VNS Health EasyCare: Outpatient Hospital Services
Many services and procedures today are provided as outpatient in ambulatory service areas of the hospital or at freestanding health services centers.
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How To Receive
Details on how to apply
Obtain a network provider order for outpatient services (unless visiting the emergency department).
Contact the VNS Health EasyCare Team at (866) 783-1444 (TTY 711) for prior authorization.
The ordering provider may help with authorization.
Schedule the services at a network facility selected by the network provider.
It is likely that the scheduling department of that facility will reach out to schedule the services.
The scheduling facility may also help with authorization.
Here is a searchable list of network services: Click on the Hospitals tab or the Ancillary Services tab on the page and select the appropriate service.
Attend the appointment and complete the services.
Engage in recommended follow-up treatment and/or referrals.
If transportation is needed to and from the appointment:
Call (877) 718-4219 (TTY: 711), M-F 8am-8pm, at least 48 hours in advance of the needed transportation.
Have the date, time, location, and reason for transportation ready when calling.
Receive authorization and guidance on scheduling the transportation service.
Get confirmation of scheduled transportation.
Use the transportation service to and from the appointment.
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Medically necessary services in the outpatient department of a hospital for diagnosis or treatment of an illness or injury are covered.
Covered services include, but are not limited to
Services in an emergency department or outpatient clinic, such as observation services or ambulatory/outpatient surgery center
Laboratory and diagnostic tests billed by the hospital
Mental health care, including care in a partial-hospitalization program (PHP), if a provider certifies that inpatient treatment would be required without it
X-rays and other radiology services billed by the hospital
Medical supplies such as splints and casts
Certain drugs and biologicals that cannot be self-administered
Unless the provider has written an order for inpatient admission to the hospital, the episode is considered outpatient and cost-sharing amounts for outpatient hospital services apply. Even if there is an overnight hospital stay (rare), it may still be considered outpatient. If outpatient versus inpatient status isn’t clear, ask the hospital staff.
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