Urgent and Primary Care for Baylor Scott & White Employees

BSW Employee Plan Care at Z-2-H

When you or a family member needs medical attention, understanding where to receive care should not add more stress to your day. Baylor Scott & White employees may be able to receive convenient urgent and primary care through Z-2-H Family Med & Urgent Care Clinic.

Z-2-H provides thoughtful, personalized care for everyday illnesses, minor injuries, preventive needs, and ongoing health concerns. Visit the Z-2-H website to learn more about available services, or call (469) 283-0076 if you need help before scheduling.

Understanding Your Baylor Scott & White Employee Benefits

The Baylor Scott & White Employee Plan includes four primary plan types:

• SEQA Plan
• EQA Plan
• PPO Plan
• HDHP Plan

All four plans include eligible preventive care at no cost when plan requirements are met.

The SEQA and EQA plans use the BSW Premier HMO network as their first level of coverage. The PPO and HDHP plans may have different deductibles and cost-sharing amounts based on the provider’s network tier.

Before scheduling, review the Baylor Scott & White insurance page and have your current member ID card available.

SEQA and EQA Copays

For participating Tier 1 providers, the available plan information lists the following visit costs:

SEQA Plan

• Primary care visit: $10 copay
• Specialist visit: $40 copay

EQA Plan

• Primary care visit: $30 copay
• Specialist visit: $50 copay

The amount due for an urgent care visit may differ from the listed primary care or specialist copay. Your final responsibility depends on the type of service, provider network, medical care performed, and your individual benefits.

PPO and HDHP members may be responsible for a deductible, copay, coinsurance, or a combination of these amounts. Confirming your benefits before your appointment can help you better understand what to expect.

Care for Everyday Health Needs

Z-2-H helps patients receive care for a range of non-emergency health concerns. Depending on your symptoms and the provider’s clinical evaluation, the medical team may be able to assist with:

• Colds, flu symptoms, coughs, and sore throats
• Fever, congestion, and seasonal allergies
• Minor illnesses and injuries
• Routine checkups and preventive care
• Physicals and ongoing health concerns
• Urinary symptoms
• Minor skin conditions
• Allergy testing and treatment
• Weight-management care
• STD testing
• Hormone treatment
• IV therapy when clinically appropriate

Your provider will evaluate your symptoms and recommend the appropriate next step. Additional testing, treatment, or specialty care may be recommended based on your individual medical needs.

Z-2-H is not a replacement for emergency medical care. Call 911 or visit the nearest emergency room for severe chest pain, significant difficulty breathing, signs of a stroke, uncontrolled bleeding, loss of consciousness, or another life-threatening concern.

What Will Your Visit Cost?

Your financial responsibility depends on your plan, provider network, remaining deductible, and the services performed during your appointment.

Z-2-H can collect your insurance information and request benefit verification, but Baylor Scott & White Health Plan makes the final determination regarding eligibility, covered services, and claim payment. A benefit quote or cost estimate does not guarantee that every service will be covered.

For benefit and claim-status questions, contact Baylor Scott & White Health Plan Customer Service at (844) 843-3229, visit the BSW Health Plan member portal, or use the MyBSWHealth app.

Prior Authorization and Claim Information

When prior authorization is required, healthcare providers can use the BSW Health Plan provider portal, call (866) 384-3488, or fax the request to (800) 626-3042.

Electronic claims may be submitted through Availity using Payor ID 94999. Mailed claims should be sent to:

Baylor Scott & White Health Plan
Attn: Claims
P.O. Box 211342
Eagan, MN 55121-1342

Patients generally do not need to submit claims themselves when the healthcare provider files the claim.

Finding an In-Network Provider

The SEQA and EQA plans use the BSW Premier HMO network for Tier 1 care. PPO and HDHP members may have several network levels, with different costs depending on the participating provider selected.

To search for an in-network provider, visit the BSW Health Plan provider directory or contact the BSWQA Care Navigation Team at 1-844-279-7589.

A specialist referral requirement is not listed in the available plan information. Members should confirm referral and authorization requirements with Baylor Scott & White Health Plan before scheduling specialty care.

Schedule Care at a Texas Clinic

Z-2-H serves patients at locations in Arlington, Austin, Brownwood, El Paso, Farmers Branch, Houston, Keller, and San Antonio. Services and appointment availability may vary by clinic.

When you are ready, book a visit online or call (469) 283-0076. Have your current Baylor Scott & White Employee Plan insurance card available when requesting benefit verification.