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Evolutions Healthcare Systems, Inc.
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Terms and Conditions of Use
Disclaimer-- Evolutions Healthcare Systems has provided links to various Internet sites maintained by unrelated third parties. Neither EHS nor their affiliated network of websites operate or control any information, products, or services on these third-party sites. The materials on this site and the third-party sites are provided "as is" and without warranties of any kind, either expressed or implied.
Content found on EHSPPO.com comes from sources believed to be accurate, but may contain inaccuracies or typographical errors. EHS does not warrant that the content functions contained in the materials will be accurate. The use of the EHS website and the features thereof is at your own risk. EHS assumes no liability for or relating to errors, delay, failure, interruption, or corruption of any data or other information transmitted in connection with use of the EHS website.
Revisions-- EHS may revise and update these Terms and Conditions of Use at any time. Please periodically review the terms, conditions, and privacy statements posted on the EHS website. Continued usage of the EHS website will be considered acceptance of any changes.
Evolutions Healthcare Systems has established policies and procedures for the timely implementation and compliance with Federally mandated HIPAA Regulations. As part of this process, Evolutions has updated and or created new provider and client contracts to ensure partner compliance with HIPAA regulations; and enhanced systems and procedures to meet the prescribed standards for the privacy of individual healthcare information, and for secure electronic data interchange (EDI).
Provider Information and Directories
The Provider Search and Create a Directory features are provided for the use of clients and members to determine which health care providers participate in the Evolutions Healthcare Systems Preferred Provider (PPO) Network. However, the provider you select may not be available to all Evolutions clients due to plan design, product selection, or network restrictions.
Evolutions Healthcare, Inc. makes every effort to ensure the accuracy and timely update of our participating provider data, however as changes occur daily the latest provider information may not yet be included in the directory. Please verify your benefits by calling your Health Plan Benefit Administrator or Insurance Company. In addition, you should always confirm with the provider’s office that they are still participating in the network.
Additionally, we would like to take a moment to apprise our members and clients of the following situations that have caused confusion regarding participating providers in the past. Hospitals, clinics, and other facilities listed in the directory do not ensure that all physicians affiliated with the particular facility are participating providers with Evolutions Healthcare. To ensure in-network status, you must verify both the facility and the physician from whom you are receiving treatment.
Not all Physicians in the same practice are participating providers. If for any reason your physician whom you have verified as being in-network cannot treat you, but refers you to an associate due to an emergency, vacation, etc., you must verify the treating physician is also in-network.
Evolutions Healthcare is a managed care company. We are not a health plan or an insurance company. Evolutions Healthcare does not pay health claims. As such, Evolutions Healthcare makes no determination regarding eligibility, benefits, or covered services.
If you have questions regarding these items, please call your insurance company or your plan administrator prior to receiving services.
Please Note Carefully: Evolutions Healthcare, Inc. does not and will not become involved in any matter concerning the private and sensitive nature of the patient-provider relationship. This includes, but is not limited to, all matters concerning medical decisions, treatments, and the selection of a health care provider.
Therefore, the final decision as to which health care provider to use and which procedures/treatments are performed lies with, and is the responsibility of, the insured/patient. In making this decision the insured/patient must understand that: (1) selection of an out-of-network provider could waive entitlement to benefits listed in your health plan; while (2) selection of an in-network provider does not guarantee that all services recommended or provided by an in-network provider will be covered under your health plan.
Again, every effort has been made to ensure the accuracy of this directory. However, because network providers occasionally change, we strongly recommend that you confirm whether a hospital or physician is currently participating with the PPO program prior to receiving services. Please call Evolutions Healthcare Systems at 1-800-308-2749.