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In Network ER Hospital List

In Network ER Hospital List

Emergency Room Provider Directory LifeWise Assurance Company Member Plans Last updated March 4, 2021 To make sure your benefits cover ER services at the highest level, use the following list to see if the ER physicians group serving our participating is in-network. The cost to you for receiving ER services from an out-of-network ER physicians group may be higher even when received at an in-network . LifeWise Assurance Co Network ER Physician Group City State In-Network Hospital ER Physician Group Servicing the Status Olympia WA Capital Medical Center Thurston Emergency Group In-Network Leavenworth WA Cascade Medical Center Cascade Medical Center In-Network Arlington WA Cascade Valley Hospital Northwest Emergency Physicians In-Network Wenatchee WA Central Washington Hospital Central Washington Hospital In-Network Ephrata WA Columbia Basin Hospital Beezley Springs Inpatient Services In-Network Astoria OR Columbia Memorial Hospital Oregon Health & Science University (OHSU) Out-of-Network Grand Coulee WA Coulee Medical Center Coulee Medical Center In-Network Dayton WA Dayton General Hospital Dayton General Hospital In-Network Ritzville WA East Adams Rural Hospital East Adams Rural Hospital In-Network Kirkland WA EvergreenHealth Medical Center Evergreen Emergency Services In-Network Monroe WA EvergreenHealth Monroe North Sound Emergency Medicine In-Network Republic WA Ferry County Memorial Hospital Ferry County Memorial Hospital In-Network Forks WA Forks Forks Community Hospital In-Network Pomeroy WA Garfield County Memorial Hospital Garfield County Memorial Hospital In-Network Aberdeen WA Grays Harbor Community Hospital Northwest Emergency Physicians In-Network Moscow ID Gritman Medical Center Gritman Medical Center In-Network Seattle WA Harborview Medical Center at Harborview In-Network Bremerton WA Harrison Medical Center West Sound Emergency Physicians In-Network Silverdale WA Harrison Medical Center West Sound Emergency Physicians In-Network Anacortes WA Island Hospital Northwest Emergency Physicians In-Network

LifeWise Health Plan of Washington

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Emergency Room Provider Directory LifeWise Assurance Company Member Plans Last updated March 4, 2021 ER Physician Group City State In-Network Hospital ER Physician Group Servicing the Hospital Network Status Port Townsend WA Jefferson Healthcare Hospital Jefferson Healthcare Hospital In-Network Walla Walla WA Jonathan M Wainwright Memorial VA Medical Center ER services are not offered at this facility. Richland WA Kadlec Regional Medical Center Northwest Emergency Physicians In-Network Kennewick WA Kadlec (Free-Standing) Emergency Room in Kennewick Northwest Emergency Physicians In-Network Ellensburg WA Kittitas Valley Community Hospital Kittitas Valley Community Hospital In-Network Goldendale WA Klickitat Valley Hospital Klickitat Valley Hospital In-Network Coeur D’Alene ID Kootenai Health Kootenai Health In-Network Chelan WA Lake Chelan Community Hospital Lake Chelan Community Hospital In-Network Vancouver WA Legacy Salmon Creek Northwest Acute Care Specialists Out-of-Network Davenport WA Lincoln Hospital Lincoln Hospital In-Network Pasco WA Lourdes Medical Center Northwest Emergency Physicians In-Network Tacoma WA Mary Bridge Children’s Hospital and Health Center Mary Bridge Emergency Department In-Network Shelton WA Mason General Hospital Mason General Hospital In-Network Omak WA Mid Valley Hospital Mid Valley Hospital In-Network Morton WA Morton General Hospital Morton General Hospital In-Network Tacoma WA MultiCare Allenmore Hospital Tacoma Emergency Care Physician In-Network Auburn WA MultiCare Auburn Medical Center Cascade Emergency Physicians In-Network Covington WA MultiCare Covington Medical Center Tacoma Emergency Care Physician In-Network Spokane WA MultiCare Deaconess Hospital Spokane Emergency Care Physicians In-Network MultiCare Deaconess North (Free-Standing) Emergency Spokane WA Spokane Emergency Care Physicians In-Network Center Puyallup WA MultiCare Good Samaritan Hospital Mt Rainier Emergency Physicians In-Network Parkland WA MultiCare Good Samaritan (Free-Standing) Emergency Western Washington Emergency Physicians In-Network Tacoma WA MultiCare Tacoma General Hospital Tacoma Emergency Care Physician In-Network Spokane WA MultiCare Valley Hospital Spokane Emergency Care Physicians In-Network Newport WA Newport Community Hospital Newport Community Hospital In-Network

LifeWise Health Plan of Washington

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Emergency Room Provider Directory LifeWise Assurance Company Member Plans Last updated March 4, 2021 ER Physician Group City State In-Network Hospital ER Physician Group Servicing the Hospital Network Status Tonasket WA North Valley Hospital North Valley Hospital In-Network Ilwaco WA Ocean Beach Hospital Ocean Beach Hospital In-Network Odessa WA Odessa Memorial Healthcare Center Odessa Memorial Healthcare Center In-Network Port Angeles WA Olympic Medical Center Olympic Medical Center In-Network Othello WA Othello Community Hospital Othello Community Hospital In-Network Bellevue WA Overlake Hospital Medical Center Puget Sound Physicians In-Network Friday Harbor WA PeaceHealth Peace Island Medical Center PeaceHealth Peace Island Medical Center In-Network Vancouver WA PeaceHealth Southwest Medical Center Emergency Medicine Associates Out-of-Network Bellingham WA PeaceHealth St. Joseph Medical Center Northwest Emergency Physicians In-Network Sound Physicians of Emergency Medicine of Sedro Woolley WA PeaceHealth United General Hospital Out-of-Network Washington Prosser WA Prosser Memorial Hospital Prosser Memorial Hospital In-Network Centralia WA Providence Centralia Hospital Northwest Emergency Physicians In-Network Spokane WA Providence Holy Family Hospital Emergency Physician Services In-Network Colville WA Providence Mount Carmel Hospital Providence Mount Carmel Hospital In-Network Providence Regional Medical Center Everett Colby Everett WA North Sound Emergency Medicine In-Network Campus Providence Sacred Heart Medical Center and Children’s Spokane WA Spokane Emergency Physicians In-Network Hospital Chewelah WA Providence St. Joseph’s Hospital Providence St. Joseph’s Hospital In-Network Walla Walla WA Providence St. Mary Medical Center Providence St. Mary Medical Center In-Network Olympia WA Providence St. Peter Hospital Olympia Emergency Service In-Network Pullman WA Pullman Regional Hospital Pullman Regional Hospital In-Network Quincy WA Quincy Valley Hospital Quincy Valley Hospital In-Network Moses Lake WA Samaritan Hospital Samaritan Hospital In-Network Seattle WA Seattle Cancer Care Alliance ER services are not offered at this facility. Seattle WA Seattle Children’s Hospital Seattle Children’s Hospital In-Network LifeWise Health Plan of Washington

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Emergency Room Provider Directory LifeWise Assurance Company Member Plans Last updated March 4, 2021 ER Physician Group City State In-Network Hospital ER Physician Group Servicing the Hospital Network Status Toppenish WA SHC Medical Center Toppenish Olney Emergency Group In-Network Spokane WA Shriners Hospital for Children ER services are not offered at this facility. Mount Vernon WA Skagit Valley Hospital Northwest Emergency Physicians In-Network White Salmon WA Skyline Hospital Skyline Hospital In-Network Snoqualmie WA Snoqualmie Valley Hospital Snoqualmie Valley Hospital In-Network Spokane WA Spokane VA Medical Center ER services are not offered at this facility. Burien WA St. Anne Hospital Highline Emergency Physicians In-Network Gig Harbor WA St. Anthony Hospital Northwest Emergency Physicians In-Network Lakewood WA St. Clare Hospital Northwest Emergency Physicians In-Network Enumclaw WA St. Elizabeth Hospital Northwest Emergency Physicians In-Network Federal Way WA St. Francis Community Hospital Northwest Emergency Physicians In-Network Longview WA St. John Medical Center St. John’s Emergency Physicians In-Network Tacoma WA St. Joseph Medical Center Northwest Emergency Physicians In-Network Elma WA Summit Pacific Medical Center Summit Pacific Medical Center In-Network Sunnyside WA Sunnyside Community Hospital Sunnyside Emergency Group In-Network Edmonds WA Swedish Edmonds California Emergency Physicians In-Network Seattle WA Swedish Medical Center Ballard Ballard Emergency Physicians In-Network Seattle WA Swedish Medical Center Cherry Hill Seattle Emergency Physicians In-Network Seattle WA Swedish Medical Center First Hill Seattle Emergency Physicians In-Network Issaquah WA Swedish Medical Center Issaquah Eastside Emergency Physicians In-Network Swedish Mill Creek Campus (Free-standing Emergency Mill Creek WA Eastside Emergency Physicians In-Network Room) Swedish Redmond Campus (Free-standing Emergency Redmond WA Eastside Emergency Physicians In-Network Room) Brewster WA Three Rivers Hospital Three Rivers Hospital In-Network Clarkston WA Tri-State Memorial Hospital Tri-State Memorial Hospital In-Network

LifeWise Health Plan of Washington

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Emergency Room Provider Directory LifeWise Assurance Company Member Plans Last updated March 4, 2021 ER Physician Group City State In-Network Hospital ER Physician Group Servicing the Hospital Network Status Kennewick WA Trios Southridge Hospital Columbia Valley Emergency Physicians In-Network University of Washington Medical Center – Montlake Seattle WA Emergency Department at UWMC In-Network Campus University of Washington Medical Center – Northwest Seattle WA Emergency Department at UWMC In-Network Campus VA Puget Sound Services - American Lake Tacoma WA ER services are not offered at this facility. Division Seattle WA VA Puget Sound Health Care System - Seattle ER services are not offered at this facility. Renton WA Valley Medical Center Associated Emergency Physicians In-Network Seattle WA Virginia Mason Hospital and Medical Center Virginia Mason Hospital and Medical Center In-Network Yakima WA Virginia Mason Memorial Hospital Virginia Mason Memorial Hospital In-Network Wenatchee WA Wenatchee Valley Hospital Wenatchee Valley Hospital In-Network Coupeville WA WhidbeyHealth Medical Center WhidbeyHealth Medical Center In-Network Colfax WA Whitman Hospital and Medical Center Whitman Hospital and Medical Center In-Network South Bend WA Willapa Harbor Hospital Willapa Harbor Hospital In-Network

Disclaimer: LifeWise makes reasonable efforts to validate that the list of providers displayed is up to date and accurate. If possible, please verify with the hospital or the physician that they continue to be a member of the network. A provider listing in the locator website is not an indication that the provider’s services are eligible for benefits. Please consult your summary plan description, contact customer service at 800-971-1491, or have the provider submit a benefit advisory to determine available benefits. Important note: Providers in our network may have more than one medical group affiliation, so a provider’s network participation can vary depending upon where he/she is providing services. Be sure to confirm the provider's network participation at the location you plan to visit. Also note, not all members have out-of-area coverage. Please call customer service or check your benefit summary plan to verify. Balance Billing Protection Act: The Washington state legislature passed the Balance Billing Protection Act in 2019 which prohibits balance billing for emergency services provided by non- contracted providers in Washington, Oregon, and Idaho. This act also prohibits balance billing for covered surgical or ancillary services provided by a non-contracted provider in an in-network facility in Washington. The act is effective January 1, 2020 and applies to Premera members covered under fully-insured plans and self-funded plans that choose to participate.

LifeWise Health Plan of Washington

039155 (03-04-2021) 5 Discrimination is Against the Law LifeWise Assurance Company (LifeWise) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. LifeWise does not exclude people or treat them differently because of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. LifeWise provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats, other formats). LifeWise provides free language services to people whose primary language is not English, such as qualified interpreters and information written in other languages. If you need these services, contact the Civil Rights Coordinator. If you believe that LifeWise has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Civil Rights Coordinator ─ Complaints and Appeals, PO Box 91102, Seattle, WA 98111, Toll free: 855-332-6396, Fax: 425-918-5592, TTY: 711, Email [email protected]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Ave SW, Room 509F, HHH Building, Washington, D.C. 20201, 1-800- 368-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Language Assistance ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 800-971-1491 (TTY: 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 800-971-1491(TTY:711)。 CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 800-971-1491 (TTY: 711). 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 800-971-1491 (TTY: 711) 번으로 전화해 주십시오. ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 800-971-1491 (телетайп: 711). PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 800-971-1491 (TTY: 711). УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. Телефонуйте за номером 800-971-1491 (телетайп: 711). 䮚បយ័ត�៖ េបើសិន�អ�កនិ�យ ��ែខ� រ, េស�ជំនួយែផ�ក�� េ�យមិនគិតឈ� �ល គឺ�ច�នសំ�ប់បំេរ �អ�ក។ ចូរ ទូរស័ព� 800-971-1491 (TTY: 711)។ 注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。800-971-1491(TTY:711) まで、お電話にてご連絡ください。 ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 800-971-1491 (መስማት ለተሳናቸው: 711). XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 800-971-1491 (TTY: 711). ﻣﻠﺤﻮظﺔ: إذا ﻛﻨﺖ ﺗﺘﺤﺪث اذﻛﺮ اﻟﻠﻐﺔ، ﻓﺈن ﺧﺪﻣﺎت اﻟﻤﺴﺎﻋﺪة اﻟﻠﻐﻮﯾﺔ ﺗﺘﻮاﻓﺮ ﻟﻚ ﺑﺎﻟﻤﺠﺎن. اﺗﺼﻞ ﺑ ﺮ ﻗ ﻢ 1491-971-800 ( ر ﻗ ﻢ ھﺎﺗﻒ ا ﻟ ﺼ ﻢ واﻟﺒﻜﻢ: 711). ਿਧਆਨ ਿਦਓ: ਜੇ ਤੁਸ� ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ, ਤ� ਭਾਸ਼ਾ ਿਵੱਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ। 800-971-1491 (TTY: 711) 'ਤੇ ਕਾਲ ਕਰੋ। ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 800-971-1491 (TTY: 711). ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 800-971-1491 (TTY: 711). ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 800-971-1491 (TTY: 711). ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 800-971-1491 (ATS : 711). UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 800-971-1491 (TTY: 711). ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 800-971-1491 (TTY: 711). ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 800-971-1491 (TTY: 711). ﺗﻮﺟﮫ: اﮔﺮ ﺑﮫ زﺑﺎن ﻓﺎرﺳﯽ ﮔﻔﺘﮕﻮ ﻣﯽ ﮐﻨﯿﺪ، ﺗﺴﮭﯿﻼت زﺑﺎﻧﯽ ﺑﺼﻮرت راﯾﮕﺎن ﺑﺮای ﺷﻤﺎ ﻓﺮاھﻢ ﻣﯽ ﺑﺎﺷﺪ. ﺑﺎ (TTY: 711) 1491-971-800 ﺗﻤﺎس ﺑﮕﯿﺮﯾﺪ. 037404 (11-06-2019)