PPO & Pre-Certification for GMI

GLOBAL MEDICAL INSURANCEsm
PPO and Pre-Certification

ACCESSING THE PPO

IMGsm network providers are available throughout the U.S. When you receive treatment for eligible medical expenses from a network provider, your deductible will be reduced by 50% and any coinsurance applicable to that charge will be waived. If a U.S. hospital outside the provider network is used, a co-payment of US$250 is required in addition to the regular deductible and coinsurance. This co-payment is waived if there is not a provider within 50 miles of the location of treatment.

You may access the PPO in two ways:

1. When requested, we will either forward a copy of the facilities available in the area you are seeking treatment or refer a provider to you.

2. The PPO directory may also be accessed on the IMGLOBALsm Web site, www.imglobal.com Providers are listed by location and specialty.

PRE-CERTIFICATION

Pre-certification (notification of illness or accident) simply means calling the company prior to treatment. The following treatments must be pre-certified:
Any surgery or treatment requiring hospitalization
Outpatient surgery
CAT scans, MRI's
Notification within the first 90 days of pregnancy
Within 48 hours after an emergency admission to the hospital
Care in an extended care facility
Home nursing care
Durable medical equipment including artificial limbs
Transplants

By notifying IMG we will be able to verify benefits, review length of stay and coordinate payment with the hospital or outpatient facility. Pre-certification may be done by you, the doctor, a hospital administrator or relative.

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