Out of Network Services

In some instances, if MedStar Family Choice-DC is unable to provide a necessary and covered service to a enrollee within the MedStar Family Choice-DC network, MedStar Family Choice-DC may allow the service to be provided out of network. In order for this to happen, the provider must contact MedStar Family Choice-DC for approval. MedStar Family Choice-DC has 14 days to process a request once all necessary information has been received. An additional 14 days can be granted if requested by the enrollee or provider, or if MedStar Family Choice-DC feels it is beneficial to the enrollee. The decision may be shorter depending on the urgency of the request. MedStar Family Choice-DC will review all requests on an individual basis. In cases where out of network services have been approved, you are not responsible for the cost of these services.

 

This program is funded in part by the Government of the District of Columbia Department of Health Care Finance.
Information current as of: 09/17/20