Member FAQ

Member FAQs

For your convenience, we’ve included some of our most frequently asked member questions. Click the questions below to see the answers.

I have a question regarding my claim(s). Who should I contact?

Contact Nova’s Customer Service Department:

  • Medical, Dental and Vision related questions: (716) 773-2122 or toll-free at 1-800-999-5703.
  • FSA and HRA related questions: (716) 505-8509 or toll-free at 1-800-264-9115.

 

What is a Preferred Provider Organization (PPO) and how does it benefit me?

A Preferred Provider Organization, often referred to as a PPO Network, is a group of participating providers that have agreed to provide comprehensive services at a reasonable cost to you and your employer. These participating providers have agreed to accept fixed fees for services covered under the Plan. These rates are often much lower than the provider’s standard charges. Generally, the plans cover a higher percentage of the allowable charges at a PPO Provider than a non-PPO provider to encourage in-network utilization.

How do I find a PPO Participating Provider?

You can access the PPO network directories here. It is your responsibility to confirm participation in the network by contacting the provider. It is recommended to call the provider directly prior to receiving services.

You can also find out if your doctor or dentist is participating in one of the following ways:

  • Call the toll-free number for your network that appears on your Nova ID card.
  • Contact Nova’s Customer Service Department at (716) 773-2122 or 1-800-999-5703.

 

What can I do if my provider is not in my primary network?
  • You can visit providers who do not participate in the network; however, you may be billed for out-of-pocket expenses above the plan allowable amount and any deductible or coinsurance amounts as defined by your plan.
  • If you would like the network to attempt to recruit your provider to participate in the network, please contact the network at the number listed on your ID card.
Where can I locate information about my specific plan benefits?

Please refer to your Summary Plan Description or contact Nova’s Customer Service Department at (716) 773-2122 or 1-800-999-5703.

How do I order an ID card?

You can request an ID card through Nova’s secure Consumer Information Center. Sign in here. You may also request an ID card by contacting Nova’s Customer Service Department at (716) 773-2122 or 1-800-999-5703.