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Am I really saving money with PHC?

We have established systems to ensure that medically necessary care is provided in the most appropriate setting and in the most appropriate manner for an individual patient's needs. PHC Physicians review the practice patterns and quality of care provided within the network to continually improve upon patient care. In addition, information is presented back to our clients as a means to demonstrate our clinical and financial performance.

The success of PHC is founded in our ability to provide the employers with the best possible value for each health care dollar spent. PHC is growing to accommodate the needs of the employers of Lancaster County and beyond. We are committed to working with you to develop a relationship that provides a seamless, full-service continuum of care to your employees. We look forward to working with you.

May I choose my own doctor?

Yes! You may choose any physician from our Directory of Participating Providers. You may use a provider not listed in our Directory, but your expenses may be greater.

Do I need a referral form or approval to see a specialist?

No. You may see a PHC participating specialist of your choice.

How do I access a provider who is not participating in the PHC Network?

Prior approval through PHC is required before services are rendered by an out-of-network provider.

How will my physician or hospital know I belong to PHC?

Your employer will give you an identification card which you must present whenever you see a participating provider.

What will I pay when I see a physician?

Your physician may require payment for any copayments or services not covered under your health benefit plan at the time of service. If you are scheduled for elective surgery, your physician may request you pay any applicable deductible and coinsurance prior to surgery.

What services are covered by PHC?

Covered services are defined by your company's benefit plan.

Will I receive an explanation of benefits after a claim has been submitted?

Yes. You will receive a standard explanation of benefits which detail what the provider charged, what was approved, what was applied to your deductible, what was paid to your provider, and what you owe the provider.

When will I pay my portion of the bill?

After the explanation of benefits is issued, you will receive an invoice from the participating provider.

What is PHC's relationship with my insurance company or third party administrator (TPA)?

PHC works with your providers and insurance company/TPA to manage the delivery of your health care. Our recommendations will be given to you, your providers and to your insurance company/TPA. Final authority for determining whether a requested procedure and/or admission will be covered will be made by your insurance company/TPA. It is always advisable to verify coverage before receiving any medical services.

I believe my claim was processed incorrectly, or I have a question about my health plan benefits. Who do I call?

Call your claims administrator. The telephone number is listed on your identification card.

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Preferred Health Care
Urban Place • 480 New Holland Ave, Suite #7203 • Lancaster, PA 17602
Phone: 717-560-9290 • Fax: 717-560-2312 • Email: info@phcunity.com