Devon Health Services Patient FAQs

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Is Devon Health Services an insurance company?
Devon Health Services is not an insurance company. We are a Preferred Provider Organization (PPO). We supply the provider network to insurance companies, administrators, employers, labor unions, and other self-insured employers. Our members get direct access to a large network of physicians, specialists, hospitals and ancillary providers without a referral from a primary care physician.

What is a Preferred Provider Organization (PPO)?
A Preferred Provider Organization (PPO) is a network of healthcare providers, including doctors, hospitals and ancillary providers, who have contracted to accept discounted fees. Members of PPO programs typically may see any provider, although they receive a higher level of benefits when using PPO network providers.

Who provides my health benefits coverage?
Your benefits administrator and/or insurance company provides your health benefits coverage. Coverage could include medical, dental, vision, prescription drug, life and disability. The extent of your health benefits coverage depends on the specifics of the plan in which you are enrolled. The name and logo of your benefits administrator and/or insurance company appear on your medical card.

Is my doctor or healthcare provider in the Devon Health Services Network?
To determine the participation of specific providers, search the Devon Health PPO Provider Finder located on this Web site or call one of our Customer Service Representatives at 800.431.CARE (2273).

How can I get my doctor or healthcare provider in the Devon Health Services Network?
You can submit a nomination for your provider or contact our Customer Service Department at 800.431.CARE (2273). Be sure to provide your healthcare provider's name, location, and specialty. This information will assist our Network Development Department in contacting the healthcare provider and actively recruiting them into the network; however, it is the healthcare provider who ultimately decides whether or not to join.

How can I obtain a Directory of Participating Providers?
Directories are obtained through your benefits administrator or insurance company. You can also print a small customized directory from the Provider Finder.

What happens if I use a provider that is not "in network?"
You may receive a lower level of coverage depending on your health benefit provisions. Please review your benefit plan or contact your benefits administrator and/or insurance company.

Do I need a referral?
While most benefit plans that use the Devon Health Services Network do not require a referral, some plans require pre-certification for certain types of medical care. For specific questions about pre-certification, contact your health benefit administrator.

What is my co-pay?
Co-payments are the amount of money a healthcare provider can charge at the time medical services are provided. Your insurance provider and plan type determine member co-pay amounts. Co-payment amounts should be printed on your medical card. If a co-payment amount is not printed on your card, contact your benefit plan administrator for the actual amount.

Please note: You may be responsible for additional charges over and above co-payment amounts depending upon your benefit plan design. Please contact your benefits administrator and/or insurance company for additional information.

What is my benefit structure?
Benefit structure will vary depending upon the benefit administrator, insurance company and plan type. Review your benefits package or contact your plan administrator for all benefit and eligibility questions.

Are all medical services represented by the Devon Health Services Network covered by my health benefits coverage?
No. Some health benefit plans do not cover all the medical services represented by our network. A few services like Behavioral Health, Vision, and Dental may not be covered by your health benefit plan. Contact your benefit plan administrator for specific questions about covered medical services.