Lakeland Volunteers Virtual Urgent Care

Two EHN 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.

Lakeland Volunteers in Medicine employees may be enrolled in the Rx 15-25 Plan or HSA Rx 15-25 Plan. Both plans use the EHN Preferred Network, but their copays, deductible requirements, and other member costs differ.

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

What Lakeland Volunteers Medical Plans Are Available?

Lakeland Volunteers in Medicine employees may be enrolled in one of two medical plans:

• Rx 15-25 Plan

• HSA Rx 15-25 Plan

The available plan information lists the following costs.

Rx 15-25 Plan

• $30 copay for a primary care visit

• $75 copay for a specialist visit

HSA Rx 15-25 Plan

• The applicable deductible must be met first

• Copays or coinsurance may vary after the deductible

• Medical cost-sharing information is available on the member’s insurance card

These amounts do not automatically apply to a virtual appointment. Members should ask Coastal Administrative Services what copay, deductible, or coinsurance applies to VirtualCare2go.

Laboratory testing, imaging, medications, procedures, and services ordered after a virtual appointment may be processed separately.

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

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

Can Lakeland Volunteers Employees Use VirtualCare2go?

Eligible Lakeland Volunteers in Medicine 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 Lakeland Volunteers Plans?

Coastal Administrative Services, also known as CAS, is the third-party administrator listed for the Lakeland Volunteers in Medicine plans.

CAS can assist members and providers with:

• Eligibility verification

• Medical benefit questions

• Virtual-care coverage

• Prior-authorization requirements

• Copays, deductibles, and coinsurance

• Claim-status questions

• Provider-network participation

For assistance:

• Call CAS at (800) 870-1831

• Visit the CAS Website

• Have the member identification number from your insurance card available

Elan Member Services is also listed as a resource for benefit and claim-status assistance:

• Call Elan Member Services at (833) 845-8854

How Do I Verify My Virtual-Care Benefits?

Before scheduling an appointment, contact CAS at (800) 870-1831 and ask:

• Does VirtualCare2go participate with my Lakeland Volunteers plan?

• Is a virtual medical appointment covered?

• What copay, deductible, or coinsurance applies?

• Has my HSA Plan deductible been met?

• Are there telehealth or service-location restrictions?

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

• Is 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 CAS 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 CAS at (800) 870-1831 before receiving a service that may require approval.

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, deductible requirements, plan exclusions, and other conditions may affect how the claim is processed.

What Network Does the Plan Use?

The Lakeland Volunteers medical plans use 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 their exact plan before receiving care.

To locate or verify an in-network provider:

• Use the EHN Provider Search

• Call Elan Member Services at (833) 845-8854

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

• Call CAS at (800) 870-1831

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 available Lakeland Volunteers plan information does not list a general specialist-referral requirement.

Certain specialist visits, diagnostic tests, procedures, or treatments may still require prior authorization. Contact CAS before beginning specialty 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 Lakeland Volunteers insurance card

• A photo identification card

• The name of your medical 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

Lakeland Volunteers in Medicine 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 current eligibility, exact plan name, virtual-care benefits, deductible status, 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 Lakeland Volunteers insurance card available so your eligibility, benefits, deductible status, and network participation can be reviewed before the appointment.