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Published byDangelo Ager Modified over 9 years ago
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© 2006 Texas Mutual Insurance Company
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Employee Benefits Timely access to Treating doctors Specialty care Quality doctors who will get you well and back to work You have a choice of treating doctors in the network
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Changing Doctors You may change your treating doctor once without approval You will need to get approval if you change doctors a second time
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Employee Requirements If you’re hurt on the job Follow company procedures If emergency care is needed, get it! Report your injury as soon as possible Select your treating doctor from the network list www.texasmutual.com www.texasmutual.com (800) 381-8067 If you go to a non-network doctor, you may be responsible for payments to the doctor © 2006 Texas Mutual Insurance Company
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Exceptions You do not have to go to a network treating doctor if it is an emergency you use your HMO primary care doctor* you are referred to a specialist by your treating doctor you live outside the “service area” * - applies only if employer offers HMO coverage
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Service Area Where network health care is available and accessible If you live in a service area, you must choose a network treating doctor “Live” means Principal residence (NOT a P.O. Box) Temporary residence required by employment Temporary residence for receiving help with daily activities © 2006 Texas Mutual Insurance Company
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Network Notice Rules to help you get care from the network You will receive a copy of the notice now and if you have an injury You must sign a form stating that you have received and read the network notice
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Questions? © 2006 Texas Mutual Insurance Company
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