Some of your medical benefits will include:

  • Primary Care Physician office visits
  • Diagnosis and treatment of illness or injury
  • In office procedures, lab and imaging services
  • Maternity office care
  • Specialty care
  • For a detailed list of medical benefits please read the Tuality Healthcare Plan booklet, or you may contact our Human Resource Department at 503-681-1856.

Preventive Care

Some of your preventive medical benefits include:

  • Child routine and preventive care visits
  • Immunizations
  • Well-women care
  • Mammography
  • Prostate screening
  • Colonoscopy
  • Annual hearing exams
  • Visits for naturopathic and chiropractic care must use First Choice Health Network providers.

For a complete list of preventive medical benefits please see your Tuality Healthcare Plan booklet. Some services require a “pre-certification”. It is important to understand what services need “pre-certification” to manage your care.

Medical Benefits and Pre-certification

Prior to a planned hospital admission or surgery, you or your doctor must call Innovative Care Management to request a “pre-admission certification”. Pre-admission certification is required to make sure you’ll receive the maximum amount of benefits under your plan. Failure to call could result in a penalty or reduced benefit for your hospital admission and/or surgery.

Innovative Care Management

Your physician should contact Innovative Care Management to obtain preauthorization before you are admitted to the hospital or before services which require preauthorization are provided.

Medical Emergency

In a medical emergency, you may be admitted to an inpatient facility without preauthorization/or a “pre-certification”.

  • Your physician should contact Innovative Care Management as soon as reasonably possible after your admission.
  • Additional days of inpatient care, beyond those initially authorized, must also be authorized by Innovative Care Management.
  • For a complete list of services requiring a “pre-certification”, please see your Tuality Healthcare Plan booklet or you may contact our Human Resource Department at 503-681-1856.