Download Managed Medicaid - Children`s Health

Planes de Seguro Contratados
A partir del 1.° de mayo de 2017, Children’s Health
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SM
tiene contrato con los siguientes planes de seguro en las instalaciones siguientes:
 Children’s Health Specialty Center Park Cities
SM
 Children’s Health Specialty Center Mesquite
SM
 Children’s Health Specialty Center Rockwall
SM
SM
Children’s Health Children’s Medical Center Dallas
SM
Children’s Health Children’s Medical Center Plano
SM
Children’s Health Specialty Center Dallas Campus
SM
Children’s Health Specialty Center Plano Campus
SM
Children’s Health Specialty Center Bass Center
 Children’s Health
SM
Specialty Center for Autism and Developmental Disabilities (CADD)
 Children’s Health
SM
Specialty Center Cityville
Seguros Comerciales
Aetna Health Inc.
Baylor Scott & White Health Plan (Employees)
Baylor Scott & White Health Plan Quality Alliance (BSWQA ACO Network)
BlueCross BlueShield of Texas
ChoiceCare
CIGNA Healthcare of Texas, Inc. (CIGNA Great-West)
CIGNA LocalPlus
Coventry Health Care, Inc. (First Health)
Galaxy Health Network
HealthSmart / HealthSmart ACCEL
Humana, Inc.
Imagine Health
MultiPlan
Private Health Care Systems (PHCS)
Regional Healthcare Alliance
Scott & White Health Plan
Stratose (formerly National Preferred Provider Network (NPPN))
Texas Health Aetna Joint Venture Provider Networks (Aetna/THR)
Trinity Mother Frances (Employees & Their Dependents Only)
UnitedHealthcare of Texas, Inc.
USA Managed Care Organizations (USAMCO)
Seguros Comerciales (Planes Individuales Y Familiares)
CIGNA LocalPlus (Vantage Plans)
HumanaOne (Humana Bronze 6450 Commercial PPO)
Managed Medicaid (State of Texas Access Reform (STAR))
AMERIGROUP
CookChildren’s Health Plan
FirstCare Health Plans
Molina Healthcare of Texas
Parkland Community Health Plan (HEALTHfirst)
SUPERIOR HealthPlan
Texas Children’s Health Plan
Managed Medicaid (STAR+PLUS)
AMERIGROUP
Molina Healthcare of Texas
Superior HealthPlan
Managed Medicaid (STAR Kids)
Texas Children’s Health Plan (TCHP)
UnitedHealthcare (UHC) Community Plan
AMERIGROUP
Children’s Medical Center Health Plan (CMCHP)
CookChildren’s Health Plan
Managed Medicaid Foster Care (STAR Health)
SUPERIOR HealthPlan (Servicios médicos de salud)
Cenpatico (Salud conductual)
Medicaid Rural Service Area (MRSA)
AMERIGROUP (Central, Northeast and West)
SUPERIOR HealthPlan (Central, Northeast and West)
Children’s Health Insurance Program (CHIP, CHIP Perinate, and CHIP RSA)
AMERIGROUP CHIP/CHIP Perinate
CookChildren’s Health Plan CHIP/CHIP Perinate
FirstCare Health Plans CHIP/CHIP Perinate
Molina Healthcare of Texas CHIP/CHIP Perinate/CHIP RSA*
Parkland Community Health Plan CHIP/CHIP Perinate (KIDSfirst)**
SUPERIOR HealthPlan CHIP/CHIP RSA
Texas Children’s Health Plan
*Incluye CHIP Perinate Y CHIP Perinate RSA
**Incluye solo CHIP Perinate Newborns
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Planes de Seguro Contratados
A partir del 1.° de mayo de 2017, Children’s Health





SM
tiene contrato con los siguientes planes de seguro en las instalaciones siguientes:
 Children’s Health Specialty Center Park Cities
SM
 Children’s Health Specialty Center Mesquite
SM
 Children’s Health Specialty Center Rockwall
SM
SM
Children’s Health Children’s Medical Center Dallas
SM
Children’s Health Children’s Medical Center Plano
SM
Children’s Health Specialty Center Dallas Campus
SM
Children’s Health Specialty Center Plano Campus
SM
Children’s Health Specialty Center Bass Center
 Children’s Health
SM
Specialty Center for Autism and Developmental Disabilities (CADD)
 Children’s Health
SM
Specialty Center Cityville
Medicaid Tradicional
Texas Medicaid & Healthcare Partnership (TMHP) (Texas Medicaid)
Children with Special Health Care Needs (CSHCN)
Arkansas Medicaid (CMC Dallas & Plano)
Mississippi Medicaid (CMC Dallas Only)
Oklahoma Health Care Authority (OHCA) (CMC Dallas & Plano)
Seguros de Salud Conductual
Aetna Health Inc. (Solo comercial)
AMERIGROUP
Beacon Health Options (STAR, STAR+PLUS, STAR Kids, CHIP)
BlueCross BlueShield of Texas (Se excluye el HMO Blue)
Cenpatico (STAR Health – Solo tutela temporal)
CompCare (Solo comercial)
Managed Health Network (MHN)***
OptumHealth Behavioral Solutions (Commercial)
OptumHealth Behavioral Solutions (STAR, STAR+PLUS, STAR Kids, CHIP)
Scott & White Health Plan (Solo comercial para trastornos de la alimentación)
Texas Children’s Health Plan (TCHP)
*Se excluyen las terapias y pruebas psicológicas si el paciente no está internado
Redes de Trasplante
Blue Distinction Centers for Transplant – TMO, Corazón, Hígado
CIGNA LifeSOURCE Network – TMO, Corazón, Riñón, Hígado
Humana National Transplant Network – TMO, Corazón, Riñón, Hígado
INTERLINK – TMO, CHD, Corazón, Hígado
LifeTrac – TMO, Corazón, Intestino, Riñón, Hígado, Multivisceral
OptumHealth – TMO, CHD, Corazón, Riñón, Hígado, Multivisceral
OptumHealth – UnitedHealthcare Compass W500 (COE)
Protocol Tertiary Network – TMO, Corazón, Riñón, Hígado
En caso de tener preguntas, por favor lea su tarjeta de seguro, la póliza o cualquier otro material que tenga a su disposición sobre su plan de
seguro. Además, recomendamos que se comunique a la compañía de seguro o con el administrador de beneficios a los empleados para
verificar la cobertura o para pedir más información sobre su plan de salud.
AVISO: Los médicos tienen contratos por separado con las organizaciones de atención médica administrada. Por lo tanto, esta lista sirve solamente de
referencia para los servicios del hospital. Por favor, comuníquese directamente con el médico para averiguar en cuales planes participa.
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Salud de los Niños Afiliados (Proveedores del Hospital Base)
Proveedores de Práctica Avanzada (APPs) – Enfermera Practicante and Asistente Médico
Seguros Comerciales
Aetna Health Inc.
Baylor SWHP (Employees)
Baylor SWHP Quality Alliance (ACO)
BlueCross BlueShield of Texas
ChoiceCare
CIGNA Healthcare of Texas
CIGNA LocalPlus
Coventry Health Care, Inc. (First Health)
HealthSmart / HealthSmart ACCEL
Humana
Imagine Health
MultiPlan
Private Health Care Systems (PHCS)
Scott & White Health Plan (SWHP)
Texas Health Aetna Joint Venture
Provider Networks (Aetna/THR)
Trinity Mother Frances (Employees
& Their Dependents Only)
UnitedHealthcare of Texas Inc.
Commercial (Planes Individuales
Y Familiares)
CIGNA LocalPlus (Vantage Plans)
HumanaOne (Humana Bronze 6450 PPO)
Managed Medicaid (STAR/MRSA/CHIP)
AMERIGROUP
FirstCare Health Plans
Parkland Community Health Plan (PCHP)
SUPERIOR HealthPlan (STAR Health included)
Texas Children’s Health Plan
Managed Medicaid (STAR+PLUS)
AMERIGROUP
SUPERIOR HealthPlan
Managed Medicaid (STAR Kids)
AMERIGROUP
Children’s Medical Center Health Plan
CookChildren’s Health Plan
Texas Children’s Health Plan
UnitedHealthcare (UHC) Community Plan
Behavioral Health
OptumHealth Behavioral Solutions (Commercial)
OptumHealth Behavioral Solutions (STAR,
STAR+PLUS, STAR Kids, CHIP)
Medicaid Tradicional
Childrens with Special Healthcare Needs
Texas Medicaid & Healthcare Partnership
Anesthesiologists para Niños (AFC / AFC-Pain Management)
Seguros Comerciales
Aetna Health Inc.
Baylor SWHP (Employees)
Baylor SWHP Quality Alliance (ACO)
BlueCross BlueShield of Texas
ChoiceCare
CIGNA Healthcare of Texas
CIGNA LocalPlus
Coventry Health Care, Inc. (First Health)
HealthSmart / HealthSmart ACCEL
Humana
Imagine Health
MultiPlan
Private Health Care Systems (PHCS)
Scott & White Health Plan (SWHP)
Texas Health Aetna Joint Venture
Provider Networks (Aetna/THR)
Three Rivers Network (TRPN)
UnitedHealthcare of Texas Inc.
Commercial (Planes Individuales
Y Familiares)
CIGNA LocalPlus (Vantage Plans)
HumanaOne (Humana Bronze 6450 PPO)
Managed Medicaid (STAR Kids)
AMERIGROUP
Children’s Medical Center Health Plan
Texas Children’s Health Plan
UnitedHealthcare (UHC) Community Plan
Managed Medicaid (STAR/MRSA/CHIP)
Medicaid Tradicional
AMERIGROUP
Parkland Community Health Plan (PCHP)
Children with Special Healthcare Needs
SUPERIOR HealthPlan (STAR Health included) Texas Medicaid & Healthcare Partnership
Texas Children’s Health Plan
Managed Medicaid (STAR+PLUS)
AMERIGROUP
SUPERIOR HealthPlan
Servicios de Atención Médica Compleja (CCMSC)
Seguros Comerciales
Aetna Health Inc.
Baylor SWHP (Employees)
Baylor SWHP Quality Alliance (ACO)
BlueCross BlueShield of Texas
ChoiceCare
CIGNA Healthcare of Texas
CIGNA LocalPlus
Humana, Inc.
Imagine Health
Scott & White Health Plan (SWHP)
Texas Health Aetna Joint Venture
Provider Networks (Aetna/THR)
UnitedHealthcare of Texas, Inc.
Commercial (Planes Individuales
Y Familiares)
CIGNA LocalPlus (Vantage Plans)
HumanaOne (Humana Bronze 6450 PPO)
Managed Medicaid (STAR/MRSA/CHIP)
AMERIGROUP
Texas Children’s Health Plan
Managed Medicaid (STAR+PLUS)
AMERIGROUP
Medicaid Tradicional
Children with Special Healthcare Needs
Texas Medicaid & Healthcare Partnership
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Managed Medicaid (STAR Kids)
AMERIGROUP
Children’s Medical Center Health Plan
Texas Children’s Health Plan
UnitedHealthcare (UHC) Community Plan
Seguros de Salud Conductual (Comerciales)
Aetna Health Inc.
CIGNA Behavioral Health
Magellan Behavioral Health
Seguros de Salud Conductual (STAR/CHIP)
Texas Children’s Health Plan
Salud de los Niños Afiliados (Proveedores del Hospital Base) Continuó
Dallas Médico Los Servicios Médicos Para Los Niños (DPMSC - Internistas)
Seguros Comerciales
Aetna Health Inc.
Baylor SWHP (Employees)
1
Baylor SWHP Quality Alliance (ACO)
BlueCross BlueShield of Texas
ChoiceCare
CIGNA Healthcare of Texas
CIGNA LocalPlus
Coventry Health Care, Inc. (First Health)
HealthSmart / HealthSmart ACCEL
Humana
Imagine Health
MultiPlan
Private Health Care Systems (PHCS)
Scott & White Health Plan (SWHP)
Texas Health Aetna Joint Venture
Provider Networks (Aetna/THR)
UnitedHealthcare of Texas Inc.
Commercial (Planes Individuales
Y Familiares)
CIGNA LocalPlus (Vantage Plans)
HumanaOne (Humana Bronze 6450 PPO)
Managed Medicaid (STAR Kids)
AMERIGROUP
Children’s Medical Center Health Plan
Texas Children’s Health Plan
UnitedHealthcare (UHC) Community Plan
Managed Medicaid (STAR//MRSA/CHIP)
Medicaid Tradicional
AMERIGROUP
Parkland Community Health Plan (PCHP)
Children with Special Healthcare Needs
SUPERIOR HealthPlan (STAR Health included) Texas Medicaid & Healthcare Partnership
Texas Children’s Health Plan
Managed Medicaid (STAR+PLUS)
AMERIGROUP
SUPERIOR HealthPlan
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DPMSC’s en el estado de la red miembros de Baylor SWHP Quality Alliance (ACO) es beneficio específico basado en el diseño de beneficios de miembros
con su empleador. Por favor, póngase en contacto con su seguro para determinar el estado de participación.
Dallas Médico Los Servicios Médicos Para Los Niños (DPMSC - Ortodoncia)
Aetna Dental
CIGNA Dental
Delta Dental Insurance Company (DDIC)
Dental Benefit Providers (UnitedHealthcare)
Dental Network of America (DNOA)
DentaQuest
DentaQuest for Superior HealthPlan
Humana Dental DHMO
MCNA Dental Plans
Clínica Dental de los Niños
Aetna Dental
CIGNA Dental
Delta Dental Insurance Company (DDIC)
Dental Benefit Providers (UnitedHealthcare)
Dental Network of America (DNOA)
DentaQuest
Humana Dental DHMO
MCNA Dental Plans
Atención de la Salud a Domicilio (HHC)
Seguros Comerciales
Aetna Health Inc.
Baylor SWHP (Employees)
Baylor SWHP Quality Alliance (ACO)
BlueCross BlueShield of Texas (HHC Only)
CareCentrix
ChoiceCare
CIGNA LocalPlus
Coventry Health Care, Inc. (First Health)
HealthSmart / HealthSmart ACCEL
Humana
Imagine Health
MultiPlan
Private Health Care Systems (PHCS)
Scott & White Health Plan (SWHP)
Texas Health Aetna Joint Venture
Provider Networks (Aetna/THR)
UnitedHealthcare of Texas Inc.
Commercial (Planes Individuales
Y Familiares)
CIGNA LocalPlus (Vantage Plans)
HumanaOne (Humana Bronze 6450 PPO)
Managed Medicaid (STAR Kids)
AMERIGROUP
Children’s Medical Center Health Plan
CookChildren’s Health Plan
Texas Children’s Health Plan
UnitedHealthcare (UHC) Community Plan
Managed Medicaid (STAR/MRSA/CHIP)
AMERIGROUP
Medicaid Tradicional
Molina Healthcare of Texas
Parkland Community Health Plan (PCHP)
Children with Special Healthcare Needs
SUPERIOR HealthPlan (STAR Health ONLY) Texas Medicaid & healthcare Partnership
Texas Children’s Health Plan
Managed Medicaid (STAR+PLUS)
AMERIGROUP
Molina Healthcare of Texas
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Salud de los Niños Afiliados (Proveedores del Hospital Base) Continuó
Equipo Médico a Domicilio (HME)
Seguros Comerciales
Aetna Health Inc.
Baylor SWHP (Employees)
Baylor SWHP Quality Alliance (ACO)
BlueCross BlueShield of Texas (HHC Only)
CareCentrix
ChoiceCare
CIGNA LocalPlus
Coventry Health Care, Inc. (First Health)
HealthSmart / HealthSmart ACCEL
Humana
Imagine Health
MultiPlan
Private Health Care Systems (PHCS)
Scott & White Health Plan (SWHP)
Texas Health Aetna Joint Venture
Provider Networks (Aetna/THR)
UnitedHealthcare of Texas Inc.
Commercial (Planes Individuales
Y Familiares)
CIGNA LocalPlus (Vantage Plans)
HumanaOne (Humana Bronze 6450 PPO)
Managed Medicaid (STAR/MRSA/CHIP)
AMERIGROUP
Molina Healthcare of Texas
Parkland Community Health Plan (PCHP)
Texas Children’s Health Plan
Managed Medicaid (STAR+PLUS)
AMERIGROUP
Molina Healthcare of Texas
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Managed Medicaid (STAR Kids)
AMERIGROUP
Children’s Medical Center Health Plan
CookChildren’s Health Plan
Texas Children’s Health Plan
UnitedHealthcare (UHC) Community Plan
Medicaid Tradicional
Children with Special Healthcare Needs
Texas Medicaid & Healthcare Partnership
Salud de los Niños Afiliados (Clinica de Pacientes Ambulatorios)
A partir del 1.° de mayo de 2017, Children’s Health
siguientes:
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SM
Pediatric Group tiene contrato con los siguientes planes de seguro en las instalaciones
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Children’s Health Pediatric Group Bachman Lake
Children’s Health Pediatric Group Carrollton
Children’s Health Pediatric Group Cedar Hill
Children’s Health Pediatric Group Celina
Children’s Health Pediatric Group Cockrell Hill
Children’s Health Pediatric Group DeSoto
Children’s Health Pediatric Group Garland
Children’s Health Pediatric Group Grapevine
Children’s Health Pediatric Group Irving
Children’s Health Pediatric Group Lake Highlands
Children’s Health Pediatric Group Lancaster Kiest
Children’s Health Pediatric Group McKinney
Children’s Health Pediatric Group Medical District
Children’s Health Pediatric Group Oak Cliff
Children’s Health Pediatric Group Pleasant Grove
Children’s Health Pediatric Group St. Phillips
Children’s Health Pediatric Group Prosper
Children’s Health Pediatric Group West Plano
Pediátrica de la Salud de los Niños (CHPG) - antes MyChildren’s
Seguros Comerciales
Aetna Health Inc.
Baylor SWHP (Employees)
Baylor SWHP Quality Alliance (ACO)
BlueCross BlueShield of Texas
CIGNA Healthcare of Texas
CIGNA LocalPlus
Coventry Health Care, Inc. (First Health)
Humana
Imagine Health
Integrated Health Plan
MultiPlan
Private Health Care Systems (PHCS)
Scott & White Health Plan (SWHP)
Texas Health Aetna Joint Venture
Provider Networks (Aetna/THR)
UnitedHealthcare of Texas Inc.
Commercial (Planes Individuales
Y Familiares)
CIGNA LocalPlus (Vantage Plans)
HumanaOne (Humana Bronze 6450 PPO)
Managed Medicaid (STAR/MRSA/CHIP)
AMERIGROUP
CookChildren’s Health Plan
Molina Healthcare of Texas
Parkland Community Health Plan (PCHP)
SUPERIOR HealthPlan (STAR Health included)
Texas Children’s Health Plan
Managed Medicaid (STAR+PLUS)
AMERIGROUP
Molina Healthcare of Texas
SUPERIOR HealthPlan
Managed Medicaid (STAR Kids)
AMERIGROUP
Children’s Medical Center Health Plan
CookChildren’s Health Plan*
Texas Children’s Health Plan
UnitedHealthcare (UHC) Community Plan
* Ubicaciones de Tarrant county CHPG sólo
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Seguros de Salud Conductual (Comerciales)
Aetna Health Inc.
MHNet Behavioral Health (Coventry)
LifeSynch (Humana Behavioral Health)
MultiPlan
Private Health Care Systems (PHCS)
Seguros de Salud Conductual (MMC/CHIP)
AMERIGROUP
Molina Healthcare of Texas
Texas Medicaid & Healthcare Partnership
Medicaid Tradicional
Children with Special Healthcare Needs
Texas Medicaid & Healthcare Partnership
Casa de Nuestros Niños
Como de September 20, 2015, Children’s Health
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Our Children’s House
Our Children’s House at Dallas
Our Children’s House at Waxahachie
Our Children’s House at Grapevine
Our Children’s House at Rockwall
Our Children’s House at Irving
Our Children’s House at Frisco
Our Children’s House at Plano
Our Children’s House at Las Colinas
Our Children’s House at Allen
SM
ahora incluye las siguientes Nuestros niños ubicaciones House:
1340 Empire Central, Dallas, TX 75247
1208 N. Hall Street, Dallas, TX 75204-6016
1540 N. Highway 77, Ste. 10, Waxahachie, TX 75165-5207
1643 Lancaster Drive, Ste. 300, Grapevine, TX 76051-3593
2455 Ridge Road, Ste. 255, Rockwall, TX 75087-5534
3337 Stovall Street, Irving, TX 75061-4035
7010 Preston Road, Ste. 240, Frisco, TX 75034-5875
7000 W. Plano Parkway, Ste. 210, Plano, TX 75093-1632
7453 Las Colinas Blvd., Irving, TX 75063-7561
8 Prestige Circle, Ste. 101, Allen, TX 75002-3435
Inpatient Services
Outpatient Services
Outpatient Services
Outpatient Services
Outpatient Services
Outpatient Services
Outpatient Services
Outpatient Services
Outpatient Services
Outpatient Services
Casa de Nuestros Niños
Seguros Comerciales
Aetna Health Inc.
Baylor SWHP (Employees)
Baylor SWHP Quality Alliance (ACO)
BlueCross BlueShield of Texas
CIGNA Healthcare of Texas
CIGNA LocalPlus
ChoiceCare
Coventry Health Care, Inc. (First Health)
Galaxy Health Network
HealthSmart
Humana
Imagine Health
MultiPlan
Private Health Care Systems (PHCS)
Stratose (formerly NPPN)
Scott & White Health Plan (SWHP)
Trinity Mother Frances (Employees
& Their Dependents ONLY)
UnitedHealthcare of Texas Inc.
USA Managed Care Organizations (USAMCO)
Commercial (Planes Individuales
Y Familiares)
CIGNA LocalPlus (Vantage Plans)
HumanaOne (Humana Bronze 6450 PPO)
Managed Medicaid (STAR/MRSA/CHIP)
AMERIGROUP
CookChildren’s Health Plan
Molina Healthcare of Texas
Parkland Community Health Plan (PCHP)
SUPERIOR HealthPlan (STAR Health included)
Texas Children’s Health Plan
Managed Medicaid (STAR+PLUS)
AMERIGROUP
Molina Healthcare of Texas
SUPERIOR HealthPlan
Managed Medicaid (STAR Kids)
AMERIGROUP
Children’s Medical Center Health Plan
CookChildren’s Health Plan
Texas Children’s Health Plan
UnitedHealthcare (UHC) Community Plan
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Redes de Transplante
CIGNA LifeSOURCE
Humana National Transplant Network
INTERLINK Transplant Network
LifeTrac Transplant Network
OPTUM Health
Protocol Tertiary Network
Behavioral Health
OptumHealth Behavioral Solutions (Commercial)
OptumHealth Behavioral Solutions (STAR,
STAR+PLUS, STAR Kids, CHIP)
Medicaid Tradicional
Children with Special Healthcare Needs
Oklahoma Health Care Authority (OCHA)
Texas Medicaid & Healthcare Partnership