MEMBER FREQUENTLY ASKED QUESTIONS
How do I find information about benefits?

Talk to a representative from your Human Resources Department for a copy of your plan that outlines all of your benefit information.

How do I contact HealthSmart?

HealthSmart is comprised of several healthcare companies. Your employer may be using several of our services, or they may be utilizing only one. Check the back of your healthcare ID for contact information.

How do I find a network provider?

To lookup a network healthcare provider (doctor, clinic, hospital, laboratory, etc.), CLICK HERE.

When can I contact Customer Service?

Our Customer Service Representatives are available from 7:00 a.m. to 6:00 p.m., Central Standard Time, Monday through Friday and can be reached by calling 800.687.0500.

What happens if my current physician is not a network provider?

If your physician is not a member of your PPO network, you have several options:

  1. Select a new doctor that is in the network.
  2. Discuss with your doctor about becoming a participating provider with us.
  3. Fill out the on-line provider Request Form.
I’m a Patient/Member, how do I obtain an Member ID card?

To obtain a Member ID card, please contact your benefit office directly. You can locate the telephone number by contacting your Human Resources Department where you work.

I’m a client, how do I get a directory?

First, you can simply click on the Provider Lookup to access our online directory of providers where you can create and print individualized directories or if you would like to request hard copy provider directories, please contact your Human Resources Department or benefit administrator.

What is a “Preferred Provider”?

A Preferred Provider is a prescreened doctor, hospital, or other healthcare provider or facility that has agreed to provide their services at predetermined rates.

Who do I contact regarding co-payment/deductible/premium payment questions?

Through your health plan you have access to a HealthSmart PPO network of providers, but we may or may not administer your plan and maintain information regarding your health benefits. For payment questions – including those about coverage, co-payments, deductible and premiums, check your member ID card or contact your Human Resources Department directly.

What does Board Certification mean?

Board Certification means that a physician has chosen to undergo a formal review process by a medical board to certify that he or she has fulfilled the educational requirements needed to practice medicine.