KPA Virtual Urgent Care

High Plains Health Plan Care with VirtualCare2go™

When an illness or health concern makes leaving home difficult, receiving medical attention through a secure virtual appointment may offer 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.

Kasberg, Patrick & Associates, LP employees may be enrolled in the High Plains Health Plan Option 4. The plan uses the EHN Preferred Network. Members should verify their benefits, virtual-care coverage, and provider-network participation before scheduling an appointment.

What Does the High Plains Health Plan Option 4 Include?

The available plan information lists the following costs:

• Primary care visit: $0 copay

• Specialist visit: $0 copay

• Third-party administrator: Health Plans, Inc.

• Provider network: EHN Preferred Network

A $0 copay does not mean every medical service is provided at no cost. Laboratory testing, imaging, medications, procedures, medical supplies, and services ordered after a virtual appointment may be processed separately.

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

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

Can KPA Employees Use VirtualCare2go?

Eligible KPA employees and their covered family members may be able to use VirtualCare2go for many non-emergency health 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

• Follow-up care for appropriate conditions

• Guidance about whether in-person care is needed

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

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 KPA Health Plan?

Health Plans, Inc., also known as HPI, is the third-party administrator listed for the KPA High Plains Health Plan Option 4.

HPI can assist members and providers with:

• Eligibility verification

• Medical benefit questions

• Virtual-care coverage

• Prior-authorization requirements

• Claim-status questions

• Copays, deductibles, and coinsurance

• Provider-network participation

Call HPI at (877) 734-6692 or visit the Health Plans, Inc. website.

Have the member identification number from your insurance card and the High Plains Health Plan Option 4 plan name available when requesting assistance.

How Do I Verify My Virtual-Care Benefits?

Before scheduling an appointment, contact HPI at (877) 734-6692 and ask:

• Does VirtualCare2go participate with the High Plains Health Plan Option 4?

• Is a virtual medical appointment covered?

• Does the $0 primary care copay apply to this appointment?

• Are there telehealth or service-location restrictions?

• Are laboratory tests, medications, or additional services billed separately?

• Is prior authorization required?

• Will I have a deductible, coinsurance, or 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 HPI provides the official explanation of plan benefits. Final coverage is determined when the administrator processes the claim.

Is Prior Authorization Required?

Prior authorization depends on the medical service being requested.

Members and providers should contact HPI at (877) 734-6692 before receiving a service that may require approval. This may include certain medications, imaging studies, procedures, specialist services, or follow-up treatments ordered during or after a virtual appointment.

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

What Network Does the Plan Use?

The High Plains Health Plan Option 4 uses the EHN Preferred Network. This network includes Baylor Scott & White Quality Alliance providers who have chosen to participate.

Not every Baylor Scott & White Quality Alliance provider participates in the EHN Preferred Network. Members should confirm that VirtualCare2go and the treating medical professional participate with the KPA plan before receiving care.

To locate or verify an in-network provider:

• Use the EHN Provider Search

• Call HPI at (877) 734-6692

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

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

Are Specialist Referrals Required?

The available KPA plan information does not list a general specialist-referral requirement.

Certain specialist visits, tests, procedures, or treatments may still require prior authorization. Contact HPI before beginning specialist care to confirm the current referral and authorization requirements for your plan.

How Should I Prepare for My Virtual Appointment?

Before your appointment, prepare:

• Your KPA insurance card

• A photo identification card

• 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. Please confirm location requirements when scheduling.

Claims Information for Providers

KPA claims are submitted through the Employers Health Network.

Electronic claims: Payor ID IHS07

Mailed claims:

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

Providers should verify the member’s eligibility, plan name, virtual-care benefits, 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 KPA insurance card available so your eligibility, benefits, and network participation can be reviewed before the appointment.