HMO Plan Provider Directory

Prescribed By Doctors. Inspired By You. HMO Plan Provider Directory This directory provides a list of Piedmont WellStar Medicare Choice’s network providers. This directory includes the following counties in our 11 county service area: Georgia Cherokee Cobb Coweta Douglas Fayette Fulton Henry Paulding Pickens Rockdale Spalding This directory is current as of September 1, 2013. 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. To get the most up-to-date information about Piedmont WellStar Medicare Choice’s network providers in your area, you can visit www.pwplans.org or call our Member Services Department at 855-222-1047 from 8 a.m. to 8 p.m., seven days a week.* TTY users should call 855-275-1266. Piedmont WellStar Medicare Choice is a Medicare Advantage HMO plan with a Medicare contract. Enrollment in Piedmont WellStar Medicare Choice depends on contract renewal. This document may be available in an alternative format such as Braille, larger print or audio; please call Member Services at 855-222-1047, (TTY - 855-275-1266).* *We are available to take your call: Oct. 1, 2013 through Feb. 14, 2014 from 8 a.m. to 8 p.m., seven days a week and Feb. 15, 2014 through Sept. 30, 2014 from 8 a.m. to 8 p.m., Monday through Friday, and 8 a.m. to 3 p.m. on Saturday. H9857_14_140 Accepted Section 1 — Introduction This directory provides a list of Piedmont WellStar emergency includes severe pain, a bad injury, Medicare Choice’s network providers. To get a sudden illness, or a medical condition that detailed information about your health care is quickly getting much worse. You may coverage, please see your Evidence of Coverage. get covered emergency medical care whenever you need it from the nearest If you join the Piedmont WellStar Medicare Choice hospital or provider, anywhere in the HMO plan, you must use network providers to United States. You don’t need to get approval obtain medical care and services. You will have first from Piedmont WellStar Medicare Choice to choose one of our network providers who are or your doctor. listed in this directory to be your Primary Care Physician (PCP). The term “PCP” will be used If you have an emergency, our plan will throughout this directory. talk with the doctors who are giving you emergency care to help manage and follow A PCP should be your first point of contact for up on your care. The doctors who are giving undiagnosed health concerns or health problems you emergency care will decide when your and routine health care needs. Besides providing condition is stable and the medical emergency much of your care, your PCP will help arrange or is over. After the emergency is over, you are coordinate the rest of the covered services you entitled to follow-up care to be sure your get as a plan member. This includes your x-rays, condition continues to be stable. Your follow- laboratory tests, therapies, care from doctors who up care will be covered by our plan. If your are specialists, hospital admissions, and follow-up emergency care is provided by non-network care. Referrals are not required with our Piedmont providers, we will try to arrange for network WellStar Medicare Choice HMO plan, but your PCP providers to take over your care as soon as should be your primary resource when seeking your medical condition and the circumstances specialist care, hospital care, and coordination of allow. your medical services. With the Piedmont WellStar Medicare The “network providers” listed in this directory Choice HMO plan, you must use plan have agreed to provide you with your health care providers except in an emergency, urgent coverage. You may go to any of our network care situations, or for out-of-area renal providers listed in this directory. If you have dialysis services. If you obtain routine been going to one network provider, you are not care from out-of-network providers, required to continue going to the same provider. neither Medicare nor Piedmont WellStar In some cases, you may get covered services from Medicare Choice will be responsible for non-network providers, such as for emergency, the costs. urgent care, or out-of-area renal dialysis. How to submit a paper claim What is a medical emergency and Piedmont WellStar Medicare Choice network what is covered? providers bill us directly for Medicare-covered A medical emergency is when you believe that medical services that you receive. If a non- your health is in serious danger. A medical network provider sends you a bill, please call Member Services or send the bill to us for i payment. We will pay your doctor or reimburse The Piedmont WellStar Medicare Choice online you for our share of the bill and will let you provider directory provides the most updated know what, if anything, you must pay (e.g., provider information. Our website at www. copayments, coinsurance, or deductible). If pwplans.org includes additional information, you have any questions about how to submit such as a doctor’s areas of specialty (or group a paper claim, please contact us. Our contact practice), office locations, board certifications, information appears on the front and back hospital admitting privileges, and gender, cover pages. Or you can mail your claim to: and languages spoken. We update the online Piedmont WellStar Medicare Choice, 600 Grant provider search weekly with the latest changes Street, 24th Floor, Pittsburgh, PA 15219. to the Piedmont WellStar Medicare Choice network. What is the service area for Piedmont WellStar Medicare Choice? If you have questions about Piedmont WellStar The counties in our service area are listed Medicare Choice or require assistance in below. selecting a PCP, please call our Member Services Department at 855-222-1047 from 8 a.m. to Georgia 8 p.m., seven days a week.* TTY users should Cherokee Henry call 855-275-1266. Or visit www.pwplans.org. Cobb Paulding Coweta Pickens *Our hours of operation change throughout Douglas Rockdale the year. We are available to take your call: Fayette Spalding Oct. 1, 2013 through Feb. 14, 2014 from 8 a.m. Fulton to 8 p.m., seven days a week and Feb. 15, 2014 through Sept. 30, 2014 from 8 a.m. to 8 p.m., Monday through Friday, and 8 a.m. to 3 p.m. How do you find Piedmont on Saturday. WellStar Medicare Choice providers in your area? This directory contains all Piedmont WellStar Medicare Choice’s network providers for the Atlanta area. The directory is divided into two sections. The first section of the directory includes medical providers such as hospitals, outpatient facilities, PCPs, and specialists. The second section of the directory lists network pharmacies including chain pharmacies, retail pharmacies, home infusion, long-term care, specialty, and mail-order pharmacies. There is also an alphabetical index in the back of the directory that lists both the medical providers and pharmacies for your convenience. ii Section 2 – List of Network Providers Table of Contents Network Providers Participating Hospitals .............................................................................................................. 3 Services & Facilities ................................................................................................................... 6 Primary Care Providers ............................................................................................................16 Obstetrics & Gynecology Providers ......................................................................................... 28 Specialist Providers ..................................................................................................................32 Behavioral Health Facilities .................................................................................................... 80 Behavioral Health Providers ................................................................................................... 82 Pharmacy Directory Network Pharmacies Retail Chain Pharmacies ......................................................................................................... 95 Retail Pharmacies ................................................................................................................... 98 Home Infusion Pharmacies ....................................................................................................106 Long-Term Care Pharmacies ...................................................................................................108 Specialty Pharmacies ............................................................................................................. 112 Mail-Order Pharmacy ............................................................................................................. 114 Alphabetical Index ............................................................................................. 116 iii PARTICIPATING HOSPITALS PARTICIPATING HOSPITALS Atlanta Medical Center Spalding Regional Medical Center 303 Parkway Drive North East 601 South 8th Street Atlanta, GA 30312 Griffin, GA 30224 (404) 265-4000 (770) 228-2721 Atlanta Medical Center - South Campus WellStar Cobb Hospital 1170 Cleveland Avenue 3950 Austell Road Atlanta, GA 30344 Austell, GA 30106 (404) 466-1170 (770) 732-4000 North Fulton Regional Hospital WellStar Douglas Hospital 3000 Hospital Boulevard 8954 Hospital Drive Roswell, GA 30076 Douglasville, GA 30134 (770) 751-2500 (770) 949-1500 Piedmont Atlanta Hospital WellStar Kennestone Regional Medical Center 1968 Peachtree

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