EHP offers programs and services to help members better manage their health. EHP recently launched the EHP Benefits Explorer, an interactive tool designed to help EHP members quickly and easily find coverage information related to specific services. For detailed information on what each individual employer offers, visit benefits.ehp.org or see the schedule of benefits. As EHP members, your patients can take advantage of the following:
- Prescription coverage: Prescription drug benefits vary among EHP employer groups. The EHP pharmacy and formulary can be viewed here.
- Dental care: The EHP dental benefit, offered by some EHP plans, is administered by Delta Dental. Members can call Delta Dental customer service at 1-800-932-0783.
- Visits to urgent care: Members can find urgent care centers by accessing the Provider directory or calling EHP customer service at 1-800-261-2393.
- Care management program: Members are placed in one of three levels and, depending on their level, are given a variety of support, tools, and services that are specifically designed to help them better understand and manage their medical conditions. Members can call 1-800-557-6916 for more information.
- Pregnancy resources: Various programs for expectant moms including a high risk prenatal case management program. Members can call 1-800-261-2396 Ext. 5355 for more information.
- [email protected]: This is the secure web portal for members' personal health information. Members can login and register at ehp.org.
- Members also have access to the nationwide Cigna PPO network, a supplemental provider network. EHP covers all provider health care services in the Cigna PPO network at the in-network benefit level. Members may use a Cigna PPO network provider as their primary care provider.
Appointment Access Standards
|Service||Appointment Wait Time (not more than)|
Behavioral health providers must:
- Refer patients to the ER within six hours for non-life-threatening emergencies
- Initial visits for routine care within ten business days
- Provide urgent care within 48 hours
- Follow up routine care within 30 days for new or existing patients
EHP Administration Telemedicine Policy
Original EHP Approval: 3/16/2020
Last Review: 3/16/2020
Last Revision: 3/16/2020
Description and Guidelines
Employer Health Programs (EHP) Telemedicine policy to follow Johns Hopkins HealthCare Medical Policy CMS00.27 Telemedicine/Telehealth. The following exclusions or conditions should apply to all EHP claims:
- Place of service codes: There is no restriction on place of service of rendered services as long as services meet all other appropriate CMS00.27 policy guidelines.
- Benefits are not provided for any technical fees or costs for the provision of telemedicine services.
- Benefits are not provided for any services delivered through telemedicine services that are not covered when provided face-to-face.
- An audio-only telephone conversation between a health care practitioner and a patient will be covered as long as all other stated CMS00.27 policy criteria are met.
Policy retroactive to all dates of service 2/4/2020 forward.
Member liability as defined as deductibles, copayments, or coinsurances will all apply to all telemedicine services the same as face-to-face routine office visits based on provider type (PCP vs. Specialist) for diagnosis, consultation or treatment services per individual client benefit structures.
Claims to be paid at applicable contracted provider rates.