Choosing a Provider
To receive the maximum benefit from your Scott and White Health Plan (SWHP) medical plan, you will need to use SWHP-contracted doctors, hospitals, pharmacies, and other providers of medical services that are covered by your plan.
When you need non-emergency medical services you always have the choice of using out-of-network providers. However, you will not receive the benefits of your SWHP medical plan, and you will be responsible for the full cost of any medical services you receive.
Search for providers in the BSW Plus network here and in the BSW Preferred network here.
In all emergency situations, you are encouraged to call 911 or seek care with the nearest SWHP-contracted provider. If a local network provider is not available, go to the nearest emergency room for treatment.
If you are hospitalized as a result of the emergency, you should contact the SWHP Health Services Division within 24 to 48 hours of hospital admission at 888-316-7947. Coverage for continued treatment is assured when approval is obtained from the SWHP through the Health Services Division. Emergency care in a hospital emergency room requires a copayment, which will be waived if you are admitted to the hospital within 24 hours.
Referrals are not required by Scott and White Health Plan to see specialists in your network (BSW Plus HMO or BSW Preferred HMO, depending on which plan you choose) but may be required by the specialist themselves according to their departmental policy.
Some services may require your physician to ask SWHP for prior authorization. If you want to be sure SWHP will pay for this service, you will need prior authorization before these services are performed. When authorization is given, SWHP will provide coverage for these services based on the terms of your specific plan.
If you have questions about referrals or prior authorizations, please contact us at 844-633-5235.
Prior Authorization List