Edge Systems Virtual Urgent Care From Home

EHN Plan Benefits With VirtualCare2go™ Across Texas

When you or a family member feels unwell, traveling to a medical office may add more stress to an already difficult day. VirtualCare2go™ connects eligible patients with medical professionals through convenient virtual visits from home, work, or another private location.

Edge Systems, LLC employees enrolled in the company’s medical plan may have access to participating providers through the EHN Preferred Network. Coverage, eligibility, and member costs should always be verified before receiving care.

What Does the Edge Systems Plan Include?

The available Edge Systems plan information lists:

• A $20 copay for primary-care visits

• A $40 copay for specialist visits

These amounts can help members prepare for care, but they do not automatically confirm the cost of a VirtualCare2go appointment. Your financial responsibility may depend on current eligibility, provider participation, the type of virtual service, prior authorization, medical necessity, and other plan provisions.

Review the Edge Systems insurance information before scheduling. An insurance card does not guarantee coverage or payment.

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

Can Edge Systems Employees Use VirtualCare2go?

Eligible Edge Systems employees and covered family members may be able to use VirtualCare2go for virtual urgent or primary care.

A virtual visit may be appropriate for concerns such as:

• Cold and flu symptoms

• Cough, congestion, or sore throat

• Fever and body aches

• Mild allergy symptoms

• Headaches and migraines

• Nausea, vomiting, or diarrhea

• Urinary symptoms

• Minor infections

• Rashes and skin concerns

• Medication questions

• Routine primary-care concerns

• Chronic-condition follow-ups

The medical professional will evaluate whether your concern can be managed virtually or whether you should receive in-person care.

Coverage depends on eligibility, plan benefits, network participation, medical necessity, and the services provided.

Call 911 or go to the nearest emergency room for chest pain, severe breathing difficulty, signs of a stroke, fainting, confusion, uncontrolled bleeding, major trauma, or another life-threatening emergency.

Who Administers the Edge Systems Plan?

Cornerstone Preferred Resources, also known as CPR, is listed as the third-party administrator for the Edge Systems medical plan.

Cornerstone and the associated plan resources can assist with:

• Member eligibility

• Benefit verification

• Prior-authorization requirements

• Claim-status questions

• Copays and cost-sharing information

• Provider-network participation

• General plan questions

Members should compare available information with the telephone numbers and instructions printed on their current insurance cards.

How Do I Verify My Virtual-Care Benefits?

For benefit questions, claim-status assistance, or other plan information, contact EHN at (800) 278-0703 or visit the CPR Provider Portal.

Before scheduling a virtual visit, consider asking:

• Does VirtualCare2go participate with my specific Edge Systems plan?

• Is a VirtualCare2go appointment covered?

• Will the $20 primary-care copay apply?

• Is telehealth processed differently from an office visit?

• Does the requested service require prior authorization?

• Are laboratory tests or prescriptions processed separately?

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

Ask the representative for a reference number and keep it with your records. Final coverage and financial responsibility are determined when the plan processes the claim.

Is Prior Authorization Required?

Prior-authorization requirements depend on the medical service being requested.

For prior-authorization assistance, call (888) 508-7615 or visit the MedWatch Portal. Members should confirm authorization requirements before receiving services that may need advance approval.

Receiving prior authorization does not guarantee claim payment. Eligibility, medical necessity, network participation, and other plan provisions may still apply.

What Provider Network Does the Plan Use?

The Edge Systems plan uses 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 particular network. Members should verify that VirtualCare2go and the requested service participate with their specific plan.

To locate or confirm an in-network provider:

• Visit the EHN Member Portal

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

• Call the member-services telephone number on your insurance card

Provide the Edge Systems employer name, your member identification number, the provider’s name, and the requested service when confirming participation.

Are Specialist Referrals Required?

The available Edge Systems plan information does not identify a standard specialist-referral requirement.

Referral and prior-authorization requirements can vary by service. Even when a referral is not required, certain specialist consultations, procedures, imaging studies, or treatments may need advance approval. Contact Cornerstone before beginning specialist care to confirm your plan’s current requirements.

What Should I Prepare for My Visit?

Before your appointment, please have the following available:

• Your Edge Systems insurance card

• A photo identification card

• A current medication list

• Known medication or food allergies

• Your preferred pharmacy information

• Relevant medical records

• Recent laboratory or imaging results

• Any referral or authorization documents

• A description of your symptoms

• The date your symptoms began

• A private and well-lit place for the visit

Providing accurate medical and insurance information can help the care team prepare for your virtual appointment.

Claims Information for Providers

Edge Systems claims use the following submission information:

Electronic claims: Payor ID IHS07

Mailed claims:

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

Providers should verify the member’s eligibility, insurance-card information, and current claim-submission instructions before sending a claim.

Compassionate Virtual Care Wherever You Are

VirtualCare2go helps make medical care easier to reach when traveling to a clinic is difficult or inconvenient. Our medical professionals will listen to your concerns, evaluate your symptoms, and help you understand the appropriate next step.

You can Book a Virtual Visit to begin scheduling. When you are ready, Book Today or call (817) 508-8169.

Please have your Edge Systems insurance card available so your eligibility, benefits, and network participation can be reviewed before your appointment.