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© 2006 Texas Mutual Insurance Company. Employee Benefits Timely access to  Treating doctors  Specialty care Quality doctors who will get you well and.

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Presentation on theme: "© 2006 Texas Mutual Insurance Company. Employee Benefits Timely access to  Treating doctors  Specialty care Quality doctors who will get you well and."— Presentation transcript:

1 © 2006 Texas Mutual Insurance Company

2 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

3 Changing Doctors You may change your treating doctor once without approval You will need to get approval if you change doctors a second time

4 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   (800) If you go to a non-network doctor, you may be responsible for payments to the doctor © 2006 Texas Mutual Insurance Company

5 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

6 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

7 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

8 Questions? © 2006 Texas Mutual Insurance Company


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