The Alliance is committed to ensuring that our eligible members receive medically necessary services without interruption.

We have a continuity of care process for providers not contracted with the Alliance (also known as out-of-network). New Alliance members may continue to see their non-contracted physicians and utilize specific medical services, for up to 12 months for their medical services after enrollment, as long as the following Continuity of Care guidelines are met. If your providers do not join the Alliance network by the end of 12 months, you will need to switch to providers in the Alliance network.

If your provider stops working with the Alliance, you may be able to keep getting services from that provider. This is another form of continuity of care.

聯盟集團關懷成員

該聯盟為以下機構提供持續的護理服務:

  • 急性條件– 應提供在急性狀況期間完成涵蓋的服務。
  • 診斷的產婦心理健康情況– 在分娩后12個月內影響婦女懷孕、孕前或產後或懷孕期間出現的精神健康情況。
  • 懷孕(包括出生後的護理)–當(1)懷孕是高風險的,或(2)成員處於第二或第三孕期時,應在懷孕期間提供涵蓋服務的完成。
  • 嚴重慢性疾病 • 應按聯盟與會員和未參與方協商確定的,在完成治療過程和安排安全轉移到其他供應商所需的時間內完成涵蓋的服務供應商,並符合良好的專業實踐。 完成涵蓋的服務不得超過您註冊聯盟後12 個月。
  • 手術和/或程式– 執行該成員以前的計劃作為記錄治療過程的一部分而授權的手術和/或其他程式,並且非參與供應商建議並記錄的手術和/或其他程式將在會員註冊聯盟后180 天內進行。
  • 絕症– 應在絕症期間提供涵蓋服務的完成。 從您註冊聯盟起,涵蓋服務的完成時間可能超過12 個月。

To learn more or request continuity of care, please call:

To learn more about your benefits and covered services, please view your Alliance Group Care Member Handbook.