Site of Service Benefit Option

 
You can save money on outpatient surgery or lab tests. Here’s how.

Anthem's Site of Service benefit option makes it possible to get quality care and save money at the same time, when you choose a lower-cost lab or ambulatory surgery center (ASC) for your services.

 
How does it work?

Your doctor wants you to get a lab test. If you use one of the labs located on Anthem's Find a Doctor tool you pay $0 for services. Whether you need a blood, urine, or strep test, nothing comes out of your pocket. That means no deductible or coinsurance.

 
Your doctor recommends a routine outpatient procedure, like knee arthroscopy. If you use an ambulatory surgery center listed here (ASC) for same-day surgery, you'll pay less for your care. You'll pay a one-time, low-cost copay for the covered service*. Your copay will range from $100-$150. See your plan details for the exact amount.
 
View our member flyer to learn more!
 
*Additional services may be required at the ASC as part of your surgery or procedure and be subject to deductible and/or coinsurance. An example of such a service is pathology (the study and diagnosis of a disease) or work that is not sent to one of the labs found on Anthem's Find a Doctor tool.  
 
Frequently Asked Questions
Q: How does Anthem's Site of Service benefit option help lower costs?

A: It can reduce your out-of-pocket costs, as well as the overall cost of health care. By using labs found on Anthem's Find a Doctor tool, which include all independent labs in New Hampshire and some hospital labs, you will not have a copay for your lab services. It's one of the ways we are working to help ensure you have access to affordable care when you need it.

 

Q: How do I find a zero-cost lab through the Site of Service benefit?

A: Just log on to anthem.com and click "Find a Doctor." Then, follow the prompts.

 

Q: What if I don't use a zero-cost lab located on Anthem's Find a Doctor tool?

A: You may use any lab you'd like. However, if you choose a lab that's not listed on the Find a Doctor tool, your share of the costs may be higher.

 

Q: Does an independent lab provide the same type and quality of service as a hospital outpatient lab?

A: Yes. Independent labs specialize in these types of services. They have the same level of quality and offer the same types of services as other outpatient labs.

 

Q: Can my doctor use an independent lab for my lab work?

A: Yes. When your doctor orders lab work, ask him or her to order your lab work at an independent lab. Even if your doctor usually uses another hospital lab not found on the Find a Doctor tool, he or she can order your lab work at an independent lab.

 

Q: My doctor doesn't have a contract with any independent labs. How can he or she get one?

A: Your doctor can easily set up an account with independent labs (e.g., LabCorp, Quest Diagnostics®, LLC or NorDx) through their websites.

 

While the account is being set up, your doctor can still order your lab work at an independent lab by giving you the laboratory order form. You'll need to take the form to the lab. Once your doctor has an account with the lab, the lab will automatically pick up your specimen(s) from the doctor's office.

 

Q: My doctor says he or she doesn't want to use one of the labs that I've requested under the Site of Service benefit option. What can I do?

A: Remind your doctor that under New Hampshire law, you have the right to choose where you want to receive services, including lab services. Your doctor is required to give you a laboratory order form to take to the lab you want to use.

 

Q. What are ASCs?

A: ASCs are ambulatory surgery centers that provide a wide range of same-day surgical services, such as a tonsillectomy or knee arthroscopy.

 

Q. How can I find an ASC?

A: Go to anthem.com/siteofservicenh and click on "ambulatory surgery centers," or call the Customer Service number on your member ID card.

 

Q. I'm going to have surgery. How can I find out whether it can be done at an ASC?

A: Ask your doctor to recommend a surgeon who may be able to perform your surgery at an ASC.

 

Q: How much will I have to pay if I use an ASC?

A: If you use an ASC found on anthem.com/siteofservicenh for same-day surgery, you'll have one low copay. Your copay will range from $100-$150. See your plan details for the exact amount.

 

If you need additional care as part of the surgery or procedure you may have to pay coinsurance and/or a deductible (the amount you pay before the plan pays). For example, you may pay more for pathology or lab work if it is not sent to one of the labs found on Anthem's Find a Doctor tool. Make sure your doctor at the ASC knows you have Anthem's Site of Service benefit option.

 

 

If you have additional questions about the Site of Service benefit option, just call the phone number on the back of your Anthem member ID card.