New Mexico Health Connections | my connection | Spring 2016

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{ SPRING 2016 | FOR MEMBERS OF NEW MEXICO HEALTH CONNECTIONS }
Our provider network contains
more than 7,500 providers all
over New Mexico and in the bor-
der areas of Lubbock and El Paso,
Texas. Providers include not only doctors, but
also hospitals, labs, urgent care centers and
emergency rooms. When you stay in-network
for all your provider visits, you can avoid rack-
ing up higher out-of-pocket costs. And facilities
we are not contracted with charge us more than
those with a contract. So staying in-network
benefits not only you, but also New Mexico
Health Connections (NMHC). Anything we
can do together to hold down the total cost of
healthcare helps all NMHC members.
Emergency department
and urgent care visits
In the Albuquerque/Rio Rancho area, all
Presbyterian clinics and hospitals are out of
our network. If you need emergency care in
the Albuquerque or Rio Rancho area, please go
to one of the three local Lovelace hospitals, the
Heart Hospital of New Mexico, or one of the
two University of New Mexico hospitals, if at all
possible. These facilities are in-network.
If you need urgent care, please take a moment
to review the list of in-network urgent care cen-
ters at .
Look for “View a listing of urgent-care centers
and walk-in clinics in our network.”
Lab and radiology services
Be aware that some in-network hospitals work
with out-of-network providers for lab and
radiology services. These providers may take and
read your x-rays or draw and run your lab tests
inside the in-network hospital. If those lab and
radiology providers are not in our network, they
can and will bill you directly for their services.
In addition, you may receive a bill for a facility
charge from a lab, draw station (a walk-in facility
that collects specimens for lab work) or radiol-
ogy department within the hospital.
If you receive lab or radiology services in
a hospital and you are not having a medi-
cal emergency, always ask if the radiology or
laboratory provider in the hospital is in the
NMHC network. If it isn’t, ask to have your
services done at a freestanding (not associ-
ated with a hospital) radiology provider in our
network.
‘They are
there for me’
Before the Affordable Care
Act, healthcare coverage
seemed permanently
off-limits for Daniel Boardman, an
Albuquerque restaurant owner. “I’ve
been diabetic and self-employed my
entire adult life,” he says. “And
health insurance was a difficult
thing to find.” He was considered
uninsurable. But in 2014, he joined
NMHC with a silver HMO plan, and
he upgraded to a gold HMO plan for
2016.
“I have fairly advanced diabetic
eye disease, and to save my vision, I
have to get eye injections and laser
treatments every month,” Boardman
says. “From the intensive treatment,
my eye health has stabilized and my
vision has actually improved. I’m
grateful for my health plan.”
After joining NMHC, Boardman,
who hadn’t seen a primary care
doctor in years, became established
with one and got caught up on his
preventive care. He also obtained
an insulin pump to give him greater
control over his blood glucose,
which he says will add years to his
life. “There was a big learning curve
for me with the pump,” he admits.
“But it absolutely has been worth
it.”
Whenever he has a question
about his coverage or billing, NMHC
is quick to respond, he says. “I feel
that, as a non-profit, New Mexico
Health Connections is there for me.”
Do your homework
Before your medical visit, find a complete
listing of in-network labs, lab draw stations,
radiology providers, and urgent-care centers
at
Select the “ONLINE PROVIDER SEARCH
TOOL” button to start your search, then
click on “ORGANIZATION” in the upper left corner. When you want to search for an individual
provider, such as a doctor, click on “INDIVIDUAL.” To find freestanding radiology providers, scroll
down on the page to the “Radiology Services–Freestanding Providers” heading.
Stay in-network,
save
money
CHOOSING THE RIGHT EMERGENCY
DEPARTMENTS, URGENT CARE
CENTERS, HOSPITALS, AND LABS