Fairos
Fairos works alongside your health plan to simplify the experience. From finding care to making sense of your medical claims, so you can move forward with clarity and ease.
Find Providers. Connect with Fairos.
As a Fairos member, you have access to the Fairos portal as a valuable tool and resource. The portal gives access to the provider directory and connects you to your Fairos Member Advocate via inquiry submissions or instant live chat.
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For quick answers and helpful resources about how Fairos works, your healthcare experience, and member support.
Fairos has been selected by your employer to provide claims repricing, medical cost containment and advocacy services for your health plan.
Fairos works directly with your Third Party Administrator (TPA) providing cost containment services and Member Advocacy.
The Fairos Member Advocacy team supports you, your family, providers and your health plan administrator ensuring access to care and proper member & plan payments.
Fairos works as an open access arrangement with contracted provided nationwide. This allows you the choice to use our provider finder to to select a provider, continue to use your existing provider or take the recommendation of a trusted friend.
When scheduling your appointment be sure to have your ID card handy as it contains all the required information your provider will need. When they ask who your insurance is through, the answer is "my insurance is through my employer, I have my ID card handy with my group number and member ID". Should your provider have any further questions about where to submit your claims or benefits simply give them the phone number on the top of your ID card.
On the day of your visit be sure to bring your physical ID card, many provider and hospital billing systems are driven by scanning your physical ID card when you show up for your appointment. At the time of your visit you will be expected to pay any deductible amount or co-pays. You can find your benefit information by calling your member services or logging into your health plan portal.
After your visit be sure to log into your health plan portal and open any mail you receive to stay informed regarding your plan payments.
Finding the right provider for quality and timely care is paramount in your healthcare journey. Fairos works with all providers across the U.S. so you are free to choose the provider than fits your needs. Fairos also directly partners with a large number of providers and hospital systems nation-wide offering value based arrangement for seamless care.
For assistance in finding a provider today we encourage the following:
There may be times that a provider may over bill a patient. This can happen due to the timing of the payment from your administrator or when a provider has not been properly explained your plan benefits and applicable member responsibility.
We encourage you to always open mail your providers send you and compare those statements against the EOBs (Explanation of Benefits) from your health plan administrator.
As a member you will need to satisfy any deductible or co-payments you may have but beyond that any over billing can be reported to Fairos for resolution. We make it easy to submit those over billings through our portal or email. You can login or signup for an account today.
Your providers should always refer to and call the provider number on your insurance card. That number will connect your provider directly to someone who can explain your health plan, confirm your eligibility or quote benefits for your upcoming visits.
Fairos works closely with a number of TPAs who may administer your health plan. There are times Fairos will be engaged via a warm-transfer from your TPA as Fairos holds the relationships with providers. We are here to help you on your journey.
When visiting a provider your health plan will typically include both a deductible as well as a co-payment for office services.
A deductible is a dollar amount where you, as an enrolled member, have to satisfy a defined dollar amount before plan benefits begin to pay.
A co-payment is a fixed dollar amount attached to a particular service. (ie. a $30 co-pay for an annual physician check-up).
These dollar amounts and any plan specifics can be confirmed through your administrator by calling the member services phone number on your ID card or logging into your health plan portal.
If you are asked to payment amounts beyond your member responsibility as stated above please contact your administrator and you will be connected to the Fairos Care Navigation team who works directly with you and providers ensuring access to care.
Some health plans choose to offer a PON aka Physicians Only Network. A PON is a network of physicians contracted directly by your health plan allowing members to have a directory of defined and pre-contracted physicians to choose from. If you plan offers a PON this does NOT prohibit you from continuing to use your existing doctor or choosing a doctor not listed within the PON.
When a PON is offered you can utilize the web address on the front of your ID card as the first place to look when choosing a new doctor.
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