Hospital Based Physicians
Hospital Based Physicians
Although health care services may be provided by a SWHP participating facility (such as a hospital), professional services provided by physicians at that facility may be considered out of network (OON). The member may be responsible for payment of all or part of the fees for those professional services that are not paid or covered by the member's health benefit plan. SWHP has established an out of network (OON) fee schedule for hospital based providers. Please be aware that SWHP will reimburse the out of network provider up to the amount on the fee schedule, minus any applicable copayments, coinsurance and/or deductibles.
To confirm whether or not your hospital utilizes participating physicians such as anesthesiologists or radiologists, please contact SWHP customer service at 1-800-321-7947.
See a list of in-network and out-of-network hospital based providers for select commercial plans.