Need to know information
Premier Healthcare providers are considered out-of-network for medical plans that use Anthem provider networks: PPO $900 Deductible, PPO $400 Deductible, and HDHP PPO & HSA plans.
Out-of-network means that services billed by Premier will be subject to the following provisions:
- Claims will be processed based on Anthem’s statewide fee schedule (plan coverages and reimbursements will be based on that fee schedule).
- The member is responsible for separate out-of-network deductible and co-pays. See Out-of-Network Benefits Summary.
- Premier may ask the member to pay excess amounts above the Anthem statewide fee schedule (commonly referred to as “balance billing”).
- All reimbursements will be made directly to the member, not to Premier. The member is responsible for paying Premier.
- Preventive services must be received at in-network providers for 100% coverage.
Below is contact information for in-network facilities that provide alternatives:
|IU Health Bloomington Hospital||
|IU Health Southern Indiana Physicians||www.siphysicians.org|
|IU Health University Hospital||
|Southern Indiana Radiology (SIRA)||
IU employees who would like help in locating a PPO network specialist can contact Dan Rademacher, RN Care Manager at IU Health Southern Indiana Physicians. Dan can help provide a referral connection with an alternate physician specialist in the Bloomington and Indianapolis areas. He can be reached at 812-353-3089 weekdays from 8am – 5pm.