Participation - Facts & Questions

Q: Who can participate in the program?

A: This program is for any plan member (employee, employee's spouse, employee's dependent child, etc.) of an employer's health plan that has contracted with Edison Healthcare. The member must be currently enrolled in the medical plan and meet clinical criteria for the covered services.


Q: What qualifies a member for these services?

 

A: The covered health plan must be primary health care coverage for the member. The participating member must have been seen by their local physician within the last three months, and referred for medical treatment.


Q: How can an employee participate in the program?

A: An employee (or his/her dependent) can participate in the program by calling Edison Healthcare at 1-866-982-7988. The Edison Healthcare Service Team will qualify the participant and verify eligibility. Medical needs may be discussed with our Edison Healthcare Coordinator.


Q: What does a participant need to provide Edison HealthCARE in order to obtain services?

A: The employee/participant will need to complete and return the Edison Healthcare enrollment form and the medical release form.

 

Q: What does a participant need to provide the selected medical center in order to obtain services?

 

The participant will need to sign the medical release form that will give the local physician's office permission to release records to the providing medical center.

 

Q: Why are medical records required?

Medical records are needed by the medical center's surgical team for them to build an individualized treatment plan. Appointments will not be scheduled until the proper medical records have been received by the providing medical center.

 

Q: Is there a Member ID card provided? Who provides the Member ID card?

Yes, Edison Healthcare will provide an ID card to use with this specific program. This card is only valid while receiving care under this program.