Norton Healthcare Direct is available to answer your questions over the phone, in person and online. For our most frequently asked questions, find answers on this page about your health care benefits 24 hours a day.
All health care benefits are listed in your Summary Plan document.
For other questions, contact Norton Healthcare Direct member services, available Monday through Friday from 8 a.m. to 6 p.m. Eastern time, by:
Local: (812) 245-5000
Toll-Free: (866) 370-7446
TTY: Dial Relay Indiana at 711 or (800) 743-3333, ext. 711. Give the operator either number listed above and you will be connected to a member service representative for a conference call.
Norton Healthcare DirectP.O. Box 1967Columbus, IN 47202-1787
Check your Summary Plan document for specific information for your health plan. Your Norton Healthcare Direct provider should file your claim directly with SIHO Insurance Services. However, if it becomes necessary for you to file the claim yourself, send it to:
Norton Healthcare Direct P.O. Box 1787 Columbus, IN 47202-1787
File a claim
Claims should be submitted to the plan administrator (SIHO Insurance Services) within 90 days. Please check your Summary Plan document for specific time limits on filing claims.
A provider has billed me. How do I know how much of the bill to pay?
You can find information about your part of the bill in the explanation of benefits. For more information, check your Summary Plan document.
Your plan sets a specific dollar amount of health care costs that you are responsible to pay during a calendar year before any covered charges can be considered for payment by your health plan. That dollar amount is called the deductible. Check the schedule of medical benefits in your Summary Plan document for specific plan amounts and more details about your deductible.
A copayment (or copay) is the amount you pay out of pocket in the doctor’s office on the day that you receive health care services. You pay either a specific dollar amount per visit, or a percentage of covered charges. You can find your copay information in the schedule of benefits.
The out-of-pocket maximum is the dollar amount of a deductible and/or coinsurance expense paid by a covered person and/or family for covered services in a benefit period, usually one year. After you reach your out-of-pocket limit, your plan covers 100% of the eligible charges for the remainder of the benefit period unless specified by your health plan. Check your Summary Plan document for details.
Your Summary Plan document lists the definition in detail. Coordination of Benefits, or COB, applies when you are covered by multiple health plans at the same time. Under one plan you will be designated as a primary member and benefits will be applied first. The second plan will coordinate with the first for any other possible payment.
You received a Coordination of Benefits Questionnaire because we have missing or outdated information, which indicates you may be eligible for more than one insurance coverage. Please fill out the questionnaire and return to:
Norton Healthcare Direct COB Coordinator P.O. Box 1967 Columbus, IN 47202-1787
Check your Summary Plan document for specific information regarding your rights to appeal and the process for appeals. Any appeals should be sent in writing to:
Norton Healthcare Direct Appeals Coordinator P.O. Box 1967 Columbus, IN 47202-1787
Search the provider directory to find providers in the Norton Healthcare Direct network.
If you use a provider in the Norton Healthcare Direct network, your provider will be responsible for filing the claim on your behalf and will directly receive payment from us for covered services. In most cases, you will pay less for care, because you are only responsible for deductibles, coinsurance or copayments. If you utilize a non-network provider, you may be subject to balance billing for any outstanding amount. Check your Summary Plan document for more information. Find network providers on the Norton Healthcare Direct provider directory.
Your primary care provider acts as your first stop for annual well visits and routine care. This provider can help coordinate other care you may need, such as a specialist office visit, or hospital inpatient or outpatient services. Check the provider directory for a list of primary care providers in the Norton Healthcare Direct network.
You can choose your provider on your initial enrollment form. If you need to change your current primary care provider, you have several options:
Select your provider from the provider directory, OR
Call Norton Healthcare Direct member services at the phone number listed on the back of your card, OR
Notify us in writing of the change and the effective date of the change.
You will receive a new ID card with your primary care provider listed on the card. Notifying us of your primary care provider is only needed if your health plan requires you to pick a primary care provider. See your Summary Plan document for details.
It is likely to be more expensive to use an out-of-network provider. You can do so, but depending on your plan, you may be responsible for all of the cost or a larger part of the cost. Your claim may be processed at a different rate set for out-of-network benefits, or your claim could be denied. See your Summary Plan document for details.
Call 911 or seek medical help immediately to receive care. Within 48 hours of going to the hospital, contact Norton Healthcare Direct to ensure that the highest level of benefits are paid for covered services.
Call Norton Healthcare Direct member services to request an ID card at (812) 245-5000 or (866) 370-7446.
Yes, you will be asked to present your ID card each time you visit a physician’s office, pharmacy or hospital to verify eligibility for health benefits.
What does HIPAA actually do for me as a Norton Healthcare Direct member?
The HIPAA Privacy Rule has created national standards to protect your medical records and other personal health information. It sets boundaries on how health care providers use and release health records, and it gives details of appropriate safeguards that health care providers and others must achieve to protect the privacy of health information. The law sets limits on releasing health information. Only the minimum information or reasonably needed information can be shared. HIPAA rules empower you to make decisions about certain uses and disclosures of your health information. HIPAA generally provides you the right to examine, obtain and review a copy of your own health records, and allows you to request corrections.
See a sample explanation of benefits with a detailed description of each section.
Select an appointment date and time from available spots listed below.