Kohl’s Employees Access Virtual Urgent Care

Two Centivo Plans with VirtualCare2go™ Across Texas

When an illness or health concern makes leaving home difficult, a virtual appointment may provide a more comfortable way to speak with a medical professional. VirtualCare2go™ connects eligible Texas patients with compassionate virtual medical care from home, work, or another private location.

Kohl’s employees may be enrolled in the High Performance Plan Basic or High Performance Plan Plus. Both plans are administered by Centivo, but their copays, deductible requirements, network rules, and referral requirements differ.

Verify your exact virtual-care benefits and VirtualCare2go’s network participation before scheduling an appointment.

What Kohl’s Medical Plans Are Available?

Kohl’s employees may be enrolled in one of two medical plans:

• High Performance Plan Basic

• High Performance Plan Plus

The available plan information lists the following member costs.

High Performance Plan Basic

• $0 copay for visits to a Kohl’s Wellness Center

• $0 copay for Centivo virtual primary care

• $25 copay plus the applicable deductible for primary care

• $90 copay plus the applicable deductible for specialist care

• $25 copay plus the applicable deductible for OB/GYN care

High Performance Plan Plus

• $0 copay for visits to a Kohl’s Wellness Center

• $0 copay for Centivo virtual primary care

• $20 copay for primary care

• $50 copay for specialist care

• $20 copay for OB/GYN care

The $0 virtual primary care benefit specifically applies to Centivo’s designated virtual primary care service. It does not automatically apply to an appointment with VirtualCare2go.

Members should ask Centivo what copay, deductible, or coinsurance applies to VirtualCare2go before scheduling.

Laboratory testing, imaging, medications, procedures, and services ordered after a virtual appointment may be processed separately. Members enrolled in the Basic Plan may also need to satisfy the applicable deductible.

An insurance card does not guarantee coverage or payment. Current eligibility, medical necessity, provider-network participation, service location, referral requirements, and the care provided may affect your final responsibility.

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

Can Kohl’s Employees Use VirtualCare2go?

Eligible Kohl’s employees and their covered family members may be able to use VirtualCare2go for many non-emergency concerns that can be safely evaluated through a video appointment.

The virtual medical team can evaluate concerns such as:

• Cold and flu symptoms

• Cough, congestion, or sore throat

• Fever and body aches

• Allergies and sinus symptoms

• Headaches and migraines

• Nausea, vomiting, or diarrhea

• Urinary symptoms

• Minor infections

• Mild rashes and skin concerns

• Medication questions

• Certain primary care concerns

• Appropriate follow-up visits

• Guidance about whether in-person care is needed

Some symptoms cannot be safely diagnosed or treated through a virtual appointment. The medical professional may recommend laboratory testing, imaging, an in-person examination, mobile medical care, or a higher level of care.

Coverage depends on the member’s plan, current eligibility, medical needs, provider-network participation, physical location during the appointment, and the services provided.

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

Who Administers the Kohl’s Health Plans?

Centivo is the third-party administrator for the Kohl’s High Performance Plan Basic and High Performance Plan Plus.

Centivo can assist members and providers with:

• Eligibility verification

• Medical benefit questions

• Virtual-care coverage

• Deductible and copay information

• Specialist-referral requirements

• Prior-authorization requirements

• Claim-status questions

• Provider-network participation

For benefit, authorization, or claim assistance:

• Call Centivo Customer Service at (855) 785-9389

• Visit the Kohl’s Centivo Member Website

• Providers may use the Centivo Provider Portal

Have the member identification number from your insurance card and your High Performance Plan name available when requesting assistance.

How Do I Verify My Virtual-Care Benefits?

Before scheduling an appointment, contact Centivo at (855) 785-9389 and ask:

• Does VirtualCare2go participate with my specific Kohl’s plan?

• Is an appointment through VirtualCare2go covered?

• Does the $0 Centivo virtual primary care benefit apply to VirtualCare2go?

• What copay, deductible, or coinsurance applies?

• Does the Basic Plan deductible apply?

• Are there telehealth or service-location restrictions?

• Are laboratory tests, medications, or follow-up services billed separately?

• Is a referral or prior authorization required?

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

• Will follow-up care require an in-person appointment?

Write down the representative’s name, the date of the call, and the reference number provided.

VirtualCare2go can collect your insurance information before the appointment, but Centivo provides the official explanation of plan benefits. Final coverage is determined when Centivo processes the claim.

Is Prior Authorization Required?

Prior authorization depends on the medical service being requested.

Members and providers should contact Centivo at (855) 785-9389 before receiving a service that may require approval. Providers can also review authorization requirements through the Centivo Provider Portal.

A virtual medical professional may recommend testing, imaging, medication, or follow-up treatment that requires separate authorization.

Prior authorization does not guarantee claim payment. Current eligibility, medical necessity, provider-network participation, referral requirements, plan exclusions, and other conditions may affect how the claim is processed.

What Network Does the Plan Use?

Kohl’s High Performance plans use a Centivo-managed provider network that includes participating Baylor Scott & White Quality Alliance providers.

Not every healthcare provider participates with every Centivo plan. Members should confirm that VirtualCare2go and the treating medical professional participate with their specific Kohl’s plan before receiving care.

To locate or verify a participating provider:

• Visit the Kohl’s Centivo Provider Locator

• Call Centivo Provider Locator assistance at (855) 221-2421

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

Provide the employer name, exact plan name, member identification number, requested service, and your physical location during the virtual appointment when confirming participation.

Are Specialist Referrals Required?

The Kohl’s High Performance plans require a provider referral before beginning new specialty care.

Referral exceptions include:

• OB/GYN care

• Mental health care

• Chiropractic care

• Laboratory testing

• X-rays

• Occupational therapy

• Physical therapy

• Speech therapy

A referral exception does not necessarily mean the service is covered without prior authorization or member cost-sharing.

Without a required referral, the member may be responsible for the full cost of specialty care. Contact Centivo before scheduling with a specialist to confirm the referral, authorization, and network requirements for your plan.

Providers can submit referrals through the Centivo Provider Portal.

How Should I Prepare for My Virtual Appointment?

Before your appointment, prepare:

• Your Kohl’s insurance card

• A photo identification card

• The name of your High Performance plan

• A reliable internet connection

• A smartphone, tablet, or computer with a working camera and microphone

• A quiet, private, and well-lit space

• A current medication list

• Known medication or food allergies

• Relevant medical records

• Recent laboratory or imaging results

• Any referral or authorization documents

• A description of your symptoms

• The date your symptoms began

• Your preferred pharmacy information

• Your benefit-verification reference number

If available, keep recent temperature, blood pressure, blood sugar, heart rate, or oxygen readings nearby. Only provide measurements taken safely with equipment you already know how to use.

The patient must be physically present in an eligible service area at the time of the appointment. Confirm location requirements when scheduling.

Claims Information for Providers

Kohl’s claims are administered through Centivo.

Electronic claims: Payor ID 45564

Mailed claims:

Centivo
P.O. Box 211681
Eagan, MN 55121

Providers should verify the member’s current eligibility, exact plan name, virtual-care benefits, deductible status, referral requirements, prior-authorization requirements, and current claim-submission instructions before sending a claim.

Compassionate Medical Care from Wherever You Are

VirtualCare2go helps make non-emergency medical care easier to access when traveling to a clinic is inconvenient or uncomfortable. During the appointment, the medical professional will listen to your concerns, evaluate what can be safely assessed virtually, and explain whether virtual treatment or in-person care is the appropriate next step.

When you are ready, Book a Virtual Appointment or call (817) 508-8169. Please have your Kohl’s insurance card available so your eligibility, benefits, referral requirements, and network participation can be reviewed before the appointment.