Accessing care through Option 1 saves members time and money. The PCP is responsible for filing claims, placing referrals for specialty care, and for obtaining precertification of care . The out-of pocket expenses to the member are lowest under this option. Accessing care through Option 2 gives members the freedom to select a physician other than their PCP from our extensive network of providers. As with Option 1, the physician is responsible for filing claims, placing referrals for specialty care, and for obtaining precertification of care .
Members still share in the savings associated with obtaining care through a network provider.
Accessing care through Option 3 offers members the greatest freedom to manage their health care. To find a participating Network Provider, click here to go to the QualChoice Directory of Network Providers. Behavioral Health Care is accessed in a slightly different way than medical care in the Triple Option plan. Click here for details .