Group Health Systems

Member Information:

Radiology Services:

In an ongoing effort to maximize your health care dollars and  maintain the highest
quality of service and benefit to the Trust and eligible members and their dependents,
various health care Directors, Board of Trustees, and other health care services have
contracted with Group Health Systems (GHS) radiology network, a group of highly
qualified radiology facilities, who have agreed to charge special reduced rates to
eligible members and covered dependents of the contracted Health & Welfare Trust.
The Plan will pay 100%, 90%, or 80%, as specified in your benefit plan coverage, of
the negotiated contracted rates when tests are performed at one of the contracted
participating facilities.

The facilities can be used for general radiology services (X-Ray, Mammography, MRI,
CT, PET scan, Ultrasound, Heart Scan services). When your Doctor requires radiology
services, it will be to your and your health care Trusts / Plan benefit to utilize this
program. Doing so will protect and enhance your health care dollar and at the same time
you will be covered at 100%, 90%, 80%, as specified by your plan design. Your Out of
Pocket expense is substantially reduced by the GHS negotiated deep discounted rate for
the radiology service.

If you do not take advantage of this program, both you and your health care Trust / Plan
will pay more for these services and lessen the value of your health care dollar. We
highly recommend that you follow the steps listed below to take full advantage of this
cost saving opportunity and assist your Health and Welfare Trust in maximizing the use
of these valuable health care dollars.
                                            PROGRAM PROTOCOL
When you are going to have radiology tests performed, inform your Doctor of this
program. This will apply to all radiological tests that may be required. In order to
capture these savings you must follow the steps listed below:

  •        The patient (Plan Member or covered dependent), doctor or his office staff
    must call the GHS contracted service provider shown on you Trust Radiology
    Program I D card to schedule your appointment, (Toll Free phone number will be
    provided for the client group, which will be located on the I.D card provided to
    you through your health care Trust / Plan Administrator).  The doctors’ office may
    also schedule your service by faxing the request to the GHS contract service
    provider (Toll free phone number will be provided to doctor).

  •        The patient (Plan Member or eligible dependent), doctor, or the doctors'
    office staff will have to identify you as a participating GHS Health & Welfare
    Trust participant and identify your Health and Welfare Trust (Benefit Plan).  

  •        Your test(s) will be scheduled to the most convenient facility in your area and
    you will be notified / contacted of the facility, date and time of your appointment
    (you, your doctor or his office staff may request a specific location, time and date
    for the service).

Group Health Systems (GHS) is continuously working, in your behalf, to maintain and
improve the benefits and services to its Clients and their benefit plan participants and
their dependents. This program will not only save precious health care dollars to the
Fund / Benefit Plan but will save you, the participant and covered dependents, on all out
of pocket costs for these services.

This is a win – win situation for the Benefit Plan and You.
Post Office Box 40
McArthur, California, 96056

Telephone: 800-945-7708
Fax: 530-336-7234
E-Mail:
jwghs@grouphealthsystems.net
Remember, utilizing these preferred providers will benefit you, your Health and Welfare
Trust, and most importantly, your health care dollar. Protecting your health care dollar will
mean protecting your quality of health care and your level of Benefits.

For example and further explanation, we have, below, listed an example of how your taking
advantage of and using / following the GHS Laboratory and Radiology program protocol will
clearly save you and your Health and Welfare Benefit Plan valuable health care dollars.

                        Present Plan

Test Type and Cost                        Member (Your) Co-Pay                          Trust Pays

MRI  $1,077.00                         $ 215.40     @ 20%                                        $ 861.60
                                                 $ 161.55     @ 15%                                        $ 915.45
                                                 $ 107.70     @ 10%                                        $ 969.30

           New GHS Radiology Program

Test Type and Cost                        Member (Your) Co-Pay                          Trust Pays

MRI  $1,077.00                         $  100.00     @20%                                        $ 400.00
                                                 $    75.00     @15%                                        $ 425.00
                                                 $    50.00     @10%                                        $ 450.00

*NOTE: The above example(s) show the cost for the same test and what the deep savings
will be both to you or your eligible dependent and the Health and Welfare Trust. Example
is shown assuming a 20%, 15%, and 10% member co-pay. Please consult your benefit plan
booklet or contact your benefit plan administrator for more information.

THIS IS A WIN - WIN SITUATION FOR YOU AND THE TRUST

Follow the Radiology Program protocol listed above, and you will be directed to the
Preferred Provider facility (PPO) closest to and most convenient to your physical location.
Also, there is important information regarding billing and how to utilize these services that is
listed on your Laboratory and Radiology ID Card and should be read and followed in order to
save you money at time your service is requested.