Edge Systems Employee Urgent Care at Z-2-H™

EHN Plan Benefits for Compassionate Texas Care

When you or a family member needs medical attention, knowing where to receive care can make the experience feel less stressful. Z-2-H Family Med & Urgent Care Clinic provides compassionate primary and urgent care at participating Texas clinic locations.

Edge Systems, LLC employees enrolled in the company’s medical plan may have access to participating providers through the EHN Preferred Network. Coverage and member costs depend on current eligibility, network participation, medical necessity, and the services provided.

What Does the Edge Systems Plan Include?

The available Edge Systems plan information lists:

• A $20 copay for primary-care visits

• A $40 copay for specialist visits

These copays can help members prepare for an appointment, but they do not automatically confirm how every service will be processed. Your final responsibility may depend on eligibility, provider participation, prior authorization, laboratory services, medical necessity, and other plan provisions.

Review the Edge Systems insurance information before scheduling. An insurance card does not guarantee coverage or payment.

For scheduling assistance, call Z-2-H at (469) 283-0076.

Can Edge Systems Employees Visit Z-2-H?

Eligible Edge Systems employees and covered family members may visit Z-2-H for primary care, urgent care, preventive services, and many everyday medical concerns.

The clinic can evaluate and treat concerns such as:

• Cold and flu symptoms

• Cough, congestion, or sore throat

• Fever and body aches

• Ear pain or possible ear infections

• Headaches and migraines

• Nausea, vomiting, or diarrhea

• Urinary symptoms

• Minor infections

• Mild allergic reactions

• Rashes and skin concerns

• Minor injuries

• Routine primary-care concerns

• Chronic-condition follow-ups

• Preventive care and physical examinations

Coverage depends on eligibility, plan benefits, network participation, medical necessity, and the services provided.

Call 911 or go to the nearest emergency room for chest pain, severe difficulty breathing, signs of a stroke, fainting, confusion, uncontrolled bleeding, major trauma, or another life-threatening emergency.

Who Administers the Edge Systems Plan?

Cornerstone Preferred Resources, also known as CPR, is listed as the third-party administrator for the Edge Systems medical plan.

Cornerstone and the associated plan resources can assist with:

• Member eligibility

• Benefit verification

• Prior-authorization requirements

• Claim-status questions

• Copays and cost-sharing information

• Provider-network participation

• General plan questions

Because benefits can change, members should also review the telephone numbers and instructions printed on their current insurance cards.

How Do I Verify Benefits or Claims?

For benefit questions, claim-status assistance, or other plan information, contact EHN at (800) 278-0703 or visit the CPR Provider Portal.

Before scheduling an appointment, consider asking:

• Does Z-2-H participate with my specific Edge Systems plan?

• Is the requested medical service covered?

• Will the $20 primary-care copay apply?

• What deductible or coinsurance might apply?

• Does the service require prior authorization?

• Are laboratory services billed separately?

• Are there location or network restrictions?

• Will I have a time-of-service responsibility?

Ask the representative for a reference number and keep it with your records. Final coverage and financial responsibility are determined when the plan processes the claim.

Is Prior Authorization Required?

Prior-authorization requirements depend on the medical service being requested.

For prior-authorization assistance, call (888) 508-7615 or visit the MedWatch Portal. Members should confirm authorization requirements before receiving services that may need advance approval.

Receiving prior authorization does not guarantee claim payment. Eligibility, medical necessity, network participation, and other plan provisions may still apply.

What Provider Network Does the Plan Use?

The Edge Systems plan uses the EHN Preferred Network. This network includes Baylor Scott & White Quality Alliance providers who have elected to participate.

Not every Baylor Scott & White Quality Alliance provider participates in this particular network. Members should verify that their preferred Z-2-H clinic and requested service participate before receiving care.

To locate or confirm an in-network provider:

• Visit the EHN Member Portal

• Contact BSWQA Care Navigation at 1-844-279-7589

• Call the member-services telephone number on your insurance card

Provide the Edge Systems employer name, your member identification number, the clinic name, and the requested service when confirming participation.

Are Specialist Referrals Required?

The available Edge Systems plan information does not identify a standard specialist-referral requirement.

Referral and prior-authorization requirements can vary according to the requested service. Even when a referral is not required, certain specialist visits, procedures, imaging, or treatments may need advance approval. Contact Cornerstone before beginning specialist care to confirm your plan’s current requirements.

What Should I Bring to My Appointment?

Please bring or prepare:

• Your Edge Systems insurance card

• A photo identification card

• A current medication list

• Known medication or food allergies

• Relevant medical records

• Recent laboratory or imaging results

• Any referral or authorization documents

• A brief description of your symptoms

• The date your symptoms began

• Your preferred pharmacy information

Providing accurate insurance and medical information can help prevent delays with eligibility verification and appointment preparation.

Claims Information for Providers

Edge Systems claims use the following submission information:

Electronic claims: Payor ID IHS07

Mailed claims:

Employers Health Network/SmartCare
P.O. Box 507
Arnold, MD 21012

Providers should verify the member’s eligibility, insurance-card information, and current claim-submission instructions before sending a claim.

Compassionate Primary and Urgent Care in Texas

Z-2-H works to make primary and urgent care easier to access and understand. Whether you need help with a sudden illness, a minor injury, preventive care, or an ongoing health concern, our medical team will listen and help you understand the appropriate next step.

You can Book an Appointment to select an eligible clinic location. When you are ready, Book Today or call (469) 283-0076.

Please have your Edge Systems insurance card available so your benefits and network participation can be reviewed before your visit.