Hello. My name is Emily Glassburn and I’m the Human Resource Assistant for Precision Motor Transport Group. Below are the most frequently asked questions regarding our Health Insurance.
#1. Employee Question: What is NGS American, Inc.? What is the difference between NGS and the 4 medical networks (PPOM, Emerald Health, MedCost and PHCS)?
Answer: In June 2005 PMTG changed their group health insurance plan to a self-funded group health insurance plan. This change required PMTG to hire a third party administrator (TPA) to help assist with our health care administration. PMTG hired NGS American, Inc. to act as our TPA. NGS specializes in the administration of self-funded group health plans and assists PMTG with our medical and dental benefit claims, eligibility management services and COBRA administration. NGS processes all of PMTG’s group health claims, administers explanation of benefits and works with PMTG employees to resolve claims and billing problems.
The difference between NGS and the medical networks is that NGS only aides in our health care administration, they are not the network to which PMTG employees belong. All PMTG employees are either in the PPOM, Emerald Health, MedCost or PHCS network. Employees need to contact their respective networks, please refer to your insurance card, in order to find network doctors. Employees need to contact NGS if they receive a statement/explanation of benefits that they feel has billed in error.
#2. Employee Question: How do I find an in-network provider in my area?
Answer: There are three ways an employee can find an in-network provider in their area:
1. Visit their network’s webpage and search either by location or physician specialty.
2. Call the network and speak with a Customer Service Representative.
3. Contact the PMTG Human Resources Department – a directory can be mailed to your home address or a provider can be found momentarily while speaking on the phone.
Please find below the 4 networks utilized by PMTG and the corresponding websites and phone numbers. In order to determine your network please reference your insurance card.
PPOM www.ppom.com 1-800-831-1166
Emerald Health www.emeraldhealth.com 1-800-346-3141
MedCost www.medcost.com 1-800-824-7406
PHCS www.phcs.com 1-800-785-3602
#3. Employee Question: NGS American, Inc., our health insurance third-party administrator, has mailed a request for more information to my house. Is it necessary that I respond to this request?
Answer: Yes, if NGS mails a request for more information to your house it is extremely important that you respond to the request in an efficient manner.
NGS performs an array of services for PMTG and one of their services is to keep an accurate database of information on our employees. This service requires NGS to periodically request information from our employees, specifically whether or not our employees and their dependents have health insurance coverage under another group plan or if the claims are a result of an accident.
NGS will not be able to process claims until their request for more information has been answered. Failure to respond to the request made by NGS could result in claims being pended for you, the PMTG employee, and your dependents.
If you do receive a request for more information from NGS you can respond in the following three ways:
Mail the form to: NGS American, Inc., PO Box 7676, St. Clair Shores, MI 48080
Fax the form to: (586) 416-2378
Call our NGS Claims Analyst at: (800) 521-1555 Ask for Nancy G.
I hope this information is helpful. If you have any additional questions, please feel free to post them in the comments section. I will get back with you. Thanks.
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