If you need immediate care or need care when your usual provider is closed, and your situation is not a medical emergency, you may use urgent care facilities to receive care at a lower cost than an emergency room. You do not pay the emergency room copay for urgent care services. These services are paid at the standard rate, according to the provider’s network status. Visit the UMP Provider search to find preferred urgent care facilities (see Directory for link). Virtual care Telemedicine services Telemedicine is the delivery of health care services through audio and visual technology, allowing real- time communication between the member at the originating site and a provider for the purpose of diagnosis, consultation, or treatment. Telemedicine includes audio-only telemedicine. Telemedicine does not include the use of fax or email. “Store and forward technology” is a term used for the transfer of a member’s medical information from one health care provider to another at a distant site, which results in medical diagnosis and management of the covered person. The purpose of telemedicine and store and forward technology is diagnosis, consultation, or treatment of the member. It does not include the use of fax or email. If you see a network provider, telemedicine services are paid at the network rate. If you see an out-of- network provider, telemedicine services are paid at the out-of-network rate. The plan covers store and forward technology and telemedicine from authorized originating sites under the medical benefit if: • The plan provides coverage for the service when provided in person by the provider; • The service is medically necessary; • The service is determined to be safely and effectively provided through telemedicine or store and forward technology according to generally accepted health care practices and standards; • The technology used to provide the service meets the standards required by state and federal laws governing the privacy and security of protected health information; and • The service is recognized as an essential health benefit under section 1302(b) of the federal Patient Protection and Affordable Care Act (PPACA) in effect on January 1, 2015. If services are provided through store and forward technology, there must be an associated office visit between the covered person and the referring health care provider. The associated office visit may be in person or via telemedicine. For audio-only telemedicine, the member must have an established relationship with the provider. The originating site (the member’s physical location) for telemedicine services must be one of the following sites: • Community mental health center • Federally qualified health center • Home or any location determined by the individual receiving the service • Hospital • Physician's or other health care provider's office • Renal dialysis center (except independent renal dialysis center) • Rural health clinic • Skilled nursing facility 76 2024 UMP Select (PEBB) Certificate of Coverage