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Welcome to ExclusiveChoice, a medical benefit plan of SSM Health Care. We are committed to providing quality care for our employees and their dependents as embodied in our mission statement:
Through our exceptional health care services we reveal the healing presence of God.
The ExclusiveChoice plan offers comprehensive health care services through an extensive provider network, including SSM Health Adult Hospitals, SSM Health Cardinal Glennon Children’s Health Center, SSM Health Rehabilitation Hospital, SSM Health Home Care, and participating practitioners in Missouri and Illinois. Utilizing this quality network of providers results in more enhanced benefits and reduced premiums compared to traditional health plans.
Physicians who participate in the ExclusiveChoice plan are members of the SSM Managed Care Organization and must meet a defined set of criteria designed to promote excellence in the delivery of health care services.
For more complete benefit information, see your Summary of Benefits and Coverage (SBC). You may also obtain a copy from your local Human Resources department. Employees can access all plan materials, including the Summary Plan Description (SPD) online through MyHR.
Present your ExclusiveChoice card and pay any applicable co-pay whenever you receive medical care. For replacement or additional ID cards, call CoreSource at 1-800-990-9058 or visit the CoreSource website.
Members must use in-network providers except for emergencies or if care is not available within the network. Plan authorization is required for services from any out-of-network provider. SSM Management Services reviews all requests for authorization to determine the most appropriate plan of care.
It is the member’s responsibility to obtain authorization for any service from an out-of-network (non-participating) provider. To request authorization, contact SSM Management Services at 314-989-2355. If you are admitted to a non-participating or out-of area hospital, SSM Management Services must be contacted within 48 hours (or next business day) in order to be covered under ExclusiveChoice.
The subscriber (employee) must notify his/her local Human Resources Department when there is a change in family status (example: marriage, birth, divorce, or any other eligibility change). These events must be reported within 31 days. If not reported, coverage and claims may be denied.
In order to process claims accurately and in accordance with cedrtain plan requirements, additional information may be needed. If you receive a request for injury, accident, other liability or other insurance, it's easier than ever to provide this information. Just call CoreSource at 1-800-990-9058 or visit the CoreSource website.
If you don’t provide the requested information, your claims payment may be delayed and/or denied.
Also, ExclusiveChoice members will be asked annually to provide dependent employment and health care coverage information.
See our Frequently Asked Questions page or call CoreSource at 1-800-990-9058 or your local Human Resources Department. Employees can find additional information on MyHR.