Online Directory Assistance

Size: px
Start display at page:

Download "Online Directory Assistance"

Transcription

1 P ROVI DR SCARE R Online Directory Assistance 1102 S Hillside Wichita KS Toll Free (800) Local (316) Fax (316) CustomerService@ProviDRsCare.Net

2 Online Directory PROVIDRSCARE For your convenience, there are several links available to direct you to our webpage for directory searches. Please click any of these links.

3 Online Directory PR To find a participating network provider, please select MEMBERS from the drop-down list. To find a CORE NETWORK provider (if enrolled), please select your employer from the drop-down list.

4 Directory Login Enter your Group Number PR Our online directory requires your Group Number in order to utilize the provider search engine. Please reference your Insurance ID Card to locate your Group Number. Enter your Group Number in the box show to the right and click Submit.

5 Directory Layout Multiple Search Options Available PR Once logged in with your Group Number, there are many features available to meet your needs. Each feature will be addressed throughout this booklet (i.e. Name Search, Radius Search, Custom Directories).

6 Facilities and Providers PR To search the directory by name, either the Provider Name Search or the Facility Name Search pages can be used. Please reference the list below to determine which search best suits your needs. The Facility Name Search page includes: Ambulance Ambulatory Surgery Center Breast Prosthetics and Supplies Diabetic Medical Supplies/Insulin Pumps Durable Medical Equipment Free Standing Emergency Room Health Department Home Cardiac Monitoring Home Health Home Infusion Hospice Hospital Laboratory/Specialty Laboratory Outpatient Dialysis Facility Outpatient Mental Health Facility Outpatient Radiological Facility Outpatient Rehabilitation Center Outpatient Sleep Center Outpatient Substance Abuse Treatment Outpatient Therapy Clinic Residential Treatment Facility Specialty Pharmacy Walk-in Clinic The Provider Name Search page includes: Advanced Registered Nurse Practitioner Audiologist Certified Registered Nurse Chiropractor Counselor Occupational Therapist Optometrist Physical Therapist Physician Physician Assistant Psychiatrist Psychologist Speech Language Pathologist

7 PR Search Type - Physician Last Name: When searching by Physician Last Name, only the Physician last Name field is required. The First Name, City and State fields are optional and do not need to be populated in order to run your search. Once you have entered your criteria, click the Submit button to view your results. (The first and last name fields only require partial matches. For example, if you are searching for Ackerman, you only need to enter a portion of the name, such as Ack. The search results will return any matches that have Ack in the name.) Search Type - Practice Name: When searching by Practice Name, only the Practice Name field is required. The City and State fields are optional and do not need to be populated in order to run your search. Once you have entered your criteria, click the Submit button to view your results. (The practice name field only requires partial matches. For example, if you are searching for Via Christi Clinic, PA, you only need to enter a portion of the name, such as Via Christi. The search results will return any matches that have Via Christi in the practice name.) Search Type - Specialty: When searching by Specialty, only the Specialty field is required. The City and State fields are optional and do not need to be populated in order to run your search. Once you have entered your criteria, click the Submit button to view your results.

8 PR Search Type - Facility Name: When searching by Facility & Ancillary Name, only the Facility & Ancillary Name field is required. The City and State fields are optional and do not need to be populated in order to run your search. Once you have entered your criteria, click the Submit button to view your results. (The name entered only needs to be a partial match. For example, if you are searching for Wesley Medical Center, you only need to enter a portion of the name, such as Wesley. The search results will return any matches that have Wesley in the name. ) Search Type - Specialty: When searching by Specialty, only the Type field is required. The City and State fields are optional and do not need to be populated in order to run your search. Select the specialty from the Type field. Once you have entered your criteria, click the Submit button to view your results.

9 PR Radius Search Provider Radius Searches include both individual providers and facilities. When performing a Provider Provider Radius Radius Search, the Zip Code, Radius and Specialty fields are required in order to run your search. If you do not want to narrow your search by specialty, scroll to the top of the Specialty list and select All Specialties before running your search. Once you have entered your criteria, click the Submit button to view your results.

10 PR Directory Type - Radius: When creating a custom directory based on Radius, the Zip Code, Radius and Specialty fields are required. If you do not want to narrow your search by specialty, select All Specialties. Once you have entered your criteria, click the Submit button to view your directory. Directory Type - Statewide: When creating a custom statewide directory, the State and Specialty fields are required. If you do not want to narrow your search by specialty, select All Specialties. Once you have entered your criteria, click the Submit button to view your directory.

11 PR Search Results Search results will appear within a grid using alternate row colors to separate each result. Within each result, the provider/facility name, specialty/type, address, phone and network name will appear. When performing radius searches, an additional column will show the distance in miles from the zip code entered. All search results will include a MAP button. This button will display the map for the selected provider using Google Maps. Populated with Provider or Facility Name Populated with Provider Specialty or Facility Type Populated with Location Name address, city, state and zip code. Populated with Location Telephone Number Populated with PPO Network Designation Distance in miles from zip code Map

12 Directory Results PR Directory results will appear within an embedded pdf document. The first page will be your directory cover sheet that includes the report criteria you selected. Place your cursor over the directory in order to force the pdf control box to appear. You can use the control box to save or print your directory, scroll through the pages and zoom in or out.

13 Directory PDF Control Box PR An explanation of the buttons within the pdf control box have been provided below for your convenience. The control box can vary depending on the settings on your computer or the program you utilize to view online pdf documents. These tips have been provided for users who utilize Adobe Reader X (Version ) to view online pdf documents. Show Adobe Toolbar Zoom In Zoom Out Total Pages Jump to a specific page Next Page Previous Page Print Save a Copy

14 P R VI R Customer Service If you experience difficulty utilizing our online directory, please contact our Customer Service Department at (800) or (316) You can dial Option 4 followed by Option 3. O DR SCARE 1102 S Hillside Wichita KS Toll Free (800) Local (316) Fax (316) CustomerService@ProviDRsCare.Net

Business-Facts: Healthcare NAICS Summary 2015

Business-Facts: Healthcare NAICS Summary 2015 Business-Facts: Healthcare Summary 5 Radius : 9444 WAPLES ST, SAN DIEGO, CA 9-99,. -. Miles, 6 Healthcare and Social Assistance 8,694 59.9 6 Offices of Physicians (except Mental Health Specialists) 56

More information

Benefit Plan Comparison*

Benefit Plan Comparison* Benefit Plan Comparison* Services Category 1: Ambulatory Services Primary Care Provider No Limits No Limits No Limits Physician Office 4 visits per calendar year Certified Registered Nurse Practitioner

More information

Benefit Plan Comparison*

Benefit Plan Comparison* Benefit Plan Comparison* Services Category 1: Ambulatory Services Primary Care Provider Physician Office Certified Registered Nurse Practitioner Federally Qualified Health Center/Rural Health Clinic except

More information

Coventry Health and Life Insurance Company PPO Schedule of Benefits

Coventry Health and Life Insurance Company PPO Schedule of Benefits State(s) of Issue: Oklahoma PPO Plan: OI08C30050 30 Coventry Health and Life Insurance Company PPO Schedule of Benefits Covered Services Contract Year Deductible For All Eligible Expenses (unless otherwise

More information

PREVENTIVE CARE See the REHP Benefits Handbook for a list of preventive benefits* MATERNITY SERVICES Office visits Covered in full including first

PREVENTIVE CARE See the REHP Benefits Handbook for a list of preventive benefits* MATERNITY SERVICES Office visits Covered in full including first Network Providers Non Network Providers** DEDUCTIBLE (Per Calendar Year) None $250 per person $500 per family OUT-OF-POCKET MAXIMUM (When the out-of-pocket maximum is reached, benefits are paid at 100%

More information

Benefit Plan Comparison* Services Category 1: Ambulatory Services Primary Care Provider Physician Office Certified Registered Nurse Practitioner Federally Qualified Health Center/Rural Health Clinic except

More information

Cost Sharing Definitions

Cost Sharing Definitions SU Pro ( and ) Annual Deductible 1 Coinsurance Cost Sharing Definitions $200 per individual with a maximum of $400 for a family 5% of allowable amount for inpatient hospitalization - or - 50% of allowable

More information

Facility Classification

Facility Classification Facility Classification Facility Enrollment Required Document Checklist To avoid processing delays gather these items before you get started. If applying to network, complete the application signature

More information

Provider Additions and Maintenance

Provider Additions and Maintenance Working with Anthem Subject Specific Webinar Series Provider Additions and Maintenance Access to Audio Portion of Conference: Dial-In Number: 877-497-8913 Conference Code: 1322819809# Please Mute Your

More information

Facility Enrollment Required Document Checklist

Facility Enrollment Required Document Checklist Facility Enrollment Required Document Checklist Facility Classification Ambulatory Infusion Center (AIC) Ambulatory Surgical Facility (ASF) End Stage Renal Disease Facility (ESRD) - Accreditation Commission

More information

Annual Notice of Changes for 2014

Annual Notice of Changes for 2014 True Blue Rx Option II (HMO) offered by Blue Cross of Idaho Health Service, Inc. (Blue Cross of Idaho) Annual Notice of Changes for 2014 You are currently enrolled as a member of True Blue Freedom (HMO).

More information

$250 copay per admit. $250 copay per admit

$250 copay per admit. $250 copay per admit BENEFIT IN- NETWORK OUT- OF- NETWORK Deductible NONE NONE Out- of- Pocket Maximum $6,350 Single/ $12,700 Family NONE HOSPITAL INPATIENT FACILITY - NON MATERNITY Medical/Surgical Skilled Nursing Facility

More information

SISC Custom SaveNet Zero Admit 10 Benefit Summary (Uniform Health Plan Benefits and Coverage Matrix)

SISC Custom SaveNet Zero Admit 10 Benefit Summary (Uniform Health Plan Benefits and Coverage Matrix) SISC Custom SaveNet Zero Admit 10 Benefit Summary (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Highlights: A description of the prescription drug coverage is provided separately

More information

CYE09 RFP Minimum Network Standards Excel Spreadsheet Instructions

CYE09 RFP Minimum Network Standards Excel Spreadsheet Instructions TABLE of CONTENTS CYE09 RFP Minimum Network Standards Excel Spreadsheet Instructions Definition of Terms... Introduction/Overview... Attachment 1 Provider Types Requiring NPI.... Attachment 2 Service Provider

More information

FLORIDA BLUE HOSPITAL, ANCILLARY FACILITY AND SUPPLIER BUSINESS APPLICATION. Facility Name: Legal Name (if different from above):

FLORIDA BLUE HOSPITAL, ANCILLARY FACILITY AND SUPPLIER BUSINESS APPLICATION. Facility Name: Legal Name (if different from above): FLORIDA BLUE HOSPITAL, ANCILLARY FACILITY AND SUPPLIER BUSINESS APPLICATION Florida Blue Provider Number: Facility Name: Legal Name (if different from above): Facility Physical Address: City: State: Zip

More information

Provider Network Adequacy Instructions

Provider Network Adequacy Instructions Provider Network Adequacy Instructions Table of Contents Regulatory Overview...1 Creating an Account under the MDH Provider Network Adequacy (PNA) System...2 Provider Network Adequacy Recertification Requirements...2

More information

User Guide. e-referral on the iexchange System

User Guide. e-referral on the iexchange System User Guide e-referral on the iexchange System ereferrals.bcbsm.com April 2010 Dear Blue Care Network Health Care Service Provider: Welcome to e-referral on iexchange, BCN s Web-based referral and authorization

More information

UnitedHealthcare Insurance Company of the River Valley Attachment D - Schedule of Benefits

UnitedHealthcare Insurance Company of the River Valley Attachment D - Schedule of Benefits UnitedHealthcare Insurance Company of the River Valley Attachment D - Schedule of Benefits Please refer to your Provider Directory for listings of Participating Physicians, Hospitals, and other Providers.

More information

Essentials Choice Rx 24 (HMO-POS) offered by PacificSource Medicare

Essentials Choice Rx 24 (HMO-POS) offered by PacificSource Medicare Essentials Choice Rx 24 (HMO-POS) offered by PacificSource Medicare Annual Notice of Changes for 2016 You are currently enrolled as a member of Essentials Choice Rx 24 (HMO-POS). Next year, there will

More information

National Quality Management

National Quality Management National Quality Management National Approval Date: Effective Date: 02/24/2015 Subject Practitioner and Provider Availability: Network Composition and Contracting Plan Originating Dept. National Quality

More information

StaffingForce direct and interim staffing services are available throughout the U.S. and in 45 other countries on six continents.

StaffingForce direct and interim staffing services are available throughout the U.S. and in 45 other countries on six continents. StaffingForce Healthcare Solutions Our search, recruitment and staffing services are specifically designed to reduce your cost per hire while expediting the time it takes to fill your direct and interim

More information

Essentials Choice Rx 25 (HMO-POS) offered by PacificSource Medicare

Essentials Choice Rx 25 (HMO-POS) offered by PacificSource Medicare Essentials Choice Rx 25 (HMO-POS) offered by PacificSource Medicare Annual Notice of Changes for 2016 You are currently enrolled as a member of Essentials Choice Rx 25 (HMO-POS). Next year, there will

More information

Senate Bill 91 (2011) Standard Plan - EHB and Cost Share Matrix - Updated for 2016 ***NOT INTENDED AS A STATEMENT OF COVERAGE***

Senate Bill 91 (2011) Standard Plan - EHB and Cost Share Matrix - Updated for 2016 ***NOT INTENDED AS A STATEMENT OF COVERAGE*** Deductible Medical: $1,250; Medical: $2,500; Integrated Medical/Rx: Rx: $0 Rx: $0 $5,000 Maximum OOP Combined Medical Combined Medical Combined Medical and and Drug: $6,350 and Drug: $6,350 Drug: $6,350

More information

2016 Summary of Benefits

2016 Summary of Benefits 2016 Summary of Benefits Health Net Violet Option 3 (PPO) Douglas and Josephine counties, OR Benefits effective January 1, 2016 H5520 Health Net Life Insurance Company H5520_2016_0202 CMS Accepted 09162015

More information

Retiree Health Care Plan Benefits 2012 Enrollment Guide. Medical Coverage: Pre-Medicare Retirees

Retiree Health Care Plan Benefits 2012 Enrollment Guide. Medical Coverage: Pre-Medicare Retirees Retiree Health Care Plan Benefits 2012 Enrollment Guide Medical Coverage: Pre-Medicare Retirees You ll choose from four medical plans: Basic, Comprehensive, Health Reimbursement Arrangement (HRA) and Health

More information

BadgerCare Plus and Wisconsin Medicaid Covered Services Comparison Chart

BadgerCare Plus and Wisconsin Medicaid Covered Services Comparison Chart and Wisconsin Covered Services Comparison Chart The covered services information in the following chart is provided as general information. Providers should refer to their service-specific publications

More information

Preauthorization Requirements * (as of January 1, 2016)

Preauthorization Requirements * (as of January 1, 2016) OFFICE VISITS Primary Care Office Visits Primary Care Home Visits Specialist Office Visits No Specialist Home Visits PREVENTIVE CARE Well Child Visits and Immunizations Adult Annual Physical Examinations

More information

DC Health Professional Licensing Fees

DC Health Professional Licensing Fees Profession Description of Service Fees Acupuncturist Application Fee (original, temporary, or reinstatement) 85 Acupuncturist License Fee 145 Acupuncturist Re-Examination 119 Acupuncturist Paid Inactive

More information

SUMMARY OF BADGERCARE PLUS BENEFITS

SUMMARY OF BADGERCARE PLUS BENEFITS SUMMARY OF BADGERCARE PLUS BENEFITS Medical, mental health and substance abuse services Dental emergency NOT Pharmacy, chiropractic and dental services NOT 13 Ambulatory surgery centers Coverage of certain

More information

No Charge (Except as described under "Rehabilitation Benefits" and "Speech Therapy Benefits")

No Charge (Except as described under Rehabilitation Benefits and Speech Therapy Benefits) An Independent Licensee of the Blue Shield Association Custom Access+ HMO Plan Certificated & Management Benefit Summary (For groups of 300 and above) (Uniform Health Plan Benefits and Coverage Matrix)

More information

Primary and Acute Medical Services

Primary and Acute Medical Services Primary and Acute Medical Ambulance Medically necessary emergent ground and air ambulance transport. Air (fixed wing and air) ambulance Ground ambulance Chemotherapy Outpatient hospital for radiation therapy

More information

CSAC/EIA Health Small Group Access+ HMO 15-0 Inpatient Benefit Summary

CSAC/EIA Health Small Group Access+ HMO 15-0 Inpatient Benefit Summary CSAC/EIA Health Small Group Access+ HMO 15-0 Inpatient Benefit Summary (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE

More information

Summary of Benefits January 1, 2016 December 31, 2016. FirstMedicare Direct PPO Plus (PPO)

Summary of Benefits January 1, 2016 December 31, 2016. FirstMedicare Direct PPO Plus (PPO) Summary of Benefits January 1, 2016 December 31, 2016 FIRSTCAROLINACARE INSURANCE COMPANY FirstMedicare Direct PPO Plus (PPO) Chatham, Hoke, Lee, Montgomery, Moore, Richmond, Scotland Counties This booklet

More information

TYPE AND SPECIALTY LIST AND DOCUMENTATION REQUIREMENTS FOR PROVIDER PARTICIPATION AGREEMENTS

TYPE AND SPECIALTY LIST AND DOCUMENTATION REQUIREMENTS FOR PROVIDER PARTICIPATION AGREEMENTS New Mexico Medicaid Project 1720-A Randolph Road SE Albuquerque, NM 87106 505-246-9988 505-246-8485 (fax) TYPE AND SPECIALTY LIST AND DOCUMENTATION REQUIREMENTS FOR PROVIDER PARTICIPATION AGREEMENTS Please

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Effective January 1, 2015, through December 31, 2015 H3909 Y0041_H3909_PC_15_18889 Accepted 09/01/2014 Section I: Introduction to Summary of Benefits You have choices about how

More information

HNE Premier 1 (HMO) and HNE Premier 2 (HMO)

HNE Premier 1 (HMO) and HNE Premier 2 (HMO) 2016 Medicare Advantage Summary of Benefits HNE Premier 1 (HMO) and HNE Premier 2 (HMO) January 1, 2016 - December 31, 2016 H8578_2016_429 Accepted HNE MEDICARE ADVANTAGE ENROLLMENT KIT 2016 SECTION I

More information

FIRSTCAROLINACARE INSURANCE COMPANY 2015 Summary of Benefits. FirstMedicare Direct PPO Plus (PPO)

FIRSTCAROLINACARE INSURANCE COMPANY 2015 Summary of Benefits. FirstMedicare Direct PPO Plus (PPO) FIRSTCAROLINACARE INSURANCE COMPANY 2015 Summary of Benefits FirstMedicare Direct PPO Plus (PPO) Chatham, Hoke, Lee, Montgomery, Moore, Richmond, Scotland Counties 1 P age SECTION I - INTRODUCTION TO SUMMARY

More information

welcome to the select care network

welcome to the select care network welcome to the select care network SELECT CARE NETWORK WHAT IS THE SELECT CARE NETWORK? is a carefully tailored network designed to support a suite of commercial plans that EmblemHealth is offering in

More information

Provider Network Participation Policy

Provider Network Participation Policy Participation Policy Blue Cross and Blue Shield of Montana HCS Administrative Policy Version: 8 Original Effective Date: 05/03/2004 Version Effective Date: 09/23/2013 Replaces: N/A Scope This policy applies

More information

Licensed Counselors (LPCC)

Licensed Counselors (LPCC) CREDENTIALING Molina Healthcare of Ohio s credentialing process is designed to meet the standards of the National Committee for Quality Assurance (NCQA). In accordance with those standards, Molina Healthcare

More information

Oregon Health Care Regulatory Agencies

Oregon Health Care Regulatory Agencies Citizen s Guide to Oregon Health Care Regulatory Agencies Prepared by: Oregon State Board of Nursing This is a guide to Oregon health care regulatory agencies. The boards and agencies listed here protect

More information

Summary of Benefits Community Advantage (HMO)

Summary of Benefits Community Advantage (HMO) Summary of Benefits Community Advantage (HMO) January 1, 2015 - December 31, 2015 This booklet gives you a summary of what we cover and what you pay. It doesn't list every service that we cover or list

More information

2015-2016. New England Conservatory. Student Health PPO Plan. Policy Number: SP100104. Underwritten by Tufts Insurance Company.

2015-2016. New England Conservatory. Student Health PPO Plan. Policy Number: SP100104. Underwritten by Tufts Insurance Company. New England Conservatory Student Health PPO Plan Underwritten by Tufts Insurance Company. Policy Number: SP100104 2015-2016 Form Number: 100104-1-1R3 New England Conservatory Health and Counseling Services

More information

Covered Benefits. Covered. Must meet current federal and state guidelines. Abortions. Covered. Allergy Testing. Covered. Audiology. Covered.

Covered Benefits. Covered. Must meet current federal and state guidelines. Abortions. Covered. Allergy Testing. Covered. Audiology. Covered. Covered Benefits Services Abortions Allergy Testing Audiology Birth Control Services Blood & Blood Plasma Bone Mass Measurement (bone density) Case Management Chemotherapy Chiropractor Services (manipulation/subluxation)

More information

Harvard Pilgrim Health Care of New England, Inc. THE HARVARD PILGRIM BEST BUY TIERED COPAYMENT HMO - LP NEW HAMPSHIRE

Harvard Pilgrim Health Care of New England, Inc. THE HARVARD PILGRIM BEST BUY TIERED COPAYMENT HMO - LP NEW HAMPSHIRE ID: MD0000003228_B3 X Schedule of s Harvard Pilgrim Health Care of New England, Inc. THE HARVARD PILGRIM BEST BUY TIERED COPAYMENT HMO - LP NEW HAMPSHIRE Coverage under this Plan is under the jurisdiction

More information

January 1, 2015 December 31, 2015

January 1, 2015 December 31, 2015 BLUESHIELD FOREVER BLUE MEDICARE PPO VALUE AND BLUESHIELD MEDICARE PPO 750 (PPO) (a Medicare Advantage Preferred Provider Organization (PPO) offered by HEALTHNOW NEW YORK INC. with a Medicare contract)

More information

BENEFIT PLAN. What Your Plan Covers and How Benefits are Paid. Appendix A. Prepared Exclusively for The Dow Chemical Company

BENEFIT PLAN. What Your Plan Covers and How Benefits are Paid. Appendix A. Prepared Exclusively for The Dow Chemical Company Appendix A BENEFIT PLAN Prepared Exclusively for The Dow Chemical Company What Your Plan Covers and How Benefits are Paid Choice POS II (MAP Plus Option 2 - High Deductible Health Plan (HDHP) with Prescription

More information

APPENDIX C Description of CHIP Benefits

APPENDIX C Description of CHIP Benefits Inpatient General Acute and Inpatient Rehabilitation Hospital Unlimited. Includes: Hospital-provided physician services Semi-private room and board (or private if medically necessary as certified by attending)

More information

UC Care Plan. Benefit Booklet. University of California. Group Number: W0051612 Plan ID: PPOX0001 Effective Date: January 1, 2016

UC Care Plan. Benefit Booklet. University of California. Group Number: W0051612 Plan ID: PPOX0001 Effective Date: January 1, 2016 UC Care Plan Benefit Booklet University of California Group Number: W0051612 Plan ID: PPOX0001 Effective Date: January 1, 2016 An independent member of the Blue Shield Association Claims Administered by

More information

How To Pay For Health Care Benefits

How To Pay For Health Care Benefits Blue Shield PPO Plan Benefit Booklet Stanford University Group Number: 170292 Effective Date: January 1, 2013 An independent member of the Blue Shield Association Claims Administered by Blue Shield of

More information

Schedule of Benefits HARVARD PILGRIM LAHEY HEALTH VALUE HMO MASSACHUSETTS MEMBER COST SHARING

Schedule of Benefits HARVARD PILGRIM LAHEY HEALTH VALUE HMO MASSACHUSETTS MEMBER COST SHARING Schedule of s HARVARD PILGRIM LAHEY HEALTH VALUE HMO MASSACHUSETTS ID: MD0000003378_ X Please Note: In this plan, Members have access to network benefits only from the providers in the Harvard Pilgrim-Lahey

More information

S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/14-6/30/15

S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/14-6/30/15 S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/14-6/30/15 This information sheet is for reference only. Please refer to Evidence of Coverage requirements, limitations

More information

Effective January 1, 2014 through December 31, 2014

Effective January 1, 2014 through December 31, 2014 Summary of Benefits Effective January 1, 2014 through December 31, 2014 The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.

More information

4123-6-02.2 Provider access to the HPP - provider credentialing criteria.

4123-6-02.2 Provider access to the HPP - provider credentialing criteria. 4123-6-02.2 Provider access to the HPP - provider credentialing criteria. (A) The bureau shall establish minimum credentialing criteria for provider certification. Providers must meet all licensing, certification,

More information

How Premier Members access the Verizon Member Agreement from the Premier website.

How Premier Members access the Verizon Member Agreement from the Premier website. How Premier Members access the Verizon Member Agreement from the Premier website. These instructions are designed to connect your organization to the Verizon Wireless Agreement via the Premier Inc website

More information

Medical Management Requirements Effective January 1, 2008

Medical Management Requirements Effective January 1, 2008 December 1, 2007 Dear Provider and Colleague: Please be advised that effective January 1, 2008, Health Plan will change its Medical Management Policies to include new requirements for prior authorizations

More information

Independence Blue Cross Plan Summary PPO Core Medical Plan

Independence Blue Cross Plan Summary PPO Core Medical Plan TO: FROM: SUBJECT: MLH Medical Plan Participants MLH Human Resources Benefits Team Independence Blue Cross Plan Summary PPO Core Medical Plan Attached you will find the Independence Blue Cross (IBC) Plan

More information

PROVIDER TYPE CODE DESCRIPTION OF PROVIDER TYPE SPECIALITY CODE DESCRIPTION OF PROVIDER SPECIALITY 01 INPATIENT FACILITY 010 ACUTE CARE HOSPITAL 01

PROVIDER TYPE CODE DESCRIPTION OF PROVIDER TYPE SPECIALITY CODE DESCRIPTION OF PROVIDER SPECIALITY 01 INPATIENT FACILITY 010 ACUTE CARE HOSPITAL 01 PROVIDER TYPE CODE DESCRIPTION OF PROVIDER TYPE SPECIALITY CODE DESCRIPTION OF PROVIDER SPECIALITY 01 INPATIENT FACILITY 010 ACUTE CARE HOSPITAL 01 011 PRIVATE PSYCHIATRIC HOSPITAL 01 012 INPATIENT MEDICAL

More information

Anthem Blue Cross Preferred Provider Organization (PPO)

Anthem Blue Cross Preferred Provider Organization (PPO) Anthem Blue Cross Preferred Provider Organization (PPO) 1-877-687-0549 Call Monday through Friday from 8:30 a.m. to 7:00 p.m. Plan Highlights Medical Services at Discounted Rates Anthem Blue Cross has

More information

2015 OPEN ENROLLMENT MEDICAL PLANS

2015 OPEN ENROLLMENT MEDICAL PLANS 2015 OPEN ENROLLMENT MEDICAL PLANS Table of Contents Section I. Enrollment Guidelines Page 3 Health Plan Comparison Chart Page 4 Health Plan Premiums and Employee Cost-Sharing Page 5 Section II. Blue Shield

More information

What Your Plan Covers and How Benefits are Paid BENEFIT PLAN. Prepared Exclusively for Leidos, Inc. Aetna Choice POS II (HDHP) - Advantage Plan

What Your Plan Covers and How Benefits are Paid BENEFIT PLAN. Prepared Exclusively for Leidos, Inc. Aetna Choice POS II (HDHP) - Advantage Plan BENEFIT PLAN Prepared Exclusively for Leidos, Inc. What Your Plan Covers and How Benefits are Paid Aetna Choice POS II (HDHP) - Advantage Plan Table of Contents Schedule of Benefits...1 Preface...18 Coverage

More information

Fidelis Care NY State of Health: The Official Health Plan Marketplace Standard Products

Fidelis Care NY State of Health: The Official Health Plan Marketplace Standard Products PRODUCT INFORMATION Fidelis Care NY State of Health: The Official Health Plan Marketplace Standard Products NY State of Health: The Official Health Plan Marketplace (the Marketplace) is an online insurance

More information

Home Health Services Billing Manual

Home Health Services Billing Manual Home Health Services Billing Manual F245-424-000 (07-2015) Home Health Services Billing Instructions About Billing Instructions... 1 Where can you find help with L&I billing procedures?... 1 About Labor

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Effective January 1, 2015, through December 31, 2015 H3952 Y0041_H3952_KS_15_18734 Accepted 09/01/2014 Section I: Introduction to Summary of Benefits You have choices about how

More information

Anthem Blue Cross Life and Health Insurance Company Your Plan: Solution PPO 1500/15/20 Your Network: Prudent Buyer PPO

Anthem Blue Cross Life and Health Insurance Company Your Plan: Solution PPO 1500/15/20 Your Network: Prudent Buyer PPO Anthem Blue Cross Life and Health Insurance Company Your Plan: Solution PPO 1500/15/20 Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with

More information

[2015] SUMMARY OF BENEFITS H1189_2015SB

[2015] SUMMARY OF BENEFITS H1189_2015SB [2015] SUMMARY OF BENEFITS H1189_2015SB Section I You have choices in your health care One choice is to get your Medicare benefits through Original Medicare (fee-for-service Medicare). Original Medicare

More information

Piedmont WellStar Medicare Choice (HMO) offered by Piedmont WellStar HealthPlans, Inc.

Piedmont WellStar Medicare Choice (HMO) offered by Piedmont WellStar HealthPlans, Inc. Piedmont WellStar Medicare Choice (HMO) offered by Piedmont WellStar HealthPlans, Inc. Annual Notice of Changes for 2015 You are currently enrolled as a member of Piedmont WellStar Medicare Choice HMO.

More information

Independent Health s Medicare Passport Advantage (PPO)

Independent Health s Medicare Passport Advantage (PPO) Independent Health s Medicare Passport Advantage (PPO) (a Medicare Advantage Preferred Provider Organization Option (PPO) offered by INDEPENDENT HEALTH BENEFITS CORPORATION with a Medicare contract) Summary

More information

ForwardHealth-Required Taxonomy Codes

ForwardHealth-Required Taxonomy Codes ForwardHealth-Required s Provider Type Ambulance Air Ambulance 3416A0800X Air Transport Ambulance Land Ambulance 3416L0300X Land Transport Federally Qualified Health Ambulance Water Ambulance 3416S0300X

More information

Schedule of Benefits. Plan Information Participating Provider Non-Participating Provider

Schedule of Benefits. Plan Information Participating Provider Non-Participating Provider Schedule of Benefits UPMC Consumer Advantage HSA PPO - Premium Network Primary Care Provider: 10% after Deductible Specialist: 10% after Deductible Deductible: $1,950 / $3,900 Rx: 10% after Deductible

More information

Mapping of Health Care Providers in Ireland to the Provider Classification (ICHA HP) within the System of Health Accounts.

Mapping of Health Care Providers in Ireland to the Provider Classification (ICHA HP) within the System of Health Accounts. Mapping of Health Care Providers in Ireland to the Provider Classification (ICHA HP) within the System of Health Accounts December 2015 Mapping of the Health Care Providers in Ireland to the SHA Provider

More information

ANNUAL NOTICE OF CHANGES FOR 2016

ANNUAL NOTICE OF CHANGES FOR 2016 Cigna-HealthSpring Preferred (HMO) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred (HMO). Next year, there will be

More information

2015 Medicare Advantage Summary of Benefits

2015 Medicare Advantage Summary of Benefits 2015 Medicare Advantage Summary of Benefits HNE Medicare Premium No Rx and HNE Medicare Basic No Rx January 1, 2015 - December 31, 2015 H8578_2015_034 Accepted HNE MEDICARE ADVANTAGE ENROLLMENT KIT 2015

More information

SCHEDULE OF BENEFITS

SCHEDULE OF BENEFITS SCHEDULE OF BENEFITS Premier HealthOne Bronze 5500 Health Maintenance Organization (HMO) Individual Certificate of Coverage This schedule of benefits (SOB) is part of your Certificate of Coverage (COC)

More information

How To Pay For Health Care With Bluecrossma

How To Pay For Health Care With Bluecrossma PPO Student/Affiliate Plan MIT Student/Affiliate Extended Insurance Plan Coverage Period: 2014-2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual, Couple,

More information

Wellesley College Health Insurance Program Information

Wellesley College Health Insurance Program Information Wellesley College Health Insurance Program Information Beginning August 15, 2013 Health Services All Wellesley College students, including Davis Scholars and Exchange students are encouraged to seek services

More information

Boston College Student Blue PPO Plan Coverage Period: 2015-2016

Boston College Student Blue PPO Plan Coverage Period: 2015-2016 Boston College Student Blue PPO Plan Coverage Period: 2015-2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual and Family Plan Type: PPO This is only a

More information

Disability Rights Ohio Frequently Asked Questions about Medicaid: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)

Disability Rights Ohio Frequently Asked Questions about Medicaid: Early and Periodic Screening, Diagnosis and Treatment (EPSDT) 50 West Broad Street, Suite 1400 Columbus, Ohio 43215-5923 Tel. 614-466-7264 local / 800-282-9181 in Ohio TTY 614-728-2553 / 800-858-3542 in Ohio Fax 800-644-1888 Web: disabilityrightsohio.org Disclaimer:

More information

Schedule of Benefits Summary. Health Plan. Out-of-network Provider

Schedule of Benefits Summary. Health Plan. Out-of-network Provider Schedule of Benefits Summary University Name: University of Nebraska - Student Plan Health Plan : 2014/2015 Academic Year (see attached) Payment for Services Covered Services are reimbursed based on the

More information

S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/15-6/30/16

S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/15-6/30/16 S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/15-6/30/16 This information sheet is for reference only. Please refer to Evidence of Coverage requirements, limitations

More information

Summary of Services and Cost Shares

Summary of Services and Cost Shares Summary of Services and Cost Shares This summary does not describe benefits. For the description of a benefit, including any limitations or exclusions, please refer to the identical heading in the Benefits

More information

ATTACHMENT 1--NAICS STRUCTURE

ATTACHMENT 1--NAICS STRUCTURE Part I--Proposed New Industry Structure for Ambulatory Health Care Services, Hospitals, Nursing and Residential Care Facilities, and Social Assistance Section A--NAICS Structure North American Industry

More information

Benefit Summary - A, G, C, E, Y, J and M

Benefit Summary - A, G, C, E, Y, J and M Benefit Summary - A, G, C, E, Y, J and M Benefit Year: Calendar Year Payment for Services Deductible Individual $600 $1,200 Family (Embedded*) $1,200 $2,400 Coinsurance (the percentage amount the Covered

More information

Medicare Beneficiaries (QMB) Provider Enrollment Application

Medicare Beneficiaries (QMB) Provider Enrollment Application Iowa Department of Human Services Medicare Beneficiaries (QMB) Provider Enrollment Application Please copy and complete one for each individual professional and institutional category that is part of this

More information

January 1, 2016 December 31, 2016. Summary of Benefits. Aetna Medicare Value Plan (HMO) H3312-060 H3312.060.1

January 1, 2016 December 31, 2016. Summary of Benefits. Aetna Medicare Value Plan (HMO) H3312-060 H3312.060.1 January 1, 2016 December 31, 2016 Summary of Benefits H3312-060 H3312.060.1 Y0001_2016_H3312_060 Accepted 9/2015 Summary of Benefits January 1, 2016 December 31, 2016 This booklet gives you a summary of

More information

Introduction to the Summary of Benefits for Traditional Blue Medicare PPO 701 Plus, 751 Part D and 752 Part D

Introduction to the Summary of Benefits for Traditional Blue Medicare PPO 701 Plus, 751 Part D and 752 Part D Introduction to the Summary of Benefits for, 751 Part D and 752 Part D January 1, 2007 - December 31, 2007 BlueCross BlueShield of Western New York CMS Contract #H5526 Thank you for your interest in PPO.

More information

Blue Care Elect Preferred 90 Copay Coverage Period: on or after 09/01/2015

Blue Care Elect Preferred 90 Copay Coverage Period: on or after 09/01/2015 Blue Care Elect Preferred 90 Copay Coverage Period: on or after 09/01/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Only Plan Type: PPO This is only

More information

National PPO 1000. PPO Schedule of Payments (Maryland Small Group)

National PPO 1000. PPO Schedule of Payments (Maryland Small Group) PPO Schedule of Payments (Maryland Small Group) National PPO 1000 The benefits outlined in this Schedule are in addition to the benefits offered under Coventry Health & Life Insurance Company Small Employer

More information

benefit description A preferred provider plan administered by Blue Cross and Blue Shield of Massachusetts, Inc. MIT Student Extended Insurance Plan

benefit description A preferred provider plan administered by Blue Cross and Blue Shield of Massachusetts, Inc. MIT Student Extended Insurance Plan benefit description Blue Care Elect Preferred A preferred provider plan administered by Blue Cross and Blue Shield of Massachusetts, Inc. MIT Student Extended Insurance Plan Academic Year 2010 2011 Welcome

More information

Why is doctor credentialing important to Aetna members? What does the Aetna doctor credentialing process involve?

Why is doctor credentialing important to Aetna members? What does the Aetna doctor credentialing process involve? Medical Credentialing What is doctor credentialing? Why is doctor credentialing important to Aetna members? What does the Aetna doctor credentialing process involve? What are the results of Aetna's commitment

More information

West Virginia Children s Health Insurance Program

West Virginia Children s Health Insurance Program West Virginia Children s Health Insurance Program Billing Instruction Manual for Federally Qualified Health Centers (FQHC s) and Rural Health Centers (RHC s) Under a Prospective Payment System December

More information

Summary of Benefits. Prime (HMO-POS) and Value (HMO) January 1, 2015 December 31, 2015 G ENERATIONS A DVANTAGE 1-888-408-8285 (TTY: 711)

Summary of Benefits. Prime (HMO-POS) and Value (HMO) January 1, 2015 December 31, 2015 G ENERATIONS A DVANTAGE 1-888-408-8285 (TTY: 711) Summary of s and January 1, 2015 December 31, 2015 G ENERATIONS A DVANTAGE For more information about benefits or enrollment, call us or visit our website at www.martinspoint.org/medicare. 1-888-408-8285

More information

Health Care Careers. Provided by the Kaiser Permanente Health Care Career Scholarship Program 2014-2015

Health Care Careers. Provided by the Kaiser Permanente Health Care Career Scholarship Program 2014-2015 Health Care Careers Provided by the Kaiser Permanente Health Care Career Scholarship Program 2014-2015 Agenda Market for Health Care Workers Reasons to Consider a Career in Health Care Examples of Health

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Value (HMO-POS) Essentials Rx (HMO-POS) (H4270) January 1, 2015 - December 31, 2015 Western Wisconsin (26 Counties) H4270_082914_1 CMS Accepted (09032014) SECTION I INTRODUCTION

More information

SERVICES IN-NETWORK COVERAGE OUT-OF-NETWORK COVERAGE

SERVICES IN-NETWORK COVERAGE OUT-OF-NETWORK COVERAGE COVENTRY HEALTH AND LIFE INSURANCE COMPANY 3838 N. Causeway Blvd. Suite 3350 Metairie, LA 70002 1-800-341-6613 SCHEDULE OF BENEFITS BENEFITS AND PRIOR AUTHORIZATION REQUIREMENTS ARE SET FORTH IN ARTICLES

More information

Ohio Medicaid Web Portal Enrolling Provider Checklists by Request Type

Ohio Medicaid Web Portal Enrolling Provider Checklists by Request Type Ohio Medicaid Web Portal Enrolling Provider Checklists by Request Type Ohio Department of Job and Family Services TABLE OF CONTENTS General Instructions...3 Provider Enrollment Application Checklist: Individual

More information

Your Plan: Value HMO 25/40/20% (RX $10/$30/$45/30%) Your Network: Select Plus HMO

Your Plan: Value HMO 25/40/20% (RX $10/$30/$45/30%) Your Network: Select Plus HMO Your Plan: Value HMO 25/40/20% (RX $10/$30/$45/30%) Your Network: Select Plus HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary

More information

Important Questions Answers Why this Matters:

Important Questions Answers Why this Matters: Minimum Coverage PPO Network Name: Exclusive Coverage Period: Beginning on or after 1/1/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family Plan

More information

Blue Care Elect Saver with Coinsurance Northeastern University HDHP Coverage Period: on or after 01/01/2016

Blue Care Elect Saver with Coinsurance Northeastern University HDHP Coverage Period: on or after 01/01/2016 Blue Care Elect Saver with Coinsurance Northeastern University HDHP Coverage Period: on or after 01/01/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual

More information

January 1, 2015 December 31, 2015 Summary of Benefits. Advantra (HMO) H3928-001 80.06.360.1-LA1

January 1, 2015 December 31, 2015 Summary of Benefits. Advantra (HMO) H3928-001 80.06.360.1-LA1 January, 205 December 3, 205 Summary of Benefits H3928-00 80.06.360.-LA Y0022_205_H3928_00_LA Accepted 9/204 Summary of Benefits January, 205 December 3, 205 This booklet gives you a summary of what we

More information