Answers to frequently asked questions

As a new member what are the first things I need to do?

• Schedule to attend an orientation meeting and ask questions.
• If you have an existing Primary Care Physician or other regular physicians, call 866-549-4199 to provide us with their information so we can add them to the network.
• If you do not have a Primary Care Physician, call 866-549-4199 so we can assist you in choosing one from our network.
• Once you have received your ID card, you should verify your information by logging into your member account. Visit www.ovation.health and click on “Member Log-In” which is above the toolbar.
• Go to Teladoc’s website at www.teladoc.com or download the mobile app to register your account. For more information, review the Guide to Telemedicine for Patients. 

What do I do if I need urgent care?

1. Assess the situation to determine how critical the illness or injury is.
2. Your first option should always be to use Teladoc 24/7 to consult with a doctor quickly. The average wait time is less than 10 minutes. Then follow the doctor’s instructions.
3. If your illness or injury is critical, go to an Urgent Care Center or Emergency Room. If you or someone can drive you, this is more cost-effective than calling for an ambulance. The average cost for ambulance services is around $1200.
4. Once at an Urgent Care Center or Emergency Room, please give them your insurance information. However, you do not have to sign anything. The law states that no one under duress can be held accountable for a signed contract. If you are pressured into signing, write “what my plan pays” in the place for your signature. 

How can I find a provider in the network?

• During office hours:
  Call our Care Team at 866-549-4199 and they will assist you in finding a provider and making an appointment. You can reach our team Mon-Fri from 8am-5pm CST or via email at membership@innovationshr.com
• Outside of office hours:
  Please wait until the next business day to call our Care Team. If you cannot wait, you can use Teladoc to consult with a doctor quickly. The average wait time is less than 10 minutes.

When is it important to add a doctor to the network?

We are always interested in adding new Providers to our network, as this gives all our members more provider options. However, more specifically you will want to add your Provider if you visit that provider frequently, such as your Primary Care Provider.

How long does it take to add a doctor to the network?

When adding a Provider, we must verify that their credentials meet our requirements and there are Provider payment negotiations to work through. This process will depend on how quickly the Provider and their office staff respond and provide the proper documentation.

If a doctor is in the network, can I go ahead and make an appointment with them directly?

We recommend that members call our Care Team and allow us to set up initial provider visits. That way, our members have a positive experience visiting the Provider’s office for the first time.

After the first visit, you can contact the Provider directly. However, the Provider should still call us to verify benefits if they have any questions about coverage.

How long does it take to get a reimbursement?

Within 30 days, from the date that all documentation is provided.

How long does it take to get a claim processed?

We are proud to say that 90% are processed within 14 days of receipt of a clean claim, and the rest within 30 days.

How long does it take to get a pre-authorization?

Most are processed within 48-72 hours; however, we can expedite in 24 hours if needed, and the Provider/Facility is responsive.

What do I do if I get a surprise bill?

Send the bill and any related information to patientadvocate@innovationshr.com. 

What happens if my claim is denied?

Reach out to our claims department at 866-549-4199 or claims@innovationshr.com. They will review the claim and assist you.

How do I check the status of a claim being processed?

Reach out to our claims department at 866-549-4199 or claims@innovationshr.com. They will be more than happy to give you a status update.

Why is my copay/coinsurance/deductible amount different than what my provider told me?

You can call us at 866-549-4199 to discuss this or email claims@innovationshr.com. Someone from our Care Team will be more than happy to review the situation and help resolve any discrepancies.

What are my current “YTD” totals for my out-of-pocket/deductible? (If applicable)

You can find this information by logging into the Member Portal by going to our website at www.ovation.health and clicking on “Member Login” at the top. If you need further assistance, call 866-549-4199.