MR15184-19 (07/21) Blue Shield Inspire (PPO)
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Blue Shield Inspire (PPO) Provider Directory/Directorio de proveedores This directory is current as of June 24, 2021. This directory provides a list of current network providers. This directory is for: Alameda County To access BlueShield's online provider directory, you can visit blueshieldca.com/fad. For any questions about the information contained in this directory, please call Customer Care 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. Blue Shield of California is an PPO plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal. The provider network may change at any time. You will receive notice when necessary. Out-of-network/non-contracted providers are under no obligation to treat Blue Shield Inspire members, except in emergency situations. Please call Customer Care or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. This document may be available in other formats such as large print or other alternate formats. H4937_20_632B_C 09142020 MR15184-19 (07/21) Blue Shield Inspire (PPO) Provider Directory/Directorio de proveedores Este directorio es válido desde 24 de junio de 2021. Este directorio brinda una lista de los proveedores de la red actual. Este directorio es para: Condado de Alameda Para obtener acceso al directorio de proveedores en línea de Blue Shield, puede visitar blueshieldca.com/fad. Si tiene alguna pregunta sobre la informacióin incluida en este directorio, comuníquese con Atención al Cliente 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. Blue Shield of California es un plan PPO que tiene un contrato con Medicare. La inscripción en Blue Shield of California depende de la renovación del contrato. La red de proveedores puede cambiar en cualquier momento. Recibirá un aviso cuando sea necesario. Los proveedores no pertenecientes a la red o no contratados no tienen ninguna obligación de brindar tratamiento a los miembros de Blue Shield Inspire, excepto en situaciones de emergencia. Llame a nuestro número de Atención al Cliente o consulte su Evidencia de cobertura (EOC, por sus siglas en inglés) para obtener más información, como el costo compartido que se aplica a los servicios fuera de la red. Este documento puede estar disponible en letra grande o en otros formatos alternativos. H4937_20_632B_SP_C 09142020 MR15184-19 (07/21) Table of Contents/Índice de contenidos Section 1 - Introduction ...................................................................................................3 What is the service area for my plan? ................................................................4 How do I find providers that serve my area? .....................................................4 Sección 1: Introducción ..................................................................................................5 ¿Cuál es el área de servicio de Blue Shield Inspire? ........................................6 ¿Cómo puede encontrar proveedores de Blue Shield Inspire que brindan servicios en su área? ......................................................................................................................6 Section 2 - List of Network Providers ...............................................................................7 Sección 2: Lista de proveedores de la red ....................................................................7 Physician of Choice (POCs)/ Médicos elegidos (POC) ...............................................8 Specialists/ Especialistas .................................................................................................57 Hospitals/ Hospitales ........................................................................................................187 Urgent Care Centers/ Centros de atención urgente ....................................................188 Skilled Nursing Facilities (SNFs)/ Centros de enfermería especializada ....................190 Ambulatory Surgery Centers/ Centros quirúrgicos ambulatorios ...............................192 Home Health/ Salud en el hogar ....................................................................................193 Durable Medical Equipment/ Equipo médico duradero .............................................194 Home Infusion/ Infusión en el hogar ..............................................................................195 Dialysis/ Diálisis .................................................................................................................196 Alphabetical Index/ Índice Alfabético ..........................................................................197 Section 1 - a decision about whether October 1 through we will cover an March 31, and 8 a.m. to Introduction out-of-network service, we 8 p.m., weekdays (8 a.m. to encourage you or your 5 p.m., Saturday and This directory provides a list provider to ask us for a Sunday), from April 1 of in-network providers. pre-service organization through September 30. TTY determination before you users should call 711. To get detailed information receive the service. Please about your health care call Customer Care at If you need care in an coverage, please see your (800) 776-4466, 8 a.m. to emergency, get medical Evidence of Coverage 8 p.m., seven days a week, help as quickly as possible. (EOC). from October 1 through Call 911 for help or go to March 31, and 8 a.m. to the nearest emergency The network providers listed 8 p.m., weekdays (8 a.m. to room. You do not need to in this directory have 5 p.m., Saturday and get permission first from agreed to provide you with Sunday), from April 1 your physician or other your health care services. through September 30. TTY network provider. You may go to any of our users should call 711. You network providers listed in A medical emergency is may also refer to your this directory, however, when you believe that you Evidence of Coverage some services may require have medical symptoms (EOC) for more information, a referral. Covered plan that require immediate including the cost sharing services for specialist care medical attention to that applies to do not require a referral. prevent loss of life, loss of a out-of-network services. For more information about limb, or loss of function of a referrals, please refer to If you receive a bill from limb. The medical your Evidence of Coverage any out-network provider symptoms may be an (EOC) for details. for covered services, illness, injury, severe pain, or please do not pay it. a medical condition that is You have the flexibility to Instead, please send it to us quickly getting much receive care from at the following address worse. out-of-network providers if and we will pay the the services are covered Make sure that Blue Shield covered amount, minus benefits and medically knows about your any applicable necessary. Although you emergency because your copayment/coinsurance are not required to receive physician will need to be amount(s): care from in-network involved in following up on providers, your share of the Blue Shield of California your emergency care. cost for covered services Medicare Customer You or someone else could be lower when using Care should call to tell your in-network providers. P.O. Box 927 physician about your Woodland Hills, CA Out-of-network emergency care as soon as 91365 providers/non-contracted possible, preferably within providers are under no You can also call Customer 48 hours. The number to obligation to treat Blue Care at (800) 776-4466, call is located on your plan Shield Inspire members, 8 a.m. to 8 p.m., seven ID card. except in emergencies. For days a week, from 3 If you need medical help your health care services. immediately but your You may go to any of our health is not in serious network providers listed in danger, the help you need this directory, however, is called ªurgently needed some services may require servicesº. You may go to a referral. any urgent care facility listed in this directory if your You can also go to network provider is blueshieldca.com/fad and unavailable or inaccessible. enter your zip code for a list of providers nearest to If you are treated for a your home. condition that meets the definition of urgently If you have questions about needed services while you this plan or require are outside the plan service assistance in selecting a area, we recommend that POC, please call Customer you return to the service Care at (800) 776-4466, area to get follow-up care 8 a.m. to 8 p.m., seven through your POC. days a week, from However, we will cover October 1 through follow-up care that you get March 31, and 8 a.m. to from out-network providers 8 p.m., weekdays (8 a.m. to outside the plan service 5 p.m., Saturday and area as long as the care Sunday), from April 1 you are receiving meets through September 30. TTY the definition of ªurgently users should call 711. You needed services". can also visit blueshieldca.com/medicare. With the exception of emergencies, it may cost more to get care from out-of-network providers. What is the service area for my plan? The county service