Kaiser Permanente is a health care organization that provides services to millions of people across the United States. While the company is known for its top-notch medical care, there is a lesser-known aspect of Kaiser Permanente that can be beneficial to patients: the single case agreement.
What is a single case agreement (SCA)?
A single case agreement is a contract between a patient and an insurance company outlining the terms of an agreement to cover a specific treatment or procedure. In the case of Kaiser Permanente, a single case agreement provides coverage for patients seeking care outside of the Kaiser Permanente network.
Why would a patient need an SCA?
There are several reasons why a patient may seek care outside of the Kaiser Permanente network. For example, a patient may require specialized treatment that is not available within the Kaiser Permanente system. Alternatively, a patient may prefer to receive care from a particular provider or facility that is not affiliated with Kaiser Permanente.
Whatever the reason, a single case agreement can help patients receive the care they need while still being covered by their insurance.
How does an SCA work?
To obtain a single case agreement with Kaiser Permanente, a patient must submit a request to the company explaining why they require care outside of the Kaiser Permanente network. This request should include supporting documents such as medical records, a treatment plan, and any other relevant information.
Once the request has been submitted, the Kaiser Permanente team will review the patient`s case and determine whether an SCA is appropriate. If approved, the patient will be notified and provided with a contract outlining the terms of the agreement.
It is important to note that while an SCA can provide coverage for care received outside of the Kaiser Permanente network, it does not guarantee that the patient will be fully reimbursed for all costs. Patients should carefully review the terms of the agreement and check with their insurance provider to ensure they understand their coverage.
In conclusion, a single case agreement with Kaiser Permanente can be a valuable tool for patients seeking care outside of the Kaiser Permanente network. By providing coverage for specialized treatments and procedures, an SCA can help ensure that patients receive the care they need without incurring excessive costs. If you are a Kaiser Permanente patient seeking care outside of the network, consider submitting a request for a single case agreement today.