Member Cost Sharing
A member’s financial liability for certain covered services may be determined by reviewing the benefit code located on the member's Health Plan insurance card. Click here to access member cost-sharing information tools.
When a member’s benefit structure denotes financial liability in the form of a copayment, such liability typically applies to evaluation and management (E&M) services performed in the following setting: office, consultation, preventive medicine and emergency department.
Additionally, certain members may have a per day or per visit copayment responsibility for certain outpatient rehabilitative services, outpatient radiology tests, home health services, ambulance services and outpatient surgery.
Providers should contact the applicable Customer Service Team and review the Health Plan’s Explanation of Payment (EOP) to appropriately determine a member’s financial liability.
Contact the Customer Service Team to confirm enrollment
HMO/Solutions
(800) 447-4000 or (570) 271-8760
Hours: Monday-Friday, 8 a.m. to 6 p.m.
Geisinger Health Options (TPA, Indemnity)
(800) 504-0443 or (570) 271-8770
Hours: Monday-Friday, 8 a.m. to 5 p.m.
Gold
(800) 498-9731 or (570) 271-8771
Hours: Monday-Friday, 8 a.m. to 5 p.m.
Geisinger Choice PPO with Referral
and
Selectus Coordinated Care PPO
(800) 447-4000 or (570) 271-8760
Hours: Monday-Friday, 8 a.m. to 6 p.m.
Geisinger Choice PPO with No Referral
and
Selectus Direct Access PPO
(800) 504-0443 or (570) 271-8770
Hours: Monday-Friday, 8 a.m. to 5 p.m.
TDD for the hearing impaired (all products)
(800) 447-2833
Hours: Monday-Friday, 8 a.m. to 4:30 p.m.