Some of your medical benefits will include:
- Primary Care Physician office visits
- Diagnosis and treatment of illness or injury
- In office procedures, lab and imaging services
- Maternity office care
- Specialty care
- For a detailed list of medical benefits please read the Tuality Healthcare Plan booklet, or you may contact our Human Resource Department at 503-681-1856.
Some of your preventive medical benefits include:
- Child routine and preventive care visits
- Well-women care
- Prostate screening
- Annual hearing exams
- Visits for naturopathic and chiropractic care must use First Choice Health Network providers.
For a complete list of preventive medical benefits please see your Tuality Healthcare Plan booklet. Some services require a "pre-certification". It is important to understand what services need "pre-certification" to manage your care.
Medical Benefits and Pre-certification
Prior to a planned hospital admission or surgery, you or your doctor must call Innovative Care Management to request a "pre-admission certification". Pre-admission certification is required to make sure you'll receive the maximum amount of benefits under your plan. Failure to call could result in a penalty or reduced benefit for your hospital admission and/or surgery.
Innovative Care Management
Your physician should contact Innovative Care Management to obtain preauthorization before you are admitted to the hospital or before services which require preauthorization are provided.
In a medical emergency, you may be admitted to an inpatient facility without preauthorization/or a "pre-certification".
- Your physician should contact Innovative Care Management as soon as reasonably possible after your admission.
- Additional days of inpatient care, beyond those initially authorized, must also be authorized by Innovative Care Management.
- For a complete list of services requiring a "pre-certification", please see your Tuality Healthcare Plan booklet or you may contact our Human Resource Department at 503-681-1856.