ALERT! Even if your doctor is preferred, the facility or other providers such as anesthesiologists might not be. Make sure you confirm that all of the providers who will participate in your care and the facility are preferred before you receive services. Out-of-network providers and facilities can bill you for all charges not paid by the plan, while preferred providers and facilities agree to accept the payment amounts negotiated by the plan, which saves you money.
The plan pays for covered surgical services according to the network status of the provider. The surgeon and other professional providers may bill separately from the facility.
All elective inpatient surgeries and some outpatient procedures require preauthorization. In addition, your provider must notify the plan when you receive certain services, including admission as an inpatient; see list. See the list of services requiring preauthorization. Call Customer Service at 1-888-849-3681 if you have questions.
The plan covers the following services as outpatient:
- Outpatient surgery at a hospital.
- Surgery and procedures performed at an ambulatory surgery center.
- Short-stay obstetric (childbirth) services (released within 24 hours of admission).
ALERT! All surgeries must follow the plan's coverage rules. We recommend that you contact UMP Customer Service at 1-888-849-3681 before any procedure to ask if it's covered or requires preauthorization.