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2016 UPMC for Life Options (HMO SNP) Provider Directory This directory provides a list of UPMC for Life Options network providers. This directory is for the following counties in our three county service area: Pennsylvania Allegheny Erie Washington This directory is current as of August, 2015. 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 UPMC for Life Option’s network providers in your area, you can visit www.upmchealthplan.com/snp or call our Member Services Department at 1-800-606-8648, seven days a week from 8 a.m. to 8 p.m.* TTY users should call 1-866-407-8762. UPMC for Life Options is an HMO SNP plan with a Medicare contract. Enrollment in UPMC for Life Options depends on contract renewal. UPMC for Life Options is a product of and operated by UPMC Health Plan Inc. The pharmacy and provider network may change at any time. You will receive notice when necessary. This document may be available in an alternative format such as Braille, larger print, or audio; please call Member Services at the phone number listed above. Y0069_16_3000 Accepted Section 1 — Introduction This directory provides a list of UPMC for Life you must pay (e.g., copayments, coinsurance Options network providers. To get detailed or deductible). If you have any questions about information about your health care coverage, how to submit a paper claim, please contact us. please see your Evidence of Coverage. Our contact information appears on the front and back cover pages. Or, you can mail your You will have to choose one of our network claim to: UPMC for Life Options, Member providers who are listed in this directory to be Services Department, U.S. Steel Tower, 600 your Primary Care Physician (PCP). The term Grant Street, Pittsburgh, PA 15219. “PCP” will be used throughout this directory. Generally, you must get your health care services What is a medical emergency and from your PCP. what is covered? A medical emergency is when you believe that A PCP should be your first point of contact for your health is in serious danger. A medical undiagnosed health concerns or health problems emergency includes severe pain, a bad injury, and routine health care needs. Besides providing a sudden illness, or a medical condition that much of your care, your PCP will help arrange is quickly getting much worse. You may get or coordinate the rest of the covered services you covered emergency medical care whenever get as a plan member. This includes your x-rays, you need it from the nearest hospital or laboratory tests, therapies, care from doctors who provider, anywhere in the world. You don’t are specialists, hospital admissions, and follow- need to get approval first from UPMC for Life up care. Referrals are not required with UPMC Options or your doctor. for Life Options, but your PCP should be your primary resource to use when seeking specialist If you have an emergency, our plan will and hospital care and coordination of your talk with the doctors who are giving you medical services. emergency care to help manage and follow up on your care. The doctors who are giving The “network providers” listed in this directory you emergency care will decide when your have agreed to provide you with your health care, condition is stable and the medical emergency vision, and dental services. You may go to any of is over. After the emergency is over, you are our network providers listed in this directory. If entitled to follow-up care to be sure your you have been going to one network provider, you condition continues to be stable. Your follow- are not required to continue to go to that same up care will be covered by our plan. If your provider. In some cases, you may get covered emergency care is provided by non-network services from non-network providers, such as for providers, we will try to arrange for network emergency or urgent care situations, like out-of- providers to take over your care as soon as your area renal dialysis or other services. medical condition and the circumstances allow. How to submit a paper claim You must use plan providers except in an UPMC for Life Options’ network providers bill emergency, urgent care situations, or for us directly for Medicare-covered medical services out-of-area renal dialysis. If you obtain that you receive. If an out-of-network provider routine care from out-of-network providers, sends you a bill, please call Member Services and neither Medicare nor UPMC for Life they will send you a claim form. Once the claim Options will be responsible for the costs. form is received, send the claim form and the bill to us for payment consideration. We may pay your doctor or reimburse you for our share of the bill and will let you know what, if anything, i What is the service area for The UPMC for Life Options online provider UPMC for Life Options? directory provides the most updated The counties in our service area are provider information. Our website at www. listed below. upmchealthplan.com/snp includes additional information, such as a doctor’s area(s) of Pennsylvania counties: specialty (or group practice), whether he or Allegheny she is accepting new patients, office locations, Erie board certifications, hospital admitting Washington privileges, gender, and languages spoken. We update the online provider directory weekly How do you find UPMC for Life with the latest changes to the UPMC for Life Options providers in your area? Options network. All network PCPs and specialists are NOT listed in this directory. If you want to receive If you have questions about UPMC for Life additional provider information for a county Options or need help in selecting a PCP, please that is not included in this directory, please call our Member Services Department at contact Member Services at the phone number 1-800-606-8648, seven days a week from 8 a.m. listed below or visit our website at www. to 8 p.m.* TTY users should call 1-866-407- upmchealthplan.com/snp. 8762. Or, visit www.upmchealthplan.com/snp. There are provider sections in this directory, such as participating hospitals and cancer centers, where we list every hospital or facility within your service area to provide you with the most comprehensive network information. There is also an alphabetical index in the back of the directory for your convenience. *Our hours of operation change twice a year. You can call us October 1 through February 14, from 8 a.m. to 8 p.m., seven days a week. From February 15 through September 30, you can call us from 8 a.m. to 8 p.m., Monday through Friday, ii and from 8 a.m. to 3 p.m., Saturday. UPMC for Life Options Allegheny County Service Area Because of the large number of providers in Allegheny County, we have divided the provider listings into five geographic sections: Allegheny Central, North, South, East, and West. Find your ZIP code under the geographic region listed below and then reference the providers listed in that region for PCPs, Obstetrics & Gynecology, and Specialists. Allegheny County Service Areas CENTRAL NORTH SOUTH WEST 15201 Pittsburgh 15006 Bairdford 15020 Bunola 15017 Bridgeville 15203 15007 Bakerstown 15025 Clairton 15031 Cuddy 15204 15014 Brackenridge 15034 Dravosburg 15046 Crescent 15210 15015 Bradfordwoods 15037 Elizabeth 15064 Morgan 15211 15024 Cheswick 15038 Elrama 15071 Oakdale 15212 15030 Creighton 15045 Glassport 15082 Sturgeon 15213 15032 Curtisville 15088 West Elizabeth 15106 Carnegie 15214 15044 Gibsonia 15102 Bethel Park 15108 Coraopolis 15216 15049 Harwick 15122 West Mifflin 15126 Imperial 15217 15051 Indianola 15123 West Mifflin 15136 McKees Rocks 15219 15056 Leetsdale 15129 South Park 15142 Presto 15220 15222 15065 Natrona Heights 15133 McKeesport 15189 Sewickley 15224 15076 Russellton 15200 Pittsburgh 15205 Pittsburgh 15226 15084 Tarentum 15207 15231 15232 15086 Warrendale 15227 15241 15233 15090 Wexford 15228 15242 15260 15091 Wildwood 15230 15243 15261 15095 Warrendale 15234 15244 15282 15096 Warrendale 15236 15250 15101 Allison Park 15252 15251 EAST 15116 Glenshaw 15254 15253 15018 Buena Vista 15127 Ingomar 15257 15255 15028 Coulters 15143 Sewickley 15258 15263 15035 East McKeesport 15144 Springdale 15259 15264 15047 Greenock 15202 Pittsburgh 15262 15265 15075 Rural Ridge 15209 15270 15266 15104 Braddock 15215 15278 15267 15110 Duquesne 15223 15281 15268 15112 East Pittsburgh 15225 15272 15120 Homestead 15229 15274 15130 McKeesport 15237 15275 15131 15238 15276 15132 15285 15277 15134 15279 15135 15283 15137 North Versailles 15286 15139 Oakmont 15290 15140 Pitcairn 15295 15145 Turtle Creek 15146 Monroeville 15147 Verona 15148 Wilmerding 15206 Pittsburgh 15208 15218 15221 15235 15239 15240 iii Allegheny County Service Areas iv Section 2 — List of Network Providers Table of Contents Network Providers Count Page Participating Hospitals .....................................................................(62 Providers) .............................................. 9 UPMC CancerCenters - Network Locations .......................................(39 Providers) ............................................ 15 Services & Facilities .........................................................................(358 Providers) .......................................... 18 Primary Care Providers ....................................................................(973 Providers) .......................................... 44 Obstetrics & Gynecology Providers ...................................................(202
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