ATTENTION Louisiana residents: See below for information on benefits for facility-based providers
Pursuant to Louisiana Regulation RS 22:1871, Insurers are required to post on a web site available for inquiry a listing of all contracted facilities, the names of each individual or group of anesthesiologists, pathologists, radiologists, emergency medicine physicians and neonatologists who provide services at these facilities and whether they are also contracted. Your member ID. Card lists the URL/Web site for the Preferred Provider Organization we have contracted with to provide managed care services. This web site lists all PPO facilities and those providers who are contracted with the facility.
Your New York Life medical coverage provides that if you are treated or receive services at a participating in-network hospital or ambulatory surgical center, services provided by a facility-based provider (e.g. anesthesiologist, radiologist, pathologist, emergency room staff, etc.) will be paid at the in-network level of benefits, regardless of whether the provider participates in the network. You will not have a higher copay, deductible or coinsurance level for covered services rendered by these providers. Benefits will be determined based on the billed charges from these providers.
We have provided the below link to a listing of facilities who have provided New York Life with the names of their facility-based providers. It is organized by facility name. These providers will be reimbursed for covered expenses at the in-network benefit level. New York Life contracts with a number of PPO networks. Please verify via your network’s web site whether it is a participating facility for your plan.
HEALTH CARE SERVICES MAY BE PROVIDED TO YOU AT A NETWORK HEALTH CARE FACILITY BY FACILITY BASED PHYSICIANS WHO ARE NOT IN YOUR HEALTH PLAN. YOU MAY BE RESPONSIBLE FOR PAYMENT OF ALL OR PART OF THE FEES FOR THOSE OUT-OF-NETWORK SERVICES, IN ADDITION TO APPLICABLE AMOUNTS DUE FOR CO-PAYMENTS, COINSURANCE, DEDUCTIBLES AND NON-COVERED SERVICES.
SPECIFIC INFORMATION ABOUT IN-NETWORK AND OUT-OF-NETWORK FACILITY BASED PHYSICIANS CAN BE FOUND AT THE WEBSITE ADDRESS OF YOUR HEALTH PLAN OR BY CALLING THE CUSTOMER SERVICE TELEPHONE NUMBER OF YOUR HEALTH PLAN.