| Question: |
The Rensselaer HMO |
Mohawk Valley Physicians' Health Plan (MVP) |
The Rensselaer Health Plan (RHP)
[In-Network] |
| How do I select my Primary Care Physician (PCP)? |
Choose a PCP from the provider directory. For help call 1-877-724-2579. |
Choose a PCP from the provider directory. For help call Member Services at 1-800-777-4793. |
Choose a PCP from the provider directory. For help call Member Services at 1-877-724-2579. |
| Can I switch physicians within the plan? |
Yes. |
Yes, when appropriate. |
Yes, once a month. Call Member Services. |
| What if I need care and my PCP is not available? |
Your PCP is required to have a backup on call 24 hours a day who will treat you and advise your PCP. Urgent care is available at certain facilities. |
Your PCP is required to have a backup on call 24 hours a day who will treat you and advise your PCP. |
Your PCP is required to have a backup on call 24 hours a day who will treat you and advise your PCP. Urgent care is available at certain facilities. |
| Can I see a specialist? |
Yes, your PCP will refer you to one as needed. |
Yes, your PCP will refer you to one as needed. |
Yes, your PCP will refer you to one as needed. |
| What if I am involved in ongoing treatment with an out-of-network doctor, such as an obstetrician, on oncologist, or a dialysis specialist when I join the plan? |
Your PCP will coordinate with a specialist for your care. |
Your PCP will coordinate with a specialist for your care. |
Call Member Services. In general, Plan will work with you to ensure continued treatment for up to 90 days. |
| If I need emergency care, can I go to any hospital? Is there a penalty if I do? |
For life-threatening emergencies, use any hospital or emergency room. |
For life-threatening emergencies, use any hospital or emergency room. Copayment applies in network's area. |
For life-threatening emergencies, use any hospital or emergency room. You will receive in-network benefits regardless of where you receive care. However, you must contact your PCP within 48 hours. |
| How does this plan work for students away at college? |
Those who attend school away from home should schedule routine care for times when they are home. Emergency care is covered. Call 1-877-724-2579 for sick care visits. |
Those who attend school away from home should schedule routine care for times when they are home. Emergency care is covered the same as for anyone else. |
Those who attend school away from home should schedule routine care for times when they are home. Emergency care is covered. Call 1-877-724-2579 for sick care visits. |
| Are plan doctors accepting new patients? |
Many network doctors continue to accept their existing patients. Refer to the provider directory to see which doctors are accepting new patients. |
Many network doctors continue to accept their existing patients. Refer to the provider directory to see which doctors are accepting new patients. |
Most network doctors will accept their existing patients when they join the plan. Refer to the provider directory to see which doctors are accepting new patients. |
| Why are doctors motivated to join a network? |
Most join to maintain or increase their patient base. |
Most join to maintain or increase their patient base. |
Most join to maintain or increase their patient base. |
| Will I get the same physician each time I need care? |
Yes, when you call in advance. For urgent care, you may be offered an appointment with a medical partner. |
Yes. |
Yes, when you call in advance. For urgent care, you may be offered an appointment with a medical partner. |
| What if my doctor (not in the network) tells me I need an operation? Can I use network surgeons and hospitals and pay less? |
Yes, if you are referred by a network provider. |
Your PCP must refer you to participating providers. |
Yes, but you need a referral from a network PCP. |
| What if a network physician tells me I need hospital care, but the hospital I want to use is not a network hospital? Can I use it and still get paid-in-full benefits? |
Only with prior approval from CDPHN. |
No. Services must be coordinated by MVP providers. |
Only with prior approval from CDPHN. |
| Can I visit a few physicians before selecting one? |
You need to select a PCP when you enroll. PCPs are listed in the Provider Directory. |
You need to select a PCP when you enroll. You can change your PCP by contacting member services. |
You need to select a PCP when you enroll. However, you can change your selection once a month. |
| Do both my spouse and I have to choose the same PCP? |
No, you may choose a different provider for each family member. |
No, you may choose a different provider for each family member. |
No, you may choose a different provider for each family member. |
| If a physician I know joins the network, can I switch over? |
Yes. |
Yes. |
Yes, you can change your PCP once a month. |
| How were the doctors in the network selected? |
All doctors in the network have had their education, experience, and credentials reviewed. |
Physicians are recruited and must meet strict credentialing criteria. |
All doctors in the network have had their education, experience, and credentials reviewed. |
| What do I do if I have a concern? |
Contact Member Services at 1-877-724-2579. |
Call Member Services at 1-800-777-4793. |
Contact Member Services at 1-877- 724-2579. |
