The choice to enter the Carrum Health Procedure Program (“Program”) is voluntary, and the patient agrees to abide by all requirements of the program.
To be eligible for this program, the patient must have medical coverage from the Plan Sponsor’s health plan as their “primary” medical insurance coverage. If the patient is primary on another medical insurance policy (for example, a spouse’s plan or Medicare), then the patient is not eligible for this program.
Some patients who are eligible for participation in the Program may not be qualified for treatment through this Program. These decisions are at the sole discretion of Carrum Health working in conjunction with COEs, and may be based on criteria made known to the patient or on other discretionary judgment based on clinical characteristics, patient safety, and overall program appropriateness.
Carrum Health does not provide medical advice and does not provide medical care. You may be provided with reference information regarding alternative treatment options. This reference information may or may not fall within your given insurance guidelines, and is informative in nature, and does not constitute medical advice.
Individuals at COEs who may provide reference information or medical reviews are not acting in their capacity as treating physicians and thus do not formally establish a doctor-patient relationship. Their review and assessment are not a substitute for medical or professional care and patients are encouraged to consult with their own appropriate health care professional. Any subsequent questions or follow up care must be handled by the patient’s primary treating physician.
Billing for approved medical services under the program will be submitted to Carrum Health. The patient may receive billing from the hospital for any optional patient convenience items or non-covered health services unrelated to the approved procedure that the patient has chosen to have performed.