EHN Plan Care with VirtualCare2go™

Chalk Mountain Virtual Urgent Care

EHN Plan Care with VirtualCare2go

When you are feeling sick, traveling to a medical office may be the last thing you want to do. VirtualCare2go allows eligible patients to connect with a medical provider from home, work, or another private location.

Chalk Mountain employees enrolled in the PPO or HDHP medical plan may be eligible to receive care through participating EHN Preferred Network providers. Coverage and member costs depend on the specific plan, current eligibility, medical necessity, network participation, and the services provided.

Visit the VirtualCare2go Website to learn more about online medical care and eligible service areas.

What Medical Plans Are Available?

Chalk Mountain employees may be enrolled in one of two medical plans:

• PPO Plan

• HDHP Plan

The PPO Plan lists a $25 primary care copay and a $50 specialist copay.

Members enrolled in the HDHP Plan must meet the applicable deductible before the plan begins paying according to its benefit structure. Copays, coinsurance, and other member costs can vary. Review the medical cost-share information printed on your insurance card for the most accurate details.

These amounts do not automatically confirm how a virtual visit will be processed. Members should verify their benefits and provider-network participation before scheduling. An insurance card does not guarantee coverage or payment.

Who Administers the Chalk Mountain Plans?

Health Plans, Inc., also known as HPI, administers the Chalk Mountain PPO and HDHP plans.

HPI and Pathway Concierge can assist with:

• Member eligibility

• Benefit verification

• Prior authorization requirements

• Claim-status questions

• Provider-network participation

• Copays and cost-sharing information

For prior authorization, benefit verification, or claim-status assistance, call Pathway Concierge at (800) 682-4269 or visit the HPI Provider Resources.

The available plan information also lists (888) 682-4269 for general plan questions. Because the telephone numbers differ by service, members should confirm the correct number on the back of their current insurance card.

What Network Does the Plan Use?

The Chalk Mountain plans use the EHN Preferred Network. This network includes Baylor Scott & White Quality Alliance providers who have elected to participate.

Not every Baylor Scott & White Quality Alliance provider participates in this network. Members should confirm that VirtualCare2go participates with their specific Chalk Mountain plan before receiving care.

To locate or verify an in-network provider:

• Use the HPI Provider Search

• Call HPI at (800) 532-7575

• Contact BSWQA Care Navigation at 1-844-279-7589

Provide the employer name, member identification number, plan name, and requested service when verifying participation.

What Can Be Evaluated During a Virtual Visit?

Eligible Chalk Mountain employees and their covered family members may request virtual care for many routine and non-emergency medical concerns.

A virtual visit may be appropriate for:

• Cold and flu symptoms

• Cough and congestion

• Sore throat

• Headaches and body aches

• Mild allergy symptoms

• Rashes and minor skin concerns

• Nausea or digestive concerns

• Urinary symptoms

• Pink eye symptoms

• Medication-related questions

• Non-controlled medication refills

• Follow-up appointments

• General health concerns

The provider will review your symptoms and medical history to determine the appropriate next step. Some conditions may require an in-person examination, laboratory testing, imaging, specialist care, or emergency treatment.

For scheduling assistance or questions, call VirtualCare2go at (817) 508-8169.

How Do I Verify My Benefits?

Before scheduling, contact HPI or Pathway Concierge and ask:

• Does VirtualCare2go participate with my specific Chalk Mountain plan?

• Is a virtual medical visit covered?

• What copay, deductible, or coinsurance applies?

• Is prior authorization required?

• Are prescriptions or laboratory services covered separately?

• Are there location or network restrictions?

• Will I have any time-of-service responsibility?

Write down the representative’s name, the date of the call, and the reference number. Keep this information with your records in case you have questions after the visit.

Are Specialist Referrals Required?

The available Chalk Mountain plan information does not list a specific specialist-referral requirement.

Referral and authorization requirements may depend on the requested service and the member’s plan. Contact HPI before beginning specialist care to confirm whether a referral or prior authorization is required.

How Should I Prepare for My Virtual Appointment?

Before the appointment:

• Choose a quiet and private location

• Use a device with a working camera and microphone

• Confirm that your internet connection is stable

• Keep your Chalk Mountain insurance card nearby

• Prepare a photo identification card

• Make a list of medications and allergies

• Write down your symptoms and when they began

• Have recent temperature or blood pressure readings available, when applicable

• Keep any referral or authorization documents nearby

Clear and accurate information helps the provider recommend the safest next step.

Claims Information for Providers

Chalk Mountain claims are administered through Health Plans, Inc.

Electronic claims: Payor ID IHS07

Mailed claims:

Employers Health Network
P.O. Box 507
Arnold, MD 21012

Providers should verify current claim-submission instructions before sending a claim.

Professional Care From a Convenient Location

VirtualCare2go helps reduce travel and waiting-room time by allowing eligible patients to speak with a medical provider from a comfortable, private location.

When you are ready, Book Today or call (817) 508-8169. Please have your Chalk Mountain insurance card available so your benefits and network participation can be reviewed before the appointment.