PROVIDER DIRECTORY Cigna-HealthSpring STAR+PLUS CIGNA-HEALTHSPRING STAR+PLUS DIRECTORIO DE PROVEEDORES Summer 2019 Verano 2019 Tarrant Service Area: Tarrant Área de servicio: Denton, Hood, Johnson, Parker, Condados de Denton, Hood, Johnson, Parker, Tarrant, and Wise Counties Tarrant, y Wise Member Services Department: Departamento de Servicios para Miembros: 1-877-653-0327 (TTY 7-1-1) 1-877-653-0327 (TTY 7-1-1) Monday to Friday, 8 a.m. to 5 p.m. Central Time De lunas a viernes, de 8 a.m. a 5 p.m. Hora del centro http://starplus.mycignahealthspring.com http://starplus.mycignahealthspring.com MCDTX_19_74975 NA © 2019 Cigna TASP6C-0619 Table of Contents Section 1 Introduction ii Primary Care Provider Information ii OB/GYN Provider Information ii Family Planning Information iii Behavioral Health Provider and Facilities Information iii Long-Term Services and Support Information iii Pharmacy Information iii Texas Health Steps Provider Information iii Ancillary Provider Information iv How to Find Providers in Your Area iv Section 2 Network Providers iv How to Choose a Primary Care Provider iv How to Choose a Specialty Care Provider iv How to Choose Other Plan Providers iv Description of Provider Specialties v Section 3 List of Providers Primary Care Providers (PCP) 1 Urgent Care and After Hour Providers 32 Specialty Care Providers 37 Hospital Providers 101 Behavioral Health Providers and Facilities 103 Long-Term Services and Supports Providers 116 Pharmacy Providers 125 Dental Providers 126 Vision Providers 127 Nursing Facility Providers 128 Ancillary Service Providers 129 Section 4 Provider Index 143 SECTION 1 INTRODUCTION WELCOME TO CIGNA-HEALTHSPRING! You will get most of your medical services through Cigna-HealthSpring. We work with many doctors and hospitals in your community. When you sign up with Cigna-HealthSpring, you have a participating Primary Care Provider (PCP) “main doctor” who will help you get the right care for all of your health and medical needs. This Provider Directory provides a list of Cigna-HealthSpring’s network providers. The “network providers” listed in this directory have agreed to provide you with your health care coverage. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. You may go to any Cigna-HealthSpring participating provider. PRIMARY CARE PROVIDER INFORMATION When you enroll in Cigna-HealthSpring, you need to pick one of our network providers that are listed in this directory to be your Primary Care Provider or PCP. The term “PCP” will be used throughout this directory. Generally, you must get health care coverage from your PCP. Your PCP is a doctor or other healthcare provider who is trained to provide general medical care. A PCP can also help manage any other services you may need. If you have both Medicare and Medicaid coverage, you have two kinds of medical coverage. Your STAR+PLUS benefits will not reduce or change any of your Medicare benefits. Your PCP will be the doctor you have chosen through your Medicare HMO. You do not have to choose another PCP for STAR+PLUS services. Make sure that your Service Coordinator knows the name of your Medicare PCP. The following types of providers may be selected by any Cigna-HealthSpring Member as a PCP: Doctors specializing in Family Practice Doctors specializing in General Practice Doctors specializing in Internal Medicine Advanced Practice Registered Nurse (APRNS) - specializing in Adult and Family Practice Doctors specializing in Obstetrics/Gynecology (OB/GYN) – Female Members only Certified Registered Nurse Practitioners specializing in Women’s Health – Female Members Only Rural Health Clinic (RHC) Federally Qualified Health Clinic (FQHC) Pediatricians -- Members who are under the age of 21 Advanced Practice Registered Nurse (APRN) - specializing in Pediatrics – Members under the age of 21 Any Cigna-HealthSpring Member may select a Specialist doctor to act as their PCP. The Specialist doctor will need to agree to perform all of the duties of a PCP. If you need help picking a PCP, please call our Member Services Department at 1-877-653-0327, Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711). OB/GYN PROVIDER INFORMATION You have the right to pick a Cigna-HealthSpring OB/GYN without a referral from your PCP. You have access to the following services of an OB/GYN: One well-woman checkup per year Care related to pregnancy Care for any female medical condition Referral to a specialist doctor within the network You can also receive these services from your Primary Care Provider if you would like. Ask your PCP if he or she can give you OB/GYN care. You can call your Service Coordinator or Cigna-HealthSpring Member Services for help in picking an OB/GYN doctor. To enroll in Cigna-HealthSpring Call 1-800-964-2777 ii FAMILY PLANNING INFORMATION Family planning services such as birth control and counseling are very private; you do not need to ask your PCP to get these services. The Texas Women’s Health Program offers you family planning services that fit the way you live. Visit http://www.dshs.state.tx.us/famplan/locator.shtm, or call 1-800-335-8957 for help filling out the application or to find a doctor or clinic. You can also call Cigna-HealthSpring Member Services at 1-877-653-0327, Monday to Friday, 8 a.m. to 5 p.m. Central Time for assistance, TTY users (711). BEHAVORIAL HEALTH PROVIDER AND FACILITIES INFORMATION You can get behavioral health (mental health and substance abuse) services without a referral from your PCP. To get mental health and substance abuse services, call the Cigna-HealthSpring Behavioral Health Line at 1-877-725-2539. A representative will help you get the care you need by giving you the name of a provider near you. If you are experiencing a behavioral health emergency, you can call our Crisis Hotline at 877-562-4397 24 hours a day, 7 days a week. LONG TERM SUPPORT SERVICES INFORMATION You can get long-term support services (LTSS) such as adult foster care, assisted living services, day activity and health services and more as a Cigna-HealthSpring Member. Please call your Service Coordinator at 1-877-725-2688 Monday to Friday, 8 a.m. to 5 p.m. Central Time. A Service Coordinator will complete a health risk assessment that will identify the services that you may need. If you are eligible for any of these services, you, your Cigna-HealthSpring Service Coordinator, and your PCP will work together to get these services in place. PHARMACY INFORMATION You will receive your prescription medicine from participating Cigna-HealthSpring pharmacies. You do not have a limit on the number of medicines you get each month. To find out which pharmacies are in Cigna-HealthSpring’s network, you can call us at 1-877-653-0327 Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711) or look on our website at http://starplus.mycignahealthspring.com TEXAS HEALTH STEPS PROVIDER INFORMATION Texas Health Steps covers regular medical checkups. These checkups are very important. Your child may look and feel well, but may still have a health problem. With Texas Health Steps, you will know how your child is doing and how to help keep them healthy. During your child’s medical checkup, your child’s doctor will: Find health problems early Check to make sure your child is growing right, like other children their age Check your child’s teeth and gums Check your child’s eye sight and hearing Check to see how well your child is eating Check blood tests when needed Give facts and answer questions you might have about your child’s health Give vaccines Your child may go to any Texas Health Steps Medicaid provider for Texas Health Steps services. Many Cigna-HealthSpring doctors also offer Texas Health Steps services. They are listed in this Provider Directory. You may want to talk to your child’s primary care provider first. Also, do not forget to show your Cigna-HealthSpring ID card and the Your Texas Benefits Medicaid ID card to the provider. If you need help picking a Texas Health Steps provider, please call our Member Services Department at 1-877-653-0327, Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711). iii ANCILLARY PROVIDER INFORMATION Ancillary providers are providers such as laboratories, diagnostic radiology centers, hearing care providers, and providers of durable medical equipment. To help find a participating ancillary provider, please call your Service Coordinator at 1-877-725-2688 or you can call our Member Services Department at 1-877-653-0327 Monday to Friday, 8 a.m. to 5 p.m. Central Time, TTY users (711). HOW TO FIND PROVIDERS IN YOUR AREA To pick a PCP from the Provider Directory, turn to the Primary Care Providers section for a listing of primary care providers in your area. You can also call Member Services at the number below for help picking a primary provider. If you want to change to another PCP, you may do so at any time by calling our Member Services Department at the number listed below. The name and office phone number of your PCP will be printed on your membership card. To pick a specialty care provider, hospital, pharmacy, or other provider, please turn to the specific section in this Provider Directory for a listing of providers in your area. For example, to find hospitals in your area, turn to the Hospitals section of the directory.