Page 23 - EPO_Member_Kit

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Continuity Of Care
Continuity of care means that you can continue seeing your current health care provider for
medical care if you are in an active, covered treatment plan that, if interrupted, could seriously
affect your health. For example, if you are in active cancer treatment with a specialist and they
leave our network you may be able to still see that specialist. Or if you are a new enrollee and your
provider is not affiliated with us, you may be able to stay with that doctor. Continuity of care is
available to both new and current Alliance enrollees.
The Procedure For The Continuity of Care Coverage is as Follows:
Begin by contacting Client Services. A Client Services Specialist will obtain the following
information from you and forward it to a our team of medical professionals:
• Your name, address and telephone number
• Your Alliance ID number
• The date your coverage became active
• The name, address and telephone number of the
doctor who is currently treating you
A nurse will contact you (or your designee) and the
health care provider to discuss the diagnosis, history
and current treatment plan, and will also discuss the
change with the doctor with which you are currently
receiving medical care.
A nurse will review the information and coordinate your
on-going care with your doctor.
We will transfer you to an affiliated provider when
possible, without disturbing the care being provided
through your current treatment plan.