PPO and Pre-Certification

ACCESSING THE PPO

IMG’s PPO network is organized and administered by The First Health Network. To search for a medical care provider within the independent Preferred Provider Organization network. The PPO directory is updated on a routine basis, however changes may be made between updates. To ensure that the physician you have selected is in the network, please contact the physician’s office to confirm his/her participation.

The IMG 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 IMGLOBAL Web site, www.imglobal.com Providers are listed by location and specialty. You can find full plan information there.

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.

See Client Contact Page for IMG at: https://www.imglobal.com/clients/index.cfm

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