The value-based site of care program is designed to help you save on out-of-pocket costs, other than your deductible and coinsurance.
ASC Value-based Purchasing Flyer
Lab Services. Reduce your out-of-pocket costs by obtaining routine lab services at Labcorp or Quest Diagnostics.
Laboratory Site of Care Flyer
Find a Quest near you.
Find a Labcorp near you.
For details regarding Lab Exceptions, please refer to your Evidence of Coverage (EOC) or contact Included Health at (855) 633-4436.
Outpatient Surgery. If you need a procedure, such as an arthroscopy (a surgical procedure to examine and treat a joint in an area like the knee) or a colonoscopy, you can save money by going to an ambulatory surgical center (ASC) instead of a hospital. By using an ASC that is part of the Value-based Site of Care program, you will have little to no out-of-pocket costs, other than the plan’s deductible and your coinsurance.
Other procedures that are part of the program include gallbladder removal, sigmoidoscopy (a test that examines your large intestine, similar to a colonoscopy), hernia repair, and nasal or sinus corrective surgery.
Hospital Outpatient Facility Form
Hip and Knee Joint Replacement Surgery. CalPERS and Blue Shield of California have enhanced the value-based pricing program for elective hip and knee replacement. As a result of breakthroughs in clinical care and technology, most joint replacement surgeries now occur on an outpatient basis. Outpatient surgery offers many advantages, including a shorter recovery time, less pain, and a lower risk of infection.
As a PPO member, you have the option to choose any facility. However, if you get care from one of the preferred participating facilities, you can lower your out-of-pocket costs. We can help you make sure a center or lab is part of the program.
To learn more about ways to save money, log in or call Included Health at (855) 633-4436.
PPO Value-based Pricing Program for Hip and Knee Replacement Flyer
