Policy FAQs
Where can I find a list of providers who charge reasonable charges?
There isn’t a published list of reasonable charges, or a list of which health services providers charge reasonable charges.
It's a good idea to request prior approval at least 5 working days before your healthcare service is provided. Prior approval will enable us to determine if the estimated charges from your health services provider exceeds the reasonable charges for that healthcare service and whether a member contribution applies. We will contact you if this is the case.
You can choose an alternative health services provider who has reasonable charges or you can keep your preferred provider but pay an additional contribution towards the healthcare service.