SDOC Medical - FAQ
EVOLUTIONS Health Care Systems We have built custom relationships for SDOC with providers and facilities. These relationships will continue to grow. The MAIN hospitals for Evolutions are ALL of the hospitals in the Orlando Health Systems, St Cloud Regional, Nemors, and Lake Nona Medical Center (MAP) Medical Advocacy Program As a service to our members, we offer a nurse concierge service to assist in finding the HIGHEST QUALITY, COST EFFECTIVE, in the BEST TIER available. While this service is available for any claims, it is particularly important in choosing the best facility for any planned procedure. USE MAP!!!! How the MAP plan works for planned procedures and services that require pre-certification:
Member calls MAP and follows their advice:
Deductible is waived
Member calls MAP and DOES NOT follow MAP advice:
Plan pays usual benefits
Member does not call MAP:
Plan pays usual benefits
Direct Cash Pay Program for Tier 2 and Tier 3 Claims:
Prescription Drug Benefits: Developing a Tierred RX Benefit to promote using local / independent pharmacies and retail stores for prescription drugs as they are much more cost effective to the plan, The preferred pharmacies would include Publix, Costco, Walmart and Walmart family of stores (Sam's, Neighborhood Markets) When a member calls MAP for assistance with a pre-planned procedure, the MAP counselor will reach out to the facility to try and negotiate a "cash up front" Arrangement in order to secure the best price.
Explain My Benefits © 2021
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Non preferred would be chain pharmacies; IE CVS, Walgreens, Rite Aid
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