MaintenX Employees Access Mobile Urgent Care

PPO Plan Care with UrgentCare2go™ Across Texas

When you or a family member feels unwell, staying home may be more comfortable than traveling to a waiting room. UrgentCare2go™ brings professional medical care directly to eligible patients at home, work, or another approved Texas location.

MaintenX employees may be enrolled in the PPO Plan administered by CornerStone Preferred Resources. The available plan information lists a $25 primary care copay and a $50 specialist copay. Mobile medical services may be processed differently, so verify your specific benefits before scheduling a visit.

What Does the MaintenX PPO Plan Include?

The available MaintenX PPO Plan information lists:

• Primary care visit: $25 copay

• Specialist visit: $50 copay

These amounts may not automatically apply to a mobile urgent care visit. Laboratory testing, medications, injections, procedures, medical supplies, and additional services may be processed separately.

An insurance card does not guarantee coverage or payment. Current eligibility, medical necessity, network participation, prior authorization, service location, and the care provided may affect your final responsibility.

For scheduling assistance, call UrgentCare2go at (817) 508-8169.

Can MaintenX Employees Use UrgentCare2go?

Eligible MaintenX employees and their covered family members may be able to use UrgentCare2go for many non-emergency medical concerns.

The mobile medical team can evaluate and treat concerns such as:

• Cold and flu symptoms

• Cough, congestion, or sore throat

• Fever and body aches

• Ear pain or ear infections

• Headaches and migraines

• Nausea, vomiting, or diarrhea

• Urinary symptoms

• Minor infections

• Mild allergic reactions

• Rashes and skin concerns

• Minor injuries

• Routine primary care concerns

• Certain follow-up visits

Coverage depends on the member’s plan, current eligibility, medical needs, provider-network participation, service location, and the care provided.

Call 911 or visit the nearest emergency room for chest pain, severe breathing difficulty, signs of a stroke, fainting, confusion, uncontrolled bleeding, major trauma, or another life-threatening emergency.

Who Administers the MaintenX Plan?

CornerStone Preferred Resources, also known as CPR, is the third-party administrator listed for the MaintenX PPO Plan.

CornerStone Preferred Resources can assist members and providers with:

• Eligibility verification

• Medical benefit questions

• Copay and cost-sharing information

• Provider-network participation

• Prior-authorization requirements

• Claim-status questions

For plan and benefit questions:

• Call Employers Health Network at (800) 278-0703

• Visit the CornerStone Provider Portal

Have the member identification number from your MaintenX insurance card available when requesting assistance.

How Do I Verify My Benefits?

Before booking a mobile visit, call (800) 278-0703 and ask:

• Does UrgentCare2go participate with my MaintenX PPO Plan?

• Is a mobile medical visit covered?

• Will the $25 primary care copay apply to the visit?

• Are laboratory tests, medications, procedures, or supplies billed separately?

• Is prior authorization required?

• Is a referral required?

• Will I have a time-of-service responsibility?

• Are there service-area or network restrictions?

Write down the representative’s name, the date of the call, and the reference number provided. Final coverage is determined when the plan administrator processes the claim.

UrgentCare2go can collect your insurance information and help prepare for the visit, but the plan administrator provides the official explanation of your benefits.

Is Prior Authorization Required?

Prior authorization depends on the medical service being requested.

For prior-authorization assistance:

• Call (888) 508-7615

• Visit the MedWatch Authorization Website

Members and providers should confirm whether approval is required before receiving the requested service.

Prior authorization does not guarantee claim payment. Current eligibility, medical necessity, network participation, plan exclusions, and other plan requirements may affect how the claim is processed.

What Network Does the Plan Use?

The MaintenX PPO Plan uses the EHN Preferred Network. This network includes Baylor Scott & White Quality Alliance providers who have elected to participate.

Not every Baylor Scott & White Quality Alliance provider participates in the EHN Preferred Network. Members should confirm that UrgentCare2go and the treating medical professional participate with their specific MaintenX plan before receiving care.

To locate or verify an in-network provider:

• Use the EHN Preferred Network Provider Search

• Call Employers Health Network at (800) 278-0703

• Contact BSWQA Care Navigation at 1-844-279-7589

Provide the employer name, PPO Plan name, member identification number, requested service, and service location when confirming participation.

Are Specialist Referrals Required?

The available MaintenX plan information does not list a general specialist-referral requirement.

Certain specialist visits, tests, treatments, or procedures may still require prior authorization. Contact the plan administrator before beginning specialty care to confirm the current referral and authorization requirements.

How Should I Prepare for My Mobile Visit?

Before your appointment, prepare:

• Your MaintenX insurance card

• A photo identification card

• A current medication list

• Known medication or food allergies

• Relevant medical records

• Recent laboratory or imaging results

• Any referral or authorization documents

• A description of your symptoms

• The date your symptoms began

• Your preferred pharmacy information

• Your benefit-verification reference number

Please provide a safe, clean area where the medical professional can complete the visit. Secure pets before the medical assistant arrives.

UrgentCare2go uses a three-hour arrival window. The medical assistant will send a message when they are on the way.

Claims Information for Providers

MaintenX PPO Plan claims are submitted through Employers Health Network and SmartCare.

Electronic claims: Payor ID IHS07

Mailed claims:

Employers Health Network/SmartCare
P.O. Box 507
Arnold, MD 21012

Providers should verify the member’s eligibility, network participation, prior-authorization requirements, and current claim-submission instructions before providing care or submitting a claim.

Medical Care Brought to Your Location

UrgentCare2go helps make non-emergency medical care easier to access when leaving home or work is difficult. The medical team will listen to your concerns, evaluate your symptoms, and explain whether mobile treatment or a higher level of care is appropriate.

When you are ready, Book a Mobile Visit or call (817) 508-8169. Please have your MaintenX insurance card available so your eligibility, benefits, and network participation can be reviewed before the visit.