VNS Health EasyCare Plus: 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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Cost
0% - 20% coinsurance
Prior Authorization Required
Yes, except in an emergency
Provider Referral or Order Required
Yes

How To Receive

Details on how to apply

  1. Obtain a network provider order for outpatient services (unless visiting the emergency department).

  2. Contact the VNS Health EasyCare Plus Team at (866) 783-1444 (TTY 711) for prior authorization.

    • The ordering provider may help with authorization.

  3. 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.

  4. Attend the appointment and complete the services.

  5. Engage in recommended follow-up treatment and/or referrals.

  6. 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.

Availability
Ongoing, as ordered and authorized

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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

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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