Many situations are not emergencies, but do require immediate medical attention. These situations require what is referred to as urgent care. Examples of urgent care needs include ear infections, sprains, high fevers, vomiting and urinary tract infections. In-network claims don't require claim forms. Most providers will send you a statement showing the total amount due and informing you they billed the health plan.
Most providers use systems-generated billing where their computer automatically sends out the bill.
Providers belong to many different health plans and may not have billed us correctly. A specialist is a physician with extensive education, professional training and certification in a specific type of care. Examples of types of specialists are surgeons, cardiologists, psychiatrists and ophthalmologists. A referral occurs when a PCP decides their patient's situation calls for the services of a specialist or other treatment such as hospital admissions, lab or x-ray services or outpatient procedures. If you need the attention of a specialist, your PCP will provide you with a referral.