FAQs
When you first join Ryze our team asks you for your doctors and we proactively contract with them and their practices.
As a member of Ryze, when you need to see a new provider,
you start by contacting the Smart Care Navigator - your 24/7 health concierge.
They will schedule your appointment for you.
At the same time in the background our team will work to directly with your doctor.
As long as they take insurance we can contract with the provider so that when you arrive they will already be in Ryze’s network.
What if there is a situation where you see a provider directly?
See the sample insurance card and the steps laid out below.
Show card or provide information to provider prior to your visit
Ryze Health will always be your primary network
You will have also have a nationwide network provided by Cigna or BlueCross Blue Shield. You will have one or the other but not both.
EDI (Electronic Data Interchange) number is needed to to check with Cigna/BCBS clearing houses.
The provider can also call us directly for eligbility and coverage
Ryze is accepted at over 90% of providers and hospitals across the nation so you can see your existing doctor and feel at ease when you travel cross country. Ryze direct network: Ryze is building out our direct network with practices and hospitals Ryze nationwide network: Ryze utilizes Blue Cross Blue Shield and Cigna for our extended network (in network). Your ID card will indicate the nationwide network you are on.
The only scenarios where you would be out of network
The provider does not take any form of insurance
The provider does not take Blue Cross Blue Shield or Cigna
The provider is unwilling to contract directly with Ryze
No you will have one of the two networks based on which has the stronger network in your home location. Ryze network will always be the primary network
Ryze is private insurance which is the majority of coverage in the US. Both hospitals and independent practices are used to taking private insurance. As a champion of private practice, Ryze pays a higher reimbursement rate to independent providers than other insurances which creates a strong incentive to contract with Ryze. Faster payment. You get paid in days vs weeks or months.
Yes you can go to local pharmacies as they are on a common network. This includes all the big pharmacy chains such as Walgreens and CVS as well as your independent pharmacies. Members have access to a live search function in your member portal.
We use preferred mail order partners and leverage advocacy programs such as 403B plans and direct manufacturer partnerships to lower costs for members.
Ryze has large group and hospital labs in network.
As champions of independent providers we actively incentivize patients go to go independent labs. If you have a preferred independent lab please call the support number on your membership card so that we can check eligibility.
Dental and vision insurance only covers routine check ups, glasses/contacts, teeth cleaning, orthonditics and endodontics.
We don’t recommend this type of coverage because these routine costs are low enough that it is more beneficial to save the money and pay directly out of pocket rather than pay a company to hold and administer your own money.
However, Ryze does cover medical dental and medical vision as part of your health insurance.
These vision and dental services are not covered
For normal dental care benefits, including any dental, gum treatments, or oral surgery,
except as otherwise specifically provided herein.
Vision Care. Expenses for the following are not covered:
1. For eye refractions, eyeglasses, contact lenses, or the vision examination for prescribing or fitting
eyeglasses or contact lenses (except for aphakic patients, and soft lenses or sclera shells
intended for use in the treatment of Illness or Injury).
2. For refractive procedures or other plastic surgeries to correct vision in lieu of eyeglasses.
3. Vision therapy (orthoptics) and supplies.
4. Orthokeratology lenses for reshaping the cornea of the eye to improve vision.