Presbyterian Health Plan | Summer 2019 | Your Story

8 We want our members to get the best care, in the best place, at the right time. One of the ways we do this is by using a prior authorization process. Prior authorization is part of our Utilization Management Program. This program helps ensure that the services our members receive are medically necessary. This means that the care you receive is needed to diagnose, treat, or prevent medical conditions. It also helps ensure that the medical facilities, such as hospitals, are being used in the right way. We do not reward or pay healthcare providers for not providing services. We also do not reward or pay healthcare providers for not referring you for care. Your providers and Presbyterian staff members consider these factors when making decisions about your care: ● ● Is the service or care covered by your health plan? ● ● Is the service or care appropriate for your healthcare needs? The right care at the right time Have questions about UM? To learn more about the Utilization Management Program, call the customer service number on your member ID card. TruHearing® benefit The ability to hear well is important to good health! Beginning on Jan. 1, 2020, Presbyterian will offer a hearing exam and aid benefit through TruHearing ® . As long as you use the TruHearing ® network of providers, you can receive an exam for $45 and the member price for the aids of $699 per aid for the 32-channel Advanced model, or $999 per aid for the 48-channel Premium model. Members may receive up to two aids per year (one per ear, per year). For more information, or to schedule an appointment, call TruHearing ® directly at 1-866-202-0110 (TTY: 711) , Monday through Friday, 8 a.m. to 8 p.m. Or go to www.TruHearing.com/Select .