(HMO) Provider Directory
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Blue Shield Trio Medicare (HMO) Blue Shield Inspire (HMO) Provider Directory/Directorio de Proveedores This directory is current as of June 23, 2020. This directory provides a list of Blue Shield Trio Medicare (HMO) and Blue Shield Inspire (HMO) current network providers. This directory is for: Northern California To access Blue Shield Trio Medicare (HMO) and Blue Shield Inspire (HMO)'s online provider directory, you can visit blueshieldca.com/fad. For any questions about the information contained in this directory, please call our Member Services Department at (800) 776-4466, 8 a.m. to 8 p.m., seven days a week, from October 1 through March 31, and 8 a.m. to 8 p.m., weekdays (8 a.m. to 5 p.m., Saturday and Sunday), from April 1 through September 30. TTY users should call 711. The provider network may change at any time. You will receive notice when necessary. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call (800) 776-4466 (TTY: 711). This document may be available in other formats such as large print or other alternate formats. H0504_19_302A2_C 09162019 MR15184-10 (07/20-1) Este directorio es válido desde: 23 de junio de 2020. Este directorio brinda una lista de los proveedores actuales de la red de Blue Shield Trio Medicare (HMO) Blue Shield Inspire (HMO) Este directorio es para: Zona norte de California Para obtener acceso al directorio de proveedores en línea de Blue Shield Trio Medicare (HMO) y Blue Shield Inspire (HMO), puede visitar blueshieldca.com/fad. Si tiene alguna pregunta sobre la informacióin incluida en este directorio, comuníquese con nuestro Departamento de Servicio para Miembros llamando al (800) 776-4466, de 8:00 a. m. a 8:00 p. m., cualquier día de la semana, desde el 1 de octubre hasta el 31 de marzo, y de 8:00 a. m. a 8:00 p. m., de lunes a viernes (de 8:00 a. m. a 5:00 p. m. los sábados y domingos), desde el 1 de abril hasta el 30 de septiembre. Los usuarios del sistema TTY deben llamar al 711. La red de proveedores puede cambiar en cualquier momento. Recibirá un aviso cuando sea necesario. ATENCIÓN: Si no habla inglés, tiene a su disposición gratis el servicio de asistencia en idiomas. Llame al (800) 776-4466 (TTY: 711). Este documento puede estar disponible en letra grande o en otros formatos alternativos. H0504_19_302A2_C_SP 09162019 MR15184-10 (07/20-1) Table of Contents/Índice de contenidos Section 1 - Introduction....................................................................................................... I What is the service area for Blue Shield Trio Medicare (HMO) / Blue Shield Inspire (HMO)? ...................................................................................... II How do you find Blue Shield Trio Medicare (HMO) / Blue Shield Inspire (HMO) providers that serve your area?.................................................................................. II Section 2 - List of Network Providers................................................................................... III Sección 1: Introducción ....................................................................................................... IV ¿Cuál es el área de servicio de Blue Shield Trio Medicare (HMO) / Blue Shield Inspire (HMO)? ...................................................................................... V ¿Cómo puede encontrar proveedores de Blue Shield Trio Medicare (HMO) / Blue Shield Inspire (HMO) que brindan servicios en su área?.............................. V Sección 2: Lista de proveedores de la re d ........................................................................ VI Physician Groups/ Grupos médicos Brown And Toland Health Services Inc ...................................................................... 1 Alameda Hospital Alta Bates Summit Med Ctr Summit Campus Eden Medical Center San Leandro Hospital Washington Hospital Hill Phys Sacramento Primed Inc................................................................................ 57 Mercy General Hospital Mercy Hospital Of Folsom Mercy San Juan Hospital Methodist Hosp Of Sacramento Hill Phys San Francisco Inc .......................................................................................... 81 Seton Medical Center Hill Physicians East Bay................................................................................................ 132 Washington Hospital Mercy Medical Group................................................................................................. 155 Mercy General Hospital Mercy Hospital Of Folsom Mercy San Juan Hospital Methodist Hosp Of Sacramento Pamf Mills Peninsula Division....................................................................................... 168 Mills Mills Health Center Physicians Med Grp San Jose.....................................................................................184 Santa Clara Cnty IPA....................................................................................................202 Mental Health Providers/ Proveedores de servicios de salud me ntal ...................226 Dentists / Dentistas........................................................................................................229 Skilled Nursing Facilities/ Centros de enfermería especializada........................... 252 Index/ Índice.................................................................................................................255 minus any applicable as soon as possible, preferably Section 1 - copayment/coinsurance within 48 hours. The number to Introduction amount(s): call is located on your plan ID card. Blue Shield of California This directory provides a list of Medicare Member Services If you need medical help Blue Shield Trio Medicare P.O. Box 927 immediately but your health is (HMO) and Blue Shield Inspire Woodland Hills, CA 91365 not in serious danger, the help (HMO) network providers. you need is called “urgently You can also call our Member needed services”. If you are in To get detailed information Service Department for your plan's service area about your health care assistance at (800) 776-4466, please call your PCP or, if your coverage, please see your 8 a.m. to 8 p.m., seven days a physician's office is closed, go Evidence of Coverage (EOC). week, from October 1 through to any urgent care facility March 31, and 8 a.m. to listed in this directory or You will have to choose one 8 p.m., weekdays (8 a.m. to affiliated with your physician of our network providers listed 5 p.m., Saturday and Sunday), group. in this directory to be your from April 1 through Primary Care Physician (PCP). September 30. TTY users If you are outside the plan Generally, you must get your should call 711. service area, first call your health care services from your PCP whenever possible. If you PCP. When you choose your If you need care in an are treated for a condition PCP, you are also choosing emergency, get medical help that meets the definition of the hospital(s) and specialty as quickly as possible. Call 911 urgently needed services network affiliated with the for help or go to the nearest while you are outside the plan physician group. emergency room. You do not service area, we prefer that need to get permission first you return to the service area The network providers listed in from your physician or other to get follow-up care through this directory have agreed to network provider. your PCP. However, we will provide you with your health cover follow-up care that you care and/or dental services. A medical emergency is get from non-network You may go to any of our when you believe that you providers outside the plan network providers listed in this have medical symptoms that service area as long as the directory, however, some require immediate medical care you are receiving meets services may require a attention to prevent loss of the definition of “urgently referral. For more information life, loss of a limb, or loss of needed services.” about referrals, please read function of a limb. The the plan's Evidence of medical symptoms may be You must use network Coverage (EOC) for details. an illness, injury, severe pain, providers except in Other providers are available or a medical condition that is emergency or urgent care in our network. quickly getting much worse. situations or for out-of-area renal dialysis or other services. If you receive a bill from any Make sure that Blue Shield If you obtain routine care non-network provider for knows about your emergency from out-of-network providers, covered services such as because your physician will neither Medicare nor Blue emergency or urgently need to be involved in Shield will be responsible for needed services or following up on your the costs. out-of-area renal dialysis emergency care. services, please do not pay it. Instead, please send it to us at You or someone else should the following address and we call to tell your physician will pay the covered amount, about your emergency care I (800) 776-4466, 8 a.m. to What is the service area for 8 p.m., seven days a week, Blue Shield Trio Medicare from October 1 through (HMO) and Blue Shield March 31, and 8 a.m. to Inspire (HMO)? 8 p.m., weekdays (8 a.m. to 5 p.m., Saturday and Sunday), The “county” or “counties” from April 1 through and parts of counties/zip September 30. TTY users codes in our service area are should call 711. You can also listed below. visit blueshieldca.com/medicare. Blue Shield Trio Medicare (HMO) Sacramento County (All Zips) Blue Shield Inspire (HMO) Alameda