"I have confidence in the size of the TTC network and the availability of top-quality providers."

Ilona, Member in
Dallas, TX

members - frequently asked questions  
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Q:
How do I select a TTC physician?
A:
To select a physician in the TTC network, call one of the physician offices listed in the on-line or printed directory, identify yourself as a TTC member, and schedule an appointment. Please remember that in the event you are directed by a participating TTC physician to visit another physician, you will want to verify that they also participate with TTC.
  
Q:
How often can I visit my TTC physician or participating provider?
A:
You may see your TTC provider as often as you feel is necessary.
  
Q:
What should I do in the event of an emergency?
A:
In an emergency, it is important to obtain medical care as soon as possible. If you have questions or concerns about your emergency care benefits, please contact your employer's Human Resources Department or refer to your Summary of Benefits/Plan Document for more details.
  
Q:
My provider is not listed in the TTC provider directory. What should I do?
A:
If your physician is not currently participating with TTC, you may nominate your physician by completing the "Provider Nomination Form" and submitting it to TTC. We will contact your provider to furnish information about becoming a participating TTC provider.
  
Q:
Will a physician who is "on-call" but not a participating TTC provider be paid under my in-network PPO benefits?
A:
Generally not. Please contact your employer's Human Resources Department or refer to your Summary of Benefits/Plan Document for your specific plan provisions.
  
Q:
Who do I call regarding benefit questions?
A:
TTC does not maintain any health plan benefit information. To verify benefit information, call the telephone number listed for your health plan, typically shown on the back of your ID card, or contact your employer's Human Resources Department.
  
Q:
Who do I call to get a new, or replacement ID card?
A:
You will want to contact your employer's Human Resources Department, or your plan administrator identified on the back of your ID card, if you are in need of a new or replacement ID card. TTC does not generate ID cards.
  
Q:
How is eligibility verified?
A:
Eligibility information is not maintained by Texas True Choice. To verify eligibility information, you will want to contact your plan administrator, identified on the back of your ID card, or your employer's Human Resources Department.
  
Q:
How are claims handled?
A:
If you visit a participating TTC provider, and present your medical plan ID card which displays the TTC logo, all claims should be filed for you by the TTC provider. In the event you need to file a claim form for reimbursement, you will want to secure the appropriate form(s) and claim submission address from your plan administrator or employer's Human Resources Department.
  
Q:
What are the requirements for pre-certifying medical services?
A:
Each employee benefit plan can have different provisions. Become familiar with the pre-certification and utilization review requirements of your employer's benefit plan. Most plans require pre-certification for hospital admissions, hospital outpatient procedures or higher cost diagnostic procedures. Failure to pre-certify a hospital stay or outpatient procedure may result in a reduction of your benefits. Please refer to your ID card or Summary of Benefits/Plan Document for specific information relating to your employer's pre-certification and utilization review requirements.
  
Q:
As a TTC member, am I automatically entitled to the discounts associated with the VSP WellVisionŽ Access Plan?
A:
Yes, the VSP WellVisionŽ Access Plan discounts are available to all TTC members at no additional premium charge. You may view the discount information by going to the "products/services : vision (VSP)" page of the TTC web-site. You may view the participating vision doctors by going to the "provider search" page of the TTC web-site.
  
Q:
How does my VSP vision doctor know that I am a TTC member?
A:
When you call to make an appointment to receive your VSP plan discounts, you should identify yourself as a TTC member. The VSP doctor will then contact TTC to verify that you are indeed an eligible, current member of TTC. You may be asked to show your TTC I.D. card at the time of your appointment.
  



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