1. Is Devon Health an insurance company?
No, Devon Health is not an insurance company; it is the provider network. The
name and logo of the patient’s insurance company or benefit administrator are
printed on the front of the member’s ID card.
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2. Who do I call if I need to check
eligibility or to check whether a service will be covered?
Call the third party administrator or insurance carrier listed on the member’s
insurance ID card.
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3. Who do I call if I need to check the
status of a claim?
The third party administrator or insurance carrier handles insurance claims
(payments, denials, etc.). Their telephone number will be listed on the
member’s ID card. Questions about payment should be directed primarily to the
payer. However, should you encounter any difficulties or require assistance or
intervention from Devon Health, you should contact your Hospital Relations
Representative immediately. If you do not know who your Representative is,
please call 800.431.2273 and ask to speak to a member of the Hospital Relations
Department.
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4. Which services require pre-authorization?
This will vary depending on the client. Generally, surgeries, non-emergency
hospitalizations, and high cost diagnostics usually require pre-certification.
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5. What type of products does Devon Health
offer to its clients?
We offer our clients group health, workers’ compensation and motor vehicle PPO
networks, as well as a host of other cost saving products. Read more about them
on our Products & Services page.
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6. Will the Explanation of Benefits (EOB)
have Devon Health’s name on it?
Along with the payment you should receive an Explanation of Benefit (EOB) that
indicates how the claim was processed and stating that the discount was taken
according to your Devon Health agreement. The Devon Health indicator is
typically in the comments or explanation section. An explanation of how the
claim was processed and any reason for non-payment will appear on the EOB.
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7. Who are Devon Health’s clients?
Our clients include Insurance Companies, Third Party Administrators (TPA),
Self-funded Employers, and Union Trust Funds.
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8. How should a patient be registered?
Patients should be registered according to the hospital’s normal registration
process. The registration should include the patient’s insurance company or
TPA, as well as Devon Health. We are the network and never the payer.
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9. Who handles the Medical Management
programs at Devon Health?
Our clients provide their own Medical Management programs. Programs may be
proprietary to the client or contracted to an outside vendor.
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10. Are providers responsible for making
sure the labs they use and other specialists they may refer the patient to are
participating in the Devon Health network?
No. It is the member’s responsibility to ensure that all physicians and
facilities are participating with Devon Health.
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11. How quickly will claims be paid?
Claims are generally paid within 30-45 days of receipt of a clean claim.
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12. What other hospitals/ancillaries in my
region are participating?
This will vary from region to region, but you may inquire by calling our
Customer Service Department at 800.431.2273, or by visiting our online
Provider Finder to search for other hospitals, physicians, or ancillary
providers in your region.
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13. What do plan designs look like?
Devon Health is only the network of providers and does not design any benefit
plans. Our members’ benefit plan designs may differ from client to client. For
detailed information on members’ benefits, contact the client directly by
calling the phone number on the member’s ID card.
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14. How do we identify a Devon Health
patient?
Devon Health patients are easily identified with an ID card that should be
presented by the patient at the time of admission. The Devon Health logo will
usually appear on the front of the member’s ID card.
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