Edge Systems Employee Urgent Care at Home

EHN Plan Care With UrgentCare2go™ Across Texas

When you or a family member suddenly feels sick, leaving home and sitting in a waiting room may be the last thing you want to do. UrgentCare2go™ provides convenient mobile medical care in eligible Texas service areas, allowing patients to receive professional care at home, at work, or another approved location.

Edge Systems, LLC employees enrolled in the company’s medical plan may have access to participating providers through the EHN Preferred Network. Coverage, eligibility, and member costs should always be verified before receiving care.

What Does the Edge Systems Plan Include?

The available Edge Systems plan information lists:

• A $20 copay for primary-care visits

• A $40 copay for specialist visits

These amounts are helpful when preparing for care, but they do not guarantee how a particular visit or service will be processed. Your responsibility may depend on eligibility, network participation, medical necessity, prior-authorization rules, and the services provided.

Review the Edge Systems insurance information before scheduling. You may also call UrgentCare2go at (817) 508-8169 if you need help understanding the next step.

Can Edge Systems Employees Use UrgentCare2go?

Eligible Edge Systems employees and covered family members may be able to receive mobile urgent or primary care through UrgentCare2go.

The medical team can evaluate many everyday concerns, including:

• Cold and flu symptoms

• Cough, congestion, or sore throat

• Fever and body aches

• Ear pain or possible ear infections

• Headaches and migraines

• Nausea, vomiting, or diarrhea

• Urinary symptoms

• Minor infections

• Mild allergic reactions

• Rashes and skin concerns

• Minor injuries

• Routine primary-care concerns

• Chronic-condition follow-ups

Coverage depends on the member’s eligibility, benefits, network requirements, and the services provided. An insurance card does not guarantee coverage or payment.

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

Who Administers the Edge Systems Plan?

Cornerstone Preferred Resources, also known as CPR, is listed as the third-party administrator for the Edge Systems plan.

Cornerstone and the associated plan resources can assist with:

• Eligibility and benefit verification

• Prior-authorization requirements

• Claim-status questions

• Copays and other member costs

• Provider-network participation

• General plan questions

Because benefit information can change, use the telephone numbers and instructions printed on your current insurance card whenever they differ from information available online.

How Do I Verify Benefits or Claims?

For benefit questions, claim-status assistance, or other plan information, contact EHN at (800) 278-0703 or use the CPR Provider Portal.

Before scheduling care, consider asking:

• Does UrgentCare2go participate with my specific Edge Systems plan?

• Is the requested service covered?

• Will the $20 primary-care copay apply?

• Does the visit require prior authorization?

• Are laboratory tests or medications billed separately?

• Are there service-area or network restrictions?

• Will I have an additional time-of-service responsibility?

Write down the representative’s name, the date of the call, and the reference number. Final coverage and financial responsibility are determined when the plan processes the claim.

Is Prior Authorization Required?

Prior-authorization requirements depend on the medical service being requested.

For prior-authorization assistance, call (888) 508-7615 or visit the MedWatch Portal. Members should confirm authorization requirements before receiving services that may need advance approval.

Receiving prior authorization does not guarantee claim payment. Eligibility, medical necessity, network participation, and other plan provisions may still apply.

How Can I Find an In-Network Provider?

The Edge Systems plan uses the EHN Preferred Network. This network includes Baylor Scott & White Quality Alliance providers who have elected to participate.

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

To locate or confirm an in-network provider:

• Visit the EHN Member Portal

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

• Call the telephone number printed on your insurance card

Provide the Edge Systems employer name, your member identification number, the provider’s name, and the requested service when confirming network participation.

Are Specialist Referrals Required?

The available Edge Systems plan information does not identify a standard specialist-referral requirement.

However, referrals and prior authorizations are not the same. Even when a referral is not required, certain specialist services, procedures, imaging, or treatments may need advance approval. Contact Cornerstone or the plan before beginning specialist care to confirm the current requirements.

What Should I Prepare Before My Visit?

Please have the following available:

• Your Edge Systems insurance card

• A photo identification card

• A current medication list

• Known medication or food allergies

• Relevant medical records

• Recent laboratory or imaging results

• Any referral or authorization documents

• A brief description of your symptoms

• The date your symptoms began

• Your preferred pharmacy information

Providing accurate insurance and medical information helps the team prepare for your visit and may prevent delays during benefit verification.

Claims Information for Providers

Edge Systems claims use the following submission information:

Electronic claims: Payor ID IHS07

Mailed claims:

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

Providers should verify the member’s current eligibility, claim-submission instructions, and insurance-card information before submitting a claim.

Compassionate Mobile Care That Comes to You

UrgentCare2go helps make medical care easier to access when traveling to a clinic feels difficult or inconvenient. Our team will listen to your concerns, evaluate your symptoms, and help you understand the appropriate next step.

You can Book an Appointment to check service availability in your area. When you are ready, Book Today or call (817) 508-8169.

Please have your Edge Systems insurance card available so eligibility, benefits, and network participation can be reviewed before your visit.