Chiropractic and Acupuncture HMO Provider Directory
Total Page：16
File Type：pdf, Size：1020Kb
Health Net Medicare Advantage Chiropractic and Acupuncture HMO Provider Directory This directory provides a list of Health Net’s Medicare Advantage network providers for chiropractic and acupuncture services. This directory is for Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Placer, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Solano, Sonoma, Stanislaus, Tulare and Yolo counties. This directory is current as of September 2017. 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 Health Net Medicare Advantage network providers in your area, you can visit www.healthnet.com or call our Member Service Department at 1-800-275-4737. From October 1 through February 14, our office hours are 8:00 a.m. to 8:00 p.m., 7 days a week, excluding certain holidays. However, after February 14, our office hours are 8:00 a.m. to 8:00 p.m., Monday through Friday. On weekends and certain holidays, your call will be handled by our automated phone system. TTY users should call 711. Health Net has a contract with Medicare and the California state Medicaid program to offer HMO and HMO SNP plans. Enrollment in a Health Net Medicare Advantage plan depends on the renewal of these contracts. This information is also available in a different format including larger print and audio. Please call Member Service at the number listed above if you need plan information in another format. Y0020_18_3964DIR_NM Directorio de Proveedores de Servicios Quiroprácticos y de Acupuntura de Health Net Medicare Advantage HMO Este directorio proporciona una lista de los proveedores de la red de Health Net Medicare Advantage para servicios quiroprácticos y de acupuntura. Corresponde a los condados de Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Placer, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Solano, Sonoma, Stanislaus, Tulare y Yolo. Entra en vigencia a partir de septiembre de 2017. Es posible que se hayan agregado o eliminado algunos proveedores de nuestra red después de que se haya impreso este directorio. No garantizamos que todos los proveedores aún acepten afiliados nuevos. Para obtener la información más actualizada sobre los proveedores de la red de Health Net Medicare Advantage de su área, puede visitar www.healthnet.com, o bien, puede llamar a nuestro Departamento de Servicios al Afiliado al 1-800-275-4737. Desde el 1 de octubre hasta el 14 de febrero, nuestro horario de atención es de 8:00 a.m. a 8:00 p.m., los 7 días de la semana, excepto ciertos días feriados. Sin embargo, después del 14 de febrero, nuestro horario de atención será de 8:00 a.m. a 8:00 p.m., de lunes a viernes. Los fines de semana y ciertos días feriados su llamada será atendida por nuestro sistema automático de teléfono. Los usuarios de TTY deben llamar al 711. Health Net tiene un contrato con Medicare y el programa Medicaid de California para ofrecer planes HMO y HMO SNP. La inscripción en un plan Medicare Advantage depende de la renovación del contrato. Esta información también está disponible en un formato diferente, incluyendo letra más grande y audio. Llame al Departamento de Servicios al Afiliado al número que se indica anteriormente si necesita información sobre el plan en otro formato. Y0020_18_3964DIR_NM_SPNado 07152014 Table of Contents Section 1 – Introduction Sección 1 – Introducción Introduction ....................................................................................................................................................................................................................3 Section 2 – List of Network Providers Sección 2 – Lista de Proveedores de la Red Health Net Acupuncture Provider Listing .................................................................................................................................................17 Health Net Chiropractic Provider Listing ............................................................................................................................................... 101 Acupuncture and Chiropractic Provider Index ................................................................................................................................... 189 1 3 Section 1 – Introduction This directory provides a list of Health Net Medicare Advantage contracted network providers for chiropractic and acupuncture services. Supplemental chiropractic and acupuncture benefits are administered by American Specialty Health Groups, Inc. (ASH Groups). Authorization is not required for your first visit with an ASH Groups contracted provider; you can contact an ASH Groups provider directly to make an appointment. However, all subsequent covered chiropractic and acupuncture services must be medically necessary and may require verification of medical necessity. Your contracted provider of chiropractic or acupuncture services is responsible for obtaining any required verification of medical necessity. Not all Health Net members have the supplemental benefit that includes the acupuncture and additional chiropractic benefits. Please note that all Health Net members do have Medicare-covered chiropractic benefits (manual manipulation of the spine to correct subluxation) covered as part of the basic medical benefit. To get detailed information about your chiropractic and acupuncture care coverage, please see your Evidence of Coverage. Supplemental (non-Medicare covered) chiropractic and acupuncture services For Health Net Seniority Plus (HMO)*, Health Net Ruby Select (HMO) and Health Net Healthy Heart (HMO) members, there may be limits to the number of visits you can have for supplemental (non-Medicare covered) services. Services received from a provider who does not contract with ASH are not covered. To get detailed information about whether out-of-network providers should bill you directly or about your health care coverage, please refer to your Evidence of Coverage. 3 The“network providers” listed in this directory have agreed to provide you with your coverage. You may go to any of our network providers listed in this directory; however, some services may require a referral. Other providers are available in our network. If you have been going to one network provider, you are not required to continue going to that same provider. Some of your Health Net plan services are covered only if your network provider gets approval in advance (sometimes called “prior authorization”) from us. Please refer to your Health Net plan Evidence of Coverage for more information. Please Note: The providers in the following counties are only available to Health Net Seniority Plus (Employer HMO) Medicare Advantage members: Contra Costa County San Joaquin County San Mateo County Santa Barbara County Santa Cruz County Solano County For directories listing other Health Net participating network providers, facilities and/or pharmacies, please call Member Service at the number listed above if you need plan information in another format. Health Net Seniority Plus Ruby (HMO), Health Net Healthy Heart (HMO), Health Net Ruby Select (HMO), Health Net Gold Select (HMO), and Health Net Seniority Plus (Employer HMO) members), 8:00 a.m. to 8:00 p.m. PT., seven days a week. TTY users should call 711. 4 5 What Is the Service Area for Health Net Medicare Advantage Chiropractic and Acupuncture Providers? The counties and parts of counties in our service area are listed below. Southern area Northern area Kern County Alameda County Los Angeles County Fresno County Orange County Placer County for the following Riverside County ZIP codes only: San Bernardino County 95602, 95603, 95604, 95631, 95648, 95650, 95658, 95661, 95663, 95677, San Diego County 95678, 95681, 95701, 95703, 95713, Health Net Seniority Plus 95714, 95715, 95717, 95722, 95736, (Employer HMO) only: 95746, 95747, 95765 Contra Costa County Sacramento County San Joaquin County San Francisco County San Mateo County Santa Clara County Santa Barbara County for the following ZIP Sonoma County codes only: Stanislaus County 93013, 93014, 93067, 93101, 93102, 93103, 93105, Tulare County 93106, 93107, 93108, 93109, 93110, 93111, 93116, 93117, 93118, 93120, 93121, 93130, 93140, 93150, Yolo County 93160, 93190, 93199, 93252, 93427, 93436, 93437, 93438, 93440, 93441, 93460, 93463, 93464 Santa Cruz County Solano County 5 How Do You Find Health Net Medicare Advantage Chiropractic and Acupuncture Providers in Your Area? We have arranged the information in several different ways. If you are interested in a particular chiropractor or acupuncturist, turn to the Chiropractic and Acupuncture Providers Index. If you have questions about Health Net Medicare Advantage, please call our Member Service Department at 1-800-275-4737 (for Health Net Seniority Plus Green (HMO), Health Net Seniority Plus Ruby (HMO), Health Net Ruby Select (HMO), Health Net Healthy Heart (HMO), and Health Net Seniority Plus (Employer HMO) members). TTY users should call 711. Or, visit www.healthnet.com. Additional information can be obtained by contacting ASH Groups at 1-800-678-9133. Monday through Friday, 5:00 a.m. to 6:00 p.m. PT, except holidays. The provider network may change at any time. You will receive notice when necessary. 6 7 Sección 1 – Introducción Este directorio proporciona