SMARTCARE Mobile Medical Care

Children’s Medical Group Urgent Care

SMARTCARE Mobile Medical Care

Feeling sick or dealing with a minor injury can be stressful, especially when leaving home is difficult. UrgentCare2go™ provides convenient mobile medical care in eligible Texas service areas, helping patients receive professional attention at home, work, or another approved location.

Children’s Medical Group employees enrolled in a SMARTCARE medical plan may have access to participating providers through the EHN Preferred Network. Because benefits and medical costs differ between plans, members should verify their coverage before receiving care.

Which SMARTCARE Plans Are Available?

Children’s Medical Group employees may be enrolled in one of these medical plans:

• SMARTCARE 650100 HSA Plan

• SMARTCARE 350811 Plan

The SMARTCARE 650100 HSA Plan requires members to meet their deductible before the plan begins sharing the cost of covered services. Copays and coinsurance may vary, so members should review their insurance card and benefit documents.

The SMARTCARE 350811 Plan includes:

• $40 copay for a primary care visit

• $100 copay for a specialist visit

The available plan information does not list a specific urgent care copay. Contact Elan Member Services or Coastal Administrative Services before your appointment to confirm what you may owe for mobile urgent care.

An insurance card does not guarantee coverage or payment. Eligibility, network participation, medical necessity, deductibles, and the services provided may affect your final responsibility.

Can Children’s Medical Group Employees Use UrgentCare2go?

Eligible employees and covered family members may request a mobile medical visit through UrgentCare2go. A medical professional can evaluate many non-emergency illnesses and minor injuries without requiring the patient to travel to a traditional clinic.

Mobile urgent care may be appropriate for concerns such as:

• Cold and flu symptoms

• Cough, congestion, or sore throat

• Fever and body aches

• Headaches and migraines

• Nausea, vomiting, or diarrhea

• Urinary symptoms

• Minor infections

• Mild allergic reactions

• Minor injuries

• Dehydration concerns

• Other non-life-threatening medical needs

Service availability depends on the patient’s location, symptoms, and clinical needs. Coverage also depends on the member’s specific SMARTCARE benefits.

You can Book a Mobile Visit or call (817) 508-8169 for scheduling assistance.

Call 911 or go to the nearest emergency room for chest pain, severe difficulty breathing, signs of a stroke, confusion, fainting, uncontrolled bleeding, major trauma, or another life-threatening emergency.

Who Administers the Children’s Medical Group Plans?

Coastal Administrative Services, also known as CAS, is the third-party administrator for the Children’s Medical Group SMARTCARE plans.

CAS and Elan Member Services can assist with:

• Member eligibility

• Benefit verification

• Prior authorization requirements

• Claim-status questions

• Copays, deductibles, and coinsurance

• Provider-network participation

Members and providers may:

• Call Elan Member Services at (833) 845-8854

• Call CAS at (800) 870-1831

• Visit the CAS Website

Elan Member Services can also assist with benefit and claim-status questions.

What Provider Network Does the Plan Use?

The Children’s Medical Group SMARTCARE plans use the EHN Preferred Network. This network includes Baylor Scott & White Quality Alliance providers who have chosen to participate.

Not every Baylor Scott & White Quality Alliance provider participates in this particular network. Members should confirm that the provider and requested service participate before receiving care.

To search for an in-network provider:

• Visit the EHN Member Portal

• Call Elan Member Services at (833) 845-8854

• Contact BSWQA Care Navigation at 1-844-279-7589

When calling, provide the member identification number shown on your insurance card and ask whether UrgentCare2go participates with your specific SMARTCARE plan.

How Do I Verify My Benefits?

Before scheduling mobile care, contact Elan Member Services at (833) 845-8854 or CAS at (800) 870-1831.

Consider asking these questions:

• Is UrgentCare2go in-network with my specific SMARTCARE plan?

• Is a mobile medical or physician house-call visit covered?

• What copay, deductible, or coinsurance will apply?

• Is prior authorization required?

• Are laboratory tests billed separately?

• Are medications or medical supplies covered separately?

• Are there any location or service restrictions?

• Does my plan require me to use a particular provider network?

Ask the representative for a reference number and keep it with your records. Benefit information provided by telephone is helpful, but final coverage is determined when the insurance company processes the claim.

For additional help, call UrgentCare2go at (817) 508-8169.

Are Specialist Referrals Required?

The available Children’s Medical Group plan information does not list a specialist-referral requirement.

However, referral and prior authorization rules may vary according to the service requested. Members should contact CAS or Elan Member Services before beginning specialist care to confirm whether additional approval is required.

What Should I Have Ready?

Before scheduling your visit, please have the following information available:

• Your Children’s Medical Group insurance card

• A photo identification card

• A list of current medications

• Known medication or food allergies

• Relevant medical conditions

• A brief description of your symptoms

• The date your symptoms began

• Your preferred pharmacy

• Any referral or authorization documents

• The address where care is requested

Providing accurate information can help the care team prepare for your visit and determine whether mobile care is appropriate.

Claims Information for Providers

Children’s Medical Group SMARTCARE claims are administered through Coastal Administrative Services.

Electronic claims: Payor ID IHS07

Mailed claims:

Employers Health Network
P.O. Box 507
Arnold, MD 21012

Providers should verify current submission instructions and member eligibility before sending a claim.

Convenient Medical Care That Comes to You

UrgentCare2go makes non-emergency medical care easier to access by bringing qualified professionals to eligible patients. Our team listens to your concerns, evaluates your symptoms, and helps you understand the safest next step.

When you need care, Book Today or call (817) 508-8169. Please have your Children’s Medical Group SMARTCARE insurance card available so your benefits can be reviewed before the visit.