2021 Provider Directory Directorio de Proveedores Pinal Maricopa Banner Medicare Advantage Plus PPO H7273_ProvDirectory001CY21_C Banner Medicare Advantage Plus PPO Plan Provider Directory This directory is current as of 08/01/2021. This directory provides a list of Banner Medicare Advantage Plus PPO’s current network providers. This directory is for the following counties in Arizona: Maricopa and Pinal. To access Banner Medicare Advantage Plus PPO’s online provider directory, you can visit www.BannerMA.com. For any questions about the information contained in this directory, please call our Customer Care Center at (844) 549-1859, 8 a.m. to 8 p.m., 7 days a week. TTY users should call 711. Banner Medicare Advantage Plus PPO complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (844) 549-1859 (TTY: 711). I Section 1 – Introduction This directory provides a list of Banner Medicare Advantage Plus PPO network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC). You will have to choose one of our network providers listed in this directory to be your Primary Care Provider (PCP). The term PCP will be used throughout this directory. Generally, you must get your health care services from your PCP. Your PCP is a physician or nurse practitioner who meets the state requirements and is trained to give you basic medical care. You will receive your routine or basic care from your PCP. Your PCP will also coordinate the rest of the covered services you get as a member of our plan. For example, in order for you to see a specialist, you usually need to get your PCP’s approval first (this is called getting a “referral” to a specialist). The network providers listed in this directory have agreed to provide you with your health care, vision and dental services. You may go to any of our network providers listed in this directory; however, some services may require a referral. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers. Other physicians / providers are available in our network. Some specialists might ask for a referral from your PCP before they will agree to see you. The specialist needs to have an understanding of your medical history and the conditions the specialist will need to treat. This information prepares the specialist to provide you with the most efficient and highest quality care. Out-of-network providers are under no obligation to treat Banner Medicare Advantage Plus 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 Customer Care team at (844)549-1859, TTY 711 8 a.m. to 8 p.m., seven days a week. You may also refer to your Evidence of Coverage (EOC) for more information, including the cost sharing that applies to out-of-network services. If you receive a bill from a non-contracted provider, do not pay the bill. Send the bill to Banner Medicare Advantage Plus PPO in order for us to process and determine if you have any liability for the bill. When you have a “medical emergency”, you believe that your health is in serious danger. A medical emergency can include severe pain, a bad injury, a sudden illness or a medical condition that is quickly getting much worse. If you have a medical emergency: Get help as quickly as possible. Call 911 for help or go to the nearest emergency room, hospital or urgent care center. Call for an ambulance if you need it. You do not need to get approval or a referral first from your PCP, even if you are out of the service area. As soon as possible, make sure that Banner Medicare Advantage Plus PPO has been notified about your emergency. We need to follow up on your emergency care. You or someone else should call to tell us about your emergency care, usually within 48 hours. You can find the number to call on the back of your plan membership ID card or on the back cover of this document. II If you receive emergency care at an out-of-network hospital and need inpatient care after your emergency condition is stabilized, you must have your inpatient care at the out-of- network hospital authorized by the plan and your cost is the cost sharing you would pay at a network hospital. Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area, you must use plan providers for urgent care. When out of the service area, urgent care may be obtained from the first available provider. In addition, when out of the service area, you can obtain dialysis treatment from any qualified dialysis provider. With the exception of emergencies, it may cost more to get care from out-of-network providers. What is the service area for Banner Medicare Advantage Plus PPO? The counties in our service area are listed below. Maricopa and Pinal. How do you find Banner Medicare Advantage Plus PPO providers in your area? To find providers in your area, begin by looking for the county in which you live, then for the name of your city or town and then the provider’s name. County City Provider For the most current information about our providers, please visit our online searchable directory at: www.BannerMA.com/Find-a-Provider. If you have questions about Banner Medicare Advantage Plus PPO or require assistance in selecting a PCP, please call our Customer Care Center at (844) 549-1859, 8 a.m. to 8 p.m., 7 days a week. TTY/TDD users should call 711. You can also visit www.BannermA.com. III TABLE OF CONTENTS Section 1 – Introduction ................................................................................................................. II What is the service area for Banner Medicare Advantage Plus PPO? .........................................III How do you find Banner Medicare Advantage Plus PPO providers that serve your area? ............... III Section 2 – List of Network Providers Primary Care Physicians (PCPs) .................................................................................................. 1 Specialists .................................................................................................................................. 43 Hospitals .................................................................................................................................. 181 Skilled Nursing Facilities (SNFs) ............................................................................................... 183 Ancillary .................................................................................................................................... 186 Outpatient Mental Health Providers ......................................................................................... 247 Index ......................................................................................................................................... 257 IV Banner Medicare Advantage Plus PPO Directorio de Proveedores Este directorio está vigente a partir del 08/01/2021. Este directorio ofrece una lista de los proveedores de la red actuales de Banner Medicare Advantage Plus PPO. Este directorio es para los siguientes condados en Arizona: Maricopa y Pinal. Para acceder al directorio de proveedores en línea de Banner Medicare Advantage Plus PPO, puede visitar www.BannerMA.com. Si tiene alguna pregunta sobre la información incluida en este Directorio, llame a nuestro Centro de Atención al Cliente al (844) 549-1859, 8 a.m. a 8 p.m., 7 días de la semana. Los usuarios de TTY deben llamar al 711. Banner Medicare Advantage Plus PPO cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call (844) 549-1859 (TTY: 711). V Sección 1 – Introducción Este directorio ofrece una lista de los proveedores de la red de Banner Medicare Advantage Plus PPO. Para obtener información detallada sobre su cobertura de atención médica, consulte su Evidencia de Cobertura (EOC). Tendrá que elegir a uno de nuestros proveedores de la red que figuran en la lista de este directorio como su proveedor de atención primaria (PCP). El término PCP aparecerá en este directorio. Por lo general, debe obtener los servicios de atención médica de su PCP. Su PCP es un médico o enfermero profesional que cumple con los requisitos estatales y está capacitado para darle atención médica básica. Recibirá su atención médica básica y rutinaria de su PCP. Su PCP también coordinará el resto de sus servicios cubiertos que usted reciba como miembro de nuestro plan. Por ejemplo, para que usted pueda atenderse con un especialista, por lo general debe obtener la aprobación de su PCP primero (esto se denomina obtener una “referencia médica” o “remisión” para un especialista). Los proveedores de la red que figuran en este directorio han acordado brindar servicios de atención médica, oftalmológicos y odontológicos. Puede ir a cualquiera de los proveedores de la red que aparezca en el listado de este directorio; sin embargo, para algunos servicios es posible que necesite