Clear Spring Health PPO Plan Provider Directory This directory is current as of December 1, 2019. This directory provides a list of Clear Spring Health’s current network providers. This directory is for Colorado Service Area: Adams, Arapahoe, Boulder, Denver, Douglas, Jefferson, Larimer, and Weld county. To access Clear Spring Health’s online provider directory, you can visit www.clearspringhealthcare.com. For any questions about the information contained in this directory, please call our Member Service Department at 877-384-1241, we are open 8:00 am to 8:00 pm Md on ay – Friday from April 1 – September 30 and 8:00 am to 8:00 pm Monday – Sunday from Octe ob r 1 – March 31. TTY users should call 711. Out-of-network/non-contracted providers are under no obligation to treat Clear Spring Health members, except in emergency situations. Please call our Member Service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of- network services. Our plan has people and free interpreter services available to answer questions from disabled and non-English speaking members. We can also give you information in Braille, in large print, or other alternate formats at no cost if you need it. We are required to give you information about the plan’s benefits in a format that is accessible and appropriate for you. To get information from us in a way that works for you, please call Member Services or contact Office for Civil Rights. H2020_P054-10119_C Clear Spring Health has a contract with Medicare to offer HMO and PPO plans. Enrollment in Clear Spring Health depends on contract renewal. 1 Table of Contents Section 1 – Introduction .............................................................................................................. 3 What is the service area for Clear Spring Health? .................................................................. 5 How do you find Clear Spring Health providers in your area? .............................................. 5 Section 2 – List of Network Providers ........................................................................................ 6 Primary Care Providers (PCPs) ...............................................................................................6 Specialists............................................................................................................................... 49 Hospitals ............................................................................................................................... 236 Skilled Nursing Facilities (SNFs)......................................................................................... 238 Outpatient Mental Health Providers ..................................................................................... 240 Other Ancillary and Facility Providers... ............................................................................. 246 2 Section 1 – Introduction This directory provides a list of Clear Spring Health’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC). Clear Spring Health is a PPO plan that allows the use of in and out of network providers to obtain medical care and services. Clear Spring Health does not require you to select a physician to be your Primary Care Provider (PCP). Clear Spring Health does encourage you to identify a physician to be your PCP as generally, you must get your health care services from your PCP Your PCP should be your first point of contact for undiagnosed health concerns or health problems and routine health care needs. In addition to providing you care, your PCP will help arrange or coordinate the covered services you get as a plan member. This includes your x-rays, laboratory tests, therapies, care from doctors who are specialists, hospital admissions, and follow-up care. Referrals are not required with Clear Spring Health PPO plans, but your PCP should be your primary resource to use when seeking specialist and hospital care and coordination of your medical services. The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. Out-of-network providers are under no obligation to treat Clear Spring Health enrollees, except in emergencies. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Member Service Department at 877-384-1241, we are open 8:00 am to 8:00 pm Monday – Friday from April 1 – September 30 and 8:00 am to 8:00 pm Monday – Sunday from October 1 – March 31. TTY users should call 711. You may also refer to your Evidence of Coverage (EOC) for more information, including the cost sharing that applies to out-of-network services. In cases where out-of-network providers submit a bill directly to you, you should not pay the bill but should submit it to Clear Spring Health for processing and determination of your liability, if any. Please send the bill to the following address: Clear Spring Health P.O. Box 4048 Scranton, PA 18505 You may get covered emergency medical care whenever you need it from the nearest hospital or provider. You don’t need to get approval first from Clear Spring Health or your doctor. If you 3 have an emergency, Clear Spring Health will talk with the doctors who are giving you emergency care to help manage and follow up on your care. The doctors who are giving you emergency care will decide when your condition is stable and the medical emergency is over. After the emergency is over, you are entitled to follow-up care to be sure your condition continues to be stable. Your follow up care will be covered by our plan. Clear Spring Health pays for covered services when you visit a doctor or medical facility that is not included in the Clear Spring Health network. Except for emergencies or urgent care, it may cost more to get care. 4 What is the service area for Clear Spring Health? The counties in our service area are listed below. Colorado Service Area: Adams, Arapahoe, Boulder, Denver, Douglas, Jefferson, Larimer, and Weld county How do you find Clear Spring Health providers in your area? The Clear Spring Health Provider Directory contains participating providers within our service area. There are provider sections in the directory, such as participating hospitals and specialists, where we list facilities and providers within our service area to provide you with comprehensive network information. There is also an alphabetical index of our network providers in the back of the directory for your convenience. If you have questions about Clear Spring Health or require assistance in selecting a PCP, please call our Member Service Department at 877-384-1241, we are open 8:00 am to 8:00 pm Monday – Friday from April 1 – September 30 and 8:00 am to 8:00 pm Monday – Sunday from October 1 – March 31. TTY users should call 711. You can also visit www.clearspringhealthcare.com . 5 Primary Care Providers English MD, Aimee Palmer MD, Christina (PCPs) 12605 East 16Th Avenue 1635 Aurora Court, 3Rd Floor Aurora, CO 80045 Aurora, CO 80045 Colorado 720-848-0000 720-848-9474 Family Medicine Jacobs MD, Mollie Anne Raterink NP, Virginia 12348 East Montview Boulevard 1635 Aurora Court, 5Th Floor, Box Adams Aurora, CO 80045 B179 Arvada 303-724-9030 Aurora, CO 80045 720-848-3400 Vela Brol MD, Carlos 1635 Aurora Court, 3Rd Floor 5730 Ward Rd Aurora, CO 80045 Sharma MD, Rita Arvada, CO 80002 720-848-9474 1635 Aurora Court, 3Rd Floor 303-422-6331 Klein MD, Ann Aurora, CO 80045 720-848-9474 Aurora 1635 Aurora Court, 3Rd Floor Aurora, CO 80045 Spencer MD, Emily Abbott NP, Patricia 720-848-9474 12605 East 16Th Avenue 12348 East Montview Boulevard, Langner MD, Shannon Aurora, CO 80045 2Nd Floor 720-848-0000 Aurora, CO 80045 12605 East 16Th Avenue 303-724-6242 Aurora, CO 80045 Tanner NP, Lisa 720-848-0000 12348 East Montview Boulevard 12348 East Montview Boulevard, Aurora, CO 80045 Leininger DO, Jeffrey 2Nd Floor 303-724-9030 12605 East 16Th Avenue Aurora, CO 80045 Aurora, CO 80045 303-724-6242 Akbani NP, Mohammed 720-848-0000 Visweswaraiah MD, Anju 12348 East Montview Boulevard, 2Nd Floor Lyon DO, Corey 12605 East 16Th Avenue Aurora, CO 80045 12605 East 16Th Avenue Aurora, CO 80045 303-724-6242 Aurora, CO 80045 720-848-0000 720-848-0000 Brougham DO, Heather White DO, Marla 12605 East 16Th Avenue Martin MD, Barry 1635 Aurora Court, 3Rd Floor Aurora, CO 80045 1635 Aurora Ct, Box B178 Aurora, CO 80045 720-848-0000 Aurora, CO 80045 720-848-9474 720-848-2300 1635 Aurora Court Burke MD, Daniel Aurora, CO 80045 12605 East 16Th Avenue Mcdonough NP, Ellen 720-848-0000 Aurora, CO 80045 12348 East Montview Boulevard, 720-848-0000 2Nd Floor Woodard PA, Katie Aurora, CO 80045 12605 East 16Th Avenue Carroll MD, Jennifer 303-724-6242 Aurora, CO 80045 12348 East Montview Boulevard 720-848-0000 Aurora, CO 80045 Montgomery MD, Linda 303-724-9030 12605 East 16Th Avenue Brighton Aurora, CO 80045 1635 Aurora Court Bauer MD, William 720-848-0000 Aurora, CO 80045 1606 Prairie Center Parkway, Suite 720-848-0000 Nowels MD, David 240 Cheshire DNP, Emily 12605 E 16Th Ave Fl 3, Box B130 Brighton, CO 80601 303-659-1152 12348 East Montview Boulevard, Aurora, CO 80045 2Nd Floor 720-848-6799 1606 Prairie Center Pkwy Ste 240 Aurora, CO 80045 12605 East 16Th Avenue Brighton, CO 80601 303-724-6242 Aurora, CO 80045 303-659-1152