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• Accessibility. You want your doctor to be available when needed. Ask
about office hours, how long it takes to schedule a visit and how patients’
after-hours needs are handled. Some providers offer extended hours.
Contact your clinic for more information.
• The doctor’s approach to preventive medicine. You want a doctor who
emphasizes staying healthy. A good indicator of this is if the doctor asks
about your eating habits, exercise routines, alcohol or tobacco use or any
other health risk factors.
• Reassure your self: Check out a doctor’s qualifications. Do you want
more information about the qualifications of a primary or specialty
provider, such as medical school attended, residency completed, or board
certifications? Use the following resources:
o American Board of Medical Specialists at 1-866-275-2267 or
www.abms.org
o Minnesota Board of Medical Practice at 612-617-2130 or
www.minnesotamedicalboard.com
o North Dakota Board of Medical Practice at 701-328-6500 or
www.ndbomex.com
o South Dakota Board of Medical Practice at 605-367-7781 or
www.sdbmoe.gov
The network providers listed in this directory have agreed to provide you with
your health care coverage. You may go to any of our network providers listed in
this directory. If you have been going to one network provider, you are not
required to continue going to that same provider. In some cases, you may get
covered services from non-network providers.
If you go to a provider outside of the Medica Prime Solution® network who
accepts Medicare patients, you’re covered under Original Medicare. You would
pay the Part A and Part B deductibles and coinsurance, except if you receive
emergency or urgently needed services.
Medica Prime Solution does not require members or their providers to obtain a
referral or authorization from our plan as a condition for covering medically
necessary services that are covered by our plan. If you have any questions about
whether we will pay for any medical service or care that you are considering, you
have the right to ask us whether we will cover it before you get the service or
care.
Emergency Services
Emergency care can always be obtained in or out of the service area from the
nearest available provider. When you have a “medical emergency,” you believe
that your health is in serious danger or your health could be seriously harmed if
you do not receive medical care immediately. A medical emergency can include
severe pain, a bad injury, a sudden illness, or a medical condition that is quickly
getting much worse.