Provider and Pharmacy Network

The Provider and Pharmacy Directory is a list of the providers and pharmacies in the RiverSpring FIDA Plan network. While you are a Participant of our plan, you must use network providers, with some exceptions, to get covered services.

For more information about the directory, you can call Participant Services at 1-800-950-9600, or you are welcome to call your Nurse Care manager to provide assistance in identifying a provider who meets your needs and preferences, including any special accommodations that you may not see on the directory.

Provider and Pharmacy Directory

How to get care from out-of-network providers

Out-of-network providers are providers that are not in the RiverSpring FIDA Plan network. If you need care that our plan covers and our network providers cannot give it to you, you can get permission from RiverSpring FIDA Plan or your IDT to get the care from an out-of-network provider. Contact Participant Services at 1-800-950-9000, 7 days a week, 8 a.m. to 8 p.m. Eastern Time.

When you first join the plan, you can continue to see your existing providers that are out-of-network during a transition period of 90 days or until your Person-Centered Service Plan is finalized and implemented, whichever is later. Our Care Manager will help you find and switch to providers that are in our network. After the transition period, we will no longer pay for services by out-of-network providers, unless RiverSpring FIDA Plan or your IDT has authorized you to continue to see the out-of-network provider.

–Please note: If you need to go to an out-of-network provider, please work with RiverSpring FIDA Plan or your IDT to get approval to see an out-of-network provider and to find one that meets applicable Medicare or Medicaid requirements. If you go to an out-of-network provider without first getting Plan or IDT approval, you may have to pay the full cost of the services you get.

 Getting Care During a State of Disaster or Emergency

 If the Governor of your state, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in your geographic area, you are still entitled to care from RiverSpring Health.

During a declared disaster, we will allow you to get your care from out-of-network providers, including pharmacies, at no cost to you.

What to do if you receive a bill from a Provider or Pharmacy

Providers should only bill RiverSpring for the cost of your covered services and items. If you receive a bill from a provider, you should send it to us to pay.

Providers should only bill RiverSpring for the cost of your covered services and items. If you receive a bill from a provider, you should send it to us to pay.

If you have any questions, please call Participant Services at 1-800-950-9000 (TTY 711) 7 days a week from 8 a.m. to 8 p.m. EST.

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This page was last updated on June 6, 2018 09:30:00 EST