The PPO plan design utilizes the Piedmont Community Health Plan network. This type of plan offers two levels of benefits, in-plan and out-of-plan. When a member utilizes network providers for covered services, they receive in-plan benefits. This is a higher level of benefits as compared to the out-of-plan benefits. Pre-certification is required for all hospital related services, including inpatient or outpatient care and diagnostic testing. When a member receives covered services from providers that are not in the network or without pre-certification, they receive out-of-plan benefits. This is a lower level of benefits which costs the member more out-of-pocket than the in-plan level of benefits.

Members are not required to select a primary care physician with the PPO plans. However, they are required to receive pre-certification for all hospital related services and should contact Piedmont within two business days of all emergency or urgent care visits. By doing so, they will receive in-plan benefits.

For more information on the PPO plans offered through Piedmont Community Health Plan or Piedmont Community HealthCare, contact us at (434) 947-4463. You can also click on PPO Frequently Asked Questions for more information.

Piedmont Community Health Plan is pleased to offer its valued customers yet another welcomed, local service, Electronic Billing.  Instead of getting your monthly statement through regular mail, now you can choose to either have it mailed or faxed to your designated Accounts Payable person or department.

Mishandled mail, routing mistakes, postage holidays, or other problems associated with loose mail disappear.  You will know exactly when to expect your statement and who will receive it.  Plus, you can easily make contact changes by hitting the reply button.

Just give Piedmont a call at 434-947-4463 and we will be glad to get you started.  You can choose a single department fax number, or up to two email addresses to have your company’s Piedmont statement sent to. All at no additional cost to you.

Electronic billing from Piedmont means the convenience of timely and accurate billing, less paper hassles, and greater ease of doing business.  At Piedmont, we appreciate your business and want to service you the best we can.

Benefits of E-billing from Piedmont include:

• Timely and Accurate
• Gets to Right Person
• Easier to Forward
• Can Resend if Needed
• Electronic Filing
• Environmentally Green

Call To Sign Up Today - 434-947-4463

The HMO plan design utilizes the Piedmont Community Health Plan network. With an HMO, there is only one level of benefits: in-plan. As long as the member uses providers in the network for covered services, the member receives in-plan or the higher level of benefits. Pre-certification is required for all hospital related services, whether inpatient or outpatient. When the member utilizes providers who are not in the network, the services are not a covered benefit except in cases of emergency or where prior authorization has been granted.  HMO plans are focused on integrated care through prevention and wellness.

Members are not required to select a primary care physician with our HMO plans. However, they are required to receive pre-certification for all hospital related services and should contact Piedmont within two business days of all emergency or urgent care visits. By doing so, they will receive in-plan benefits.

For more information on the HMO plans offered through Piedmont Community Health Plan or Piedmont Community HealthCare, contact us at (434) 947-4463. You can also click on HMO Frequently Asked Questions for more information.