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Preferred Provider Network

ONE-NET

The Board of  Trustees has adopted a preferred provider network which they urge you to utilize to minimize costs to you and the plan.

On September 1, 2006, Alliance PPO changed its name to OneNet PPO. The  name may be different, but they're still the same network with growing access to quality health care services, great savings, and outstanding customer service.

Welcome to the One-Net PPO Network! One-Net  PPO, LLC (One-Net) is a network designed to offer you a wide choice of physicians and health care practitioners who provide quality health care at substantial savings. OneNet PPO provides access to 52,600 physicians and health care practitioners and 365 hospitals throughout Maryland, Virginia, Washington, D.C., Pennsylvania, Delaware, North Carolina and West Virginia. Our network provides a wide selection of health care professionals and outstanding savings. The process used to verify the credentials of health care practitioners within the OneNet network has earned Certification by the National Committee for Quality Assurance (NCQA).

 

One-Net provides you with online search capabilities. To locate a participating physician or health care practitioner in your area, please logon to our Web site, www.onenetppo.com, select Participants, Find a Doctor, One-Net PPO, LLC, and click on "Find a Doctor". You can also obtain this information by calling the One-Net Member Services Department at 1-800-342-3289. Member Services Representatives are available to assist you 24 hours a day, seven days a week. The One-Net network is contracted by your plan administrator (insurance company, third party administrator or union fund) to provide health care through the utilization of our network physicians and health care practitioners. There are no claims for you to submit for health care services covered under your health benefit plan. Participating physicians and health care practitioners submit the claim(s) directly to One-Net for re-pricing. Your plan administrator is responsible for payment of claims and determining eligibility and benefits.

QUESTIONS FREQUENTLY ASKED BY PARTICIPANTS

1. What is OneNet PPO?

OneNet PPO is a comprehensive network of physicians, hospitals, and health care practitioners who provide quality health care services. Insurance carriers, third-party administrators and union funds use the OneNet PPO network for their members, to obtain a quality health care network that allows participants the ability to choose their health care practitioners.

2. Does OneNet PPO pay my claims?

No, OneNet PPO is not your Benefits Administrator. Check your health plan identification card (ID) for the name of the insurance carrier, third-party administrator or union fund who is responsible for your claims payment.

3. When is the OneNet Member Services Department available to answer my questions?

The OneNet PPO Member Services Department is available 24 hours a day, seven days per week, and 365 days a year to answer all your network-related questions.

4. Who do I call if I lose my health plan ID card?

You will contact your employer, who will tell you how to get a new health plan ID card.

5. How do I obtain an OneNet PPO Directory?

Click here  to obtain customized Directory of Health Care Professionals,
or call our Member Services Department at 1-800-342-3289 to request a regional customized directory. We also distribute the OneNet PPO Directory of Health Care Professionals to claims administrators. Directories are available in CD ROM format. MAPSI directory can also be requested.

6. How do I submit a request to have a health care practitioner recruited into the OneNet Network?

OneNet PPO welcomes the opportunity to work with participants in identifying physicians and other health care practitioners for inclusion in our network. Please contact your designated benefits administrator to submit this request.

7. What number do I call to start the pre-certification process?

Please refer to the back of your health plan ID card to obtain the telephone number and name of the Utilization Management company (UM) that your employer group has selected for this service. Our OneNet Member Services Department provides you assistance with behavioral health pre-certification toll-free at: 1-800-962-0643.