They are a group of Specialists, sub-specialists and health service facilities with a contract with your Health Plan to provide services under your PMG. As long as you visit your PMG Preferred Network, you will not have to wait for a Referral or pay Copayments.
The information below tells about some physicians and providers, without limiting to these specializations that may belong to the Primary Medical Group of your choice:
- Specialists and sub-specialists (including but not limited to Cardiologists, Orthopedists, Rheumatologists, Endocrinologists, Urologists, Gastroenterologists, Oncologists, Physiatrists).
- Ancillary Service providers: physical therapists, nutritionists, speech pathologists, among others.
- Clinical laboratories.
- Specialized diagnostic tests.
- Imaging centers.
- Cardiovascular surgery and catheterism centers.
- Urgency rooms.
- Emergency rooms.
Another benefit you have under the GHP is that you will no longer need the countersignature of your PCP on Prescriptions ordered by any other physician that is not your PCP, as long as the physician ordering the Prescription is part of the Preferred Network of your PMG.
For laboratory and X-rays services you will need an order from the prescribing physician, but not the Authorization of your PCP, as long as you receive the services at a laboratory or X-rays facility that belongs to the Preferred Provider Network of your PMG.
The preferred networks will guarantee Access, quality and availability of the health services to be rendered to beneficiaries.
To learn more about the Preferred Providers Network, see the Enrollee Handbook.