CCC Workbook 2013 - FINAL.pdf - Cherry Creek School District

Kaiser Permanente Added Choice Triple Option (Continued)
Laboratory work
• You may bring orders for routine laboratory work from your outside provider to any Kaiser
Permanente medical office. There is no charge for this service. Just go directly to the lab
in the Kaiser Permanente office with the order from your Tier 2 or Tier 3 physician. Results
will be returned to your doctor’s office by fax, telephone, or mail.
Imaging (subject to deductible, co-pays and/or co-insurance - See page 14)
• You may also take orders for routine X-ray studies to any Kaiser Permanente medical
office. You may take the order directly to the Radiology
Department. A report will be returned to your doctor’s office.
• MRIs, CT, and PET studies may have higher costs. Appointments are required for these
studies.
• MRIs, PET, CT, bone density studies, and other studies must be completed at the
Franklin Medical Offices and will require an appointment.
• MRIs ordered by non-Kaiser Permanente providers always require precertification.
Call 1-800-448-9776.
• After pre-certification is obtained, ask your provider to call the referral line at 303-
743-5330. When the request for referral comes to Kaiser Permanente, they will call
you to make an appointment.
• Orders for other studies such as ultrasound, bone density studies and mammograms also
require appointments and referrals. Your provider’s office should refer you by calling
303-743-5330. A referral will be put on the Kaiser Permanente internal system and a fax
will be sent to the proper department. They will send a letter to you verifying the referral
and providing a phone number for you to make your appointment.
• Mammograms will only be covered at the Kaiser Permanente level of benefits if provided
at a Kaiser Permanente Medical Office.
Specialty referrals
• When using a PHCS or non-preferred provider, you may access the Kaiser Permanente
system to see a specialist without a referral from a Kaiser Permanente primary care physician.
This benefit can often allow you to access treatment at a much lower cost than the
deductible/coinsurance benefits of the 2nd and 3rd tiers of the Added Choice Triple Option
Plan. You will receive your care from a Kaiser Permanente board-certified specialist.
• Ask your PHCS or non-preferred provider to call the referral line at 303‑743‑5330. Your
provider will leave the information concerning your needs and the referral will be put on
their system.
• The appointment request will be faxed to the appropriate department.
• A letter will be sent to you verifying the referral and providing a telephone number to call
and make an appointment.
47