Is Sparrow responsible for paying claims?

SPHN does not process or pay claims. Please refer to the telephone number on your benefit plan card for the appropriate contact number of your insurer or third party administrator.

How do I determine my eligibility and coverage levels?

SPHN is a provider network and does not determine eligibility or benefit levels. Your insurance plan determines which services are covered and at what levels. The phone number for your insurance plan should be located on your benefit plan card. Otherwise, the best way to find answers to your questions is usually to contact your employer's human resources office.

As an SPHN member, must I use only physicians and hospitals participating in the Network?

It depends upon how your employer's health plan is structured. Most health plans provide you with better benefit coverage by using SPHN providers. However, if you choose a non-participating provider, your benefits may be lower, so you may pay a larger portion of the cost. For specific information on your out-of-network benefit, please refer to your benefit plan card for the appropriate contact number of your insurer or third party administrator.

What is my coverage when I am outside the SPHN service area?

The specific eligibility rules vary based upon the plan your employer is providing you. Please refer to the telephone number on your benefit plan card for the appropriate contact number of your insurer or third party administrator.

My child is attending college outside of the SPHN service area. Will this result in any coverage problems?

SPHN is a provider network and does not determine eligibility or benefit levels. Your insurance plan would determine what would happen in this specific circumstance. The phone number for your insurance plan should be located on your benefit plan card. Otherwise, the best way to find answers to your questions is usually to contact your employer's human resources office.