2016 UPMC for Life HMO/PPO Plan Provider Directory This directory provides a list of UPMC for Life’s network providers. This directory is for the following counties in our 29-county service area: Pennsylvania Armstrong Crawford Lancaster Bedford Elk Lawrence Blair Erie McKean Cambria Forest Mercer Cameron Huntingdon Potter Clarion Indiana Somerset Clearfield Jefferson Venango Warren 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’s network providers in your area, you can visit www.upmchealthplan.com/medicare or call our Member Services Department at 1-877-539-3080, seven days a week from 8 a.m. to 8 p.m.* TTY users should call 1-800-361-2629. UPMC for Life has a contract with Medicare to provide HMO and PPO plans. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc., and UPMC Health Benefits 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_2002a Accepted Section 1 — Introduction This directory provides a list of UPMC for Life’s How to submit a paper claim network providers. To get detailed information UPMC for Life network providers bill us about your health care coverage, please see your directly for Medicare-covered medical services Evidence of Coverage. that you receive. If an out-of-network provider sends you a bill, please call Member Services If you join a UPMC for Life HMO plan, you or send the bill to us for payment. We will pay must use network providers to obtain medical your doctor or reimburse you for our share of care and services. You will have to choose one the bill and will let you know what, if anything, of our network providers who are listed in this you must pay (e.g., copayments, coinsurance directory to be your Primary Care Physician or deductible). If you have any questions about (PCP). The term “PCP” will be used throughout how to submit a paper claim, please contact this directory. Generally, you must get your us. Our contact information appears on the health care services from your PCP. A PCP is not front and back cover pages. Or you can mail required with the UPMC for Life PPO plans, but your claim to: UPMC for Life, P.O. Box 2997, we still encourage you to select a primary care Pittsburgh, PA 15230. physician. What is a medical emergency and A PCP should be your first point of contact for what is covered? undiagnosed health concerns or health problems A medical emergency is when you believe that and routine health care needs. Besides providing your health is in serious danger. A medical much of your care, your PCP will help arrange emergency includes severe pain, a bad injury, or coordinate the rest of the covered services you a sudden illness, or a medical condition that get as a plan member. This includes your x-rays, is quickly getting much worse. You may get laboratory tests, therapies, care from doctors who covered emergency medical care whenever are specialists, hospital admissions, and follow-up you need it from the nearest hospital or care. Referrals are not required with UPMC for provider, anywhere in the world. You don’t Life HMO or PPO plans, but your PCP should need to get approval first from UPMC for Life be your primary resource to use when seeking or your doctor. specialist and hospital care and coordination of your medical services. If you have an emergency, our plan will talk with the doctors who are giving you The “network providers” listed in this directory emergency care to help manage and follow have agreed to provide you with your: health care/ up on your care. The doctors who are dental/vision/fitness services. You may go to any giving you emergency care will decide when of our network providers listed in this directory. If your condition is stable and the medical you have been going to one network provider, you emergency is over. After the emergency is are not required to continue going to that same over, you are entitled to follow-up care to be provider. In some cases, you may get covered sure your condition continues to be stable. services from non-network providers, such as Your follow-up care will be covered by our for emergency, urgent care, or out-of-area renal plan. If your emergency care is provided dialysis. The UPMC for Life PPO plans also pay by non-network providers, we will try to for covered services when you visit a doctor or arrange for network providers to take over medical facility that is not included in the UPMC your care as soon as your medical condition for Life network. Except for an emergency or and the circumstances allow. urgent care services, the PPO plan out-of-network cost-sharing may be higher than if network providers are used. i With the UPMC for Life HMO plans How do you find UPMC for Life you must use plan providers except in providers in your area? emergency or urgent care situations, or for This is a regional directory that contains out-of-area renal dialysis services. If you UPMC for Life network providers listed by obtain routine care from out-of-network provider type and county. All network PCPs providers, neither Medicare nor UPMC and specialists are NOT listed in this for Life will be responsible for the costs. directory. If you want to receive additional With the UPMC for Life PPO plans, the out- provider information for a county that may not of-network cost-sharing may be higher than be included in this directory, please contact us. in-network, with the exception of emergency Our contact information appears on the front and urgent care. and back cover pages. What is the service area for UPMC for Life? There are provider sections in this directory, The counties in our service area are listed such as participating hospitals and cancer below. centers, where we list every hospital or facility within our service area to provide you with Pennsylvania: the most comprehensive network information. Allegheny Greene There is also an alphabetical index in the back Armstrong Huntingdon of the directory for your convenience. Beaver Indiana Bedford Jefferson The UPMC for Life online provider Blair Lancaster directory provides the most updated Butler Lawrence provider information. Our website at www. Cambria McKean upmchealthplan.com/medicare includes Cameron Mercer additional information, such as a doctor’s Clarion Potter area(s) of specialty (or group practice), Clearfield Somerset accepting new patients, office locations, board Crawford Venango certifications, hospital admitting privileges, Elk Warren gender, and languages spoken. Erie Washington Fayette Westmoreland If you have questions about UPMC for Life or Forest require assistance in selecting a PCP, please call our Member Services Department at 1-877- 539-3080, seven days a week from 8 a.m. to 8 p.m.* TTY users should call 1-800-361-2629. Or, visit www.upmchealthplan.com/medicare. *Our hours of operation change twice a year. You can call us October 1 through February 14, seven days a week from 8 a.m. to 8 p.m. From February 15 through September 30, you can call us Monday through Friday from 8 a.m. to 8 ii p.m., and Saturday from 8 a.m. to 3 p.m. Section 2 — List of Network Providers Total counts, of each provider type, for this document are as follows: 71 Hospitals 1,139 PCPs 2,448 Specialists Table of Contents Network Providers Participating Hospitals ......................................................................................................................................... 3 UPMC CancerCenters - Network Locations ........................................................................................................... 8 Services & Facilities ........................................................................................................................................... 12 Primary Care Providers ...................................................................................................................................... 78 Obstetrics & Gynecology Providers ................................................................................................................... 120 Specialist Providers ......................................................................................................................................... 132 Behavioral Health Facilities .............................................................................................................................. 260 Behavioral Health Providers ............................................................................................................................. 266 Routine Dental ................................................................................................................................................ 278 Routine Vision .................................................................................................................................................. 297 Fitness Facilities .............................................................................................................................................. 321 Pharmacy Directory Network Pharmacies Retail Pharmacies, including Chain Pharmacies