in-network providers when possible.