| Administrator |
UMR |
| Product |
Patient Choice Care System |
Patient Choice Insights |
| Member Enrollment |
- Features a network that places Care Systems into three tiers based on cost and quality.
- Members select a Care System and primary care clinic, which determines their tier and premium.
- Once enrolled, members obtain care from providers affiliated with their selected Care System.
|
- Features a network where clinics and other health care facilities are tiered according to cost and quality factors.
- Members can access any provider in the network. They pay a lower cost to visit Tier 1 providers, a middle cost to visit Tier 2 providers, and a higher cost to visit Tier 3 providers.
|
| Tier Levels |
Care System |
Primary care clinics, specialty care clinics, hospitals and other facilities |
| Claims Information |
Learn about UMR's electronic claims tools on their Web site
Claim address:
UMR
Patient Choice Claims
P.O. Box 30541
Salt Lake City, UT 84130-0541
View UMR's Quick Reference Guide (PDF) |
| Provider Service Center |
(877) 390-7632 (option 1) |
(877) 233-1800 |
| Web Site |
|
| Member Rights and Responsibilities |
(877) 390-7632 (option 1) |
(877) 233-1800 |
| ID Card/Logo |
View sample ID card (PDF) |
View sample ID card (PDF) |
| Behavioral Health/Substance Abuse Network |
Product uses Care System-contracted behavioral health providers and Patient Choice-contracted marketwide providers added to the Care System panel.
Claim address:
Patient Choice Claims
P.O. Box 30755
Salt Lake City, UT 84130-0755 |
Product uses the UBH network (the same network used by Medica’s SelectCare product). UMR provides claim payment and managed care.
Claim address:
Patient Choice Claims
P.O. Box 30755
Salt Lake City, UT 84130-0755 |
| Chiropractic |
Product uses CCMI-Landmark network providers including Care System-contracted providers.
Claim address:
ChiroCare c/o Landmark
P.O. Box 254765
Sacramento, CA 95865
Phone number: (888) 638-7719
Fax number: (866) 525-5056 |
| Referrals to Nonparticipating Providers |
Yes, if authorized by Care System |
No, except for UM-related care availability |