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Texas 2020 Provider Directory

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Texas 2020 Provider Directory 2020 Provider Directory North Texas Directorio de Proveedores No referrals required. No se requieren referencias. Y0058_20NTXPDRDIR_C SeniorCare Advantage PPO Plan North Texas Provider Directory This directory is current as of December 1, 2020. This directory provides a list of SeniorCare Advantage PPO network providers in North Texas. This directory is for Collin, Dallas, Denton, Ellis, Rockwall, and Tarrant counties in Texas. This directory includes providers in the North Texas area only. Additional providers in the Central Texas area participate in this network, but are not listed in this directory. To get the most up-to-date information about SeniorCare Advantage PPO providers including providers not listed in this directory, please visit advantage.swhp.org to view the online provider directory or call our Customer Service number at 1-866- 334-3141, Monday–Sunday, 7 a.m. – 8 p.m. (TTY: 711). Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. The provider network may change at any time. You will receive notification when necessary. To get the most up-to-date information about SeniorCare Advantage PPO network providers in your area, you can visit advantage.swhp.org to view the online provider directory or call our Customer Service Department at 1-866-334-3141, Monday – Sunday, 7 a.m. – 8 p.m. (TTY: 711). SeniorCare Advantage PPO is offered by Scott and White Health Plan through its subsidiary Insurance Company of Scott and White, a Medicare Advantage organization with a Medicare contract. Enrollment in SeniorCare Advantage depends on contract renewal. ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-866-334-3141 (TTY: 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-334-3141 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi só 1-866-334-3141 (TTY: 711). Scott and White Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Scott and White Health Plan cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Scott and White Health Plan tuân thủ luật dân quyền hiện hành của Liên bang và không phân bi ệt đói xử dựa trên chủng tộc, màu da, nguồn góc quóc gia, độ tuổi, khuyết tật, hoặc giới tính. This document may be available in other formats such as large print or other alternate formats. H2032_SCAPPON_PD_2020_C Section 1 – Introduction This directory provides a list of SeniorCare Advantage PPO network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC). The term “PCP” (Primary Care Provider) will be used throughout this directory. Generally, you should get your health care services from your PCP. A PCP is a physician that may be selected by you to coordinate your healthcare. The SeniorCare Advantage PPO “network providers” have agreed to provide you with your health care coverage. You may go to any of our SeniorCare Advantage PPO network providers. If you have been going to one network provider, you are not required to continue going to that same provider. With the SeniorCare Advantage PPO Plan, while we encourage the use of in-network providers, you have the choice to use doctors, hospitals, and other providers that are not contracted with us. With the exception of emergency or urgent care, you will have to pay more for using non-network providers. Non-network providers are under no obligation to treat SeniorCare Advantage PPO enrollees, except in emergencies. For a decision about whether we will cover a non-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Customer Service Department at 1-866-334-3141, Monday – Sunday, 7 a.m. – 8 p.m. (TTY: 711). You may also refer to your EOC for more information, including the cost sharing that applies to non-network services. Deductibles and higher coinsurance rates will apply to non-network services. In addition, you may be billed for charges that exceed the Plan’s contracted rate for a service when provided by a non-network provider. A non-network provider may submit a bill directly to you. If this happens, you should submit the bill to us for processing and determination of your liability, if any. After we have processed the bill, you will be notified of your financial responsibility. You may be responsible for any balances billed to you by the non-network provider. You may obtain emergency services from the closest available provider, and you may obtain urgently needed services from any qualified provider when out of the SeniorCare Advantage PPO service area or when network providers are unavailable. What is the service area for North Texas SeniorCare Advantage PPO? Denton Collin Rockwall Tarrant Dallas Ellis The counties in the service area are listed below: Collin, Dallas, Denton, Ellis, Rockwall, Tarrant Cameron How do you find SeniorCare Advantage PPO providers in your area? This Provider Directory is listed by the category of provider (PCPs, Specialists, Hospitals, Skilled Nursing Facilities (SNF) and Outpatient Mental Health Providers). Each provider section is then listed alphabetically by type of provider (e.g., Family Medicine in the PCP section, Cardiologist in the Specialist section, etc.) then by county and city. The name of the provider, facility, address and phone number are listed to help you locate a provider nearest to your home. If you have questions about SeniorCare Advantage PPO or require assistance in selecting a PCP or other provider, please call our Customer Service Department at 1-866-334-3141, Monday – Sunday, 7 a.m. – 8 p.m. (TTY: 711). You may also visit our website at advantage.swhp.org to view the online provider directory. Directorio de proveedores del Plan SeniorCare Advantage PPO para el norte de Texas Este directorio estará vigente a partir del 1 de diciembre de 2020. Este directorio ofrece una lista de los proveedores de la red de SeniorCare Advantage PPO en el norte de Texas. Este directorio se aplica a los condados de Collin, Dallas, Denton, Ellis, Rockwall y Tarrant en Texas. Este directorio incluye únicamente a los proveedores en el área del norte de Texas. Proveedores adicionales en el área central de Texas participan en esta red pero no están incluidos en este directorio. Para obtener la información más actualizada sobre la red de proveedores de SeniorCare Advantage PPO incluidos los proveedores que no aparecen en este directorio, visite advantage.swhp.org para ver el directorio de proveedores en línea o llame a nuestro Departamento de Servicio al cliente al 1-866-334-3141, de lunes a domingos, de 7:00 a.m. a 8:00 p.m. (TTY: 711). Algunos proveedores de la red pueden haberse incluido o retirado de nuestra red después de que este directorio fue impreso. No garantizamos que todos los proveedores acepten miembros nuevos. La red de proveedores puede cambiar en cualquier momento. Usted recibirá un aviso cuando sea necesario. Para obtener la información más actualizada sobre la red de proveedores de SeniorCare Advantage PPO en su área, puede visitar advantage.swhp.org para ver el directorio de proveedores en línea o puede llamar a nuestro Departamento de Servicio al cliente al 1-866-334-3141, de lunes a domingos, de 7:00 a.m. a 8:00 p.m. (TTY: 711). SeniorCare Advantage PPO se ofrece a través de Scott and White Health Plan mediante su subsidiaria Insurance Company of Scott and White, una organización de Medicare Advantage que tiene un contrato con Medicare. La inscripción en SeniorCare Advantage depende de la renovación del contrato. ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-866-334-3141 (TTY: 711). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-334-3141 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-866-334-3141 (TTY: 711). Scott and White Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Scott and White Health Plan cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Scott and White Health Plan tuân thủ luật dân quyền hiện hành của Liên bang và không phân bi ệt đối xử dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính. Este documento puede estar disponible en otros formatos, como letras grandes u otros formatos alternativos. H2032_SCAPPON_PD_2020_C Sección 1: Introducción Este directorio ofrece una lista de los proveedores de la red de SeniorCare Advantage PPO. Para obtener información detallada sobre su cobertura de atención médica, consulte su Evidencia de cobertura (EOC). En todo este directorio, se empleará el término “PCP” (Proveedor de atención primaria). Por lo general, debe obtener los servicios de atención médica de su PCP. Un PCP es un médico que usted puede seleccionar usted para coordinar su atención médica. La “red de proveedores” de SeniorCare Advantage PPO ha acordado proveerle a usted cobertura de atención médica. Puede consultar a cualquiera de los proveedores de la red de SeniorCare Advantage PPO.
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