Provider ParticipationList
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1 Report Description: Provider ParticipationList Provider Participation list by Practice ates PC Aetna Behavioral Health Network Aetna: Golden Medicare Managed Care: Golden MCR & Golden Choice Aetna: HMO, QPOS, US Access Status NON Par Aetna: Traditional/PPO: Opn Ch PPO, Mgd ChPOS, Elct Ch EPO, trad Ch, NAP, Chickering, Aetna Sig Admin, SCR Afford Hlth Ch Aetna 04/01/2009 Patients Trust Netwosyracuse prime plan APA Partners Pending 130% of 2003 MCR ArchCare 10/1/14 10/01/2014 BCBS CNY (Excellus) BCBS CNY: POS; PPO; EPO; Fed Blue; and Blue Card BCBS CNY: HMOBlue BCBS CNY: MMCD-CHP-FHP-HNY A BCBS CNY: RMSCO & Univera (Lifetime Health) BCBS CNY: Traditional Indemnity BCBS CNY: Managed Medicare BCBS CNY: Safety Net s: HNY B and Value Med Not Verified Individual Contract 01/01/2014 Page 1 of 8
2 ates PC Beechstreet Corp - now part of MultiPlan NAP: Beechstreet Status 1/1/09 Inactive - Health Alli Par via North American Contract Providers in JPO excluded from participation are NON PAR CDPHP Medicare - MMCR Commercial Plans ( HMO, PPO, POS, EPO, ASO) Cigna Health Care MVP Network was individual contracts Cigna: PPO & Gatekeeper PPO Plans Cigna: Great-West Health MVP Network Empire Plan Commercial Plans ( HMO, PPO, POS, EPO, ASO) Fidelis Care New York /22/03 Fidelis: Medicare+Choice Plan (Fidelis Medicare Advantage) 03/14/2006 sent addendum for sig 1/11/06 Fidelis: MMCD-CHP-FHP 08/22/2003 not par with sjh hosp Page 2 of 8
3 ates PC First Health Network/Coventry Healthcare (an Aetna company) Workers Comp & No Fault Plan Network Status Individual Contract Commercial Plans ( HMO, PPO, POS, EPO, ASO) GHI (EmblemHealth) /19/04 06/19/ % 2001 RBRVS Commercial Plans ( HMO, PPO, POS, EPO, ASO) Health Alliance PO/IPA NON Par 6/1/04 Health Republic Insurance (Freelancers) HealthNow NY (HNNY) Magnacare Network 11/1/04 HNNY: Indemnity. HMO, PPO, POS, ASO ECPO: Eight CountyDr. Martinez HNNY: Indemnity. HMO, PPO, POS, ASO 11/01/2004 for Syrahealth physician members HNNY: Indemnity. HMO, PPO, POS, ASO 11/01/2004 non syrahealth physcians HNNY: Indemnity. HMO, PPO, POS, ASO 09/30/2005 zz-healthbest IPA/Dcontract suppressed Humana - Arcadian Health Plan (Northeast Community Care) MCR Advant 1/1/09 02/16/2009 med adv ammendment Page 3 of 8
4 ates PC Humana/ChoiceCare Magnacare Status 6/15/11 Term'd PO/IPA Contract 04/01/2008 Individual Contract sent to each doc for signature 06/15/2011 6/6/02 01/01/2014 Martins Point (US Family Health Plan) 2/13/06 Medicaid (NY) MCD Other Address Updated 03/10/2008 Medicare AA0734 address updated 01/02/2008 Medicare Revalidation approved 5/12/15 Multiplan (includes PHCS) /1/05 02/01/2005 Recredentialing 02/01/ /01/2006 Multiplan (includes PHCS) 01/01/2009 Page 4 of 8
5 ates PC MVP Health Plans MVP: MCR Advant - Midstate IPA Status Vendor # MVP: HMO - Midstate IPA MVP: NON HMO - Article 42 & 43 - EPO; Indemnity, Direct HMO; PPO; POS; HNY ; MVP Gold (MCR): Select Care; Preferred Care; Cigna Individual Contract North American Preferred (Meritain Health/Aetna) PACE CNY - MCR Special Needs Plan 9/1/11 09/01/2011 POMCO Individual Contract Rail Road Medicare CB2566 Today's Options - Medicare PPO Today's Options - Medicare PPO SJH Cardiology Associates Today's Options: Medicare PFFS Replacement (American Progressive) Total Care (Universal American) Total Care: MMCD-CHP-FHP 10/10/10 Applied 2/10/10 Touchstone Health (Medicare Managed Care) Terminated 3/1/07 12/31/11 03/01/2007 Page 5 of 8
6 ates PC Tricare Prime (HealthNet) zz-closed - SJH Hamilton 10 Eaton Street zz-closed - SJH Cortland - Dr. Ma 1122 Commons Avenue SJH Oswego Clinic 140 West 6th Street zz-closed 11/25/ SJH OH 4900 Broad Road zz-closed - 12/31/08 - SJH West 5700 W Genesee St Status Certified /1/04 Certified /1/04 Watertown - Samaritan Certified /1/04 Certified /1/04 Certified /1/04 Certified /1/04 Certified Crouse Hosp 9/1/04 Certified /1/04 Cortland Hosp Certified /1/04 Comm Mem Hosp - Hamilton Certified /1/04 Samaritan Hosp Certified /1/04 United - Community Plan (formerly AmeriChoice) 3/1/15 United Healthcare Individual Contract Most Providers also have individual contracts too United: Community Plan: MMCD-CHP-FHP NON Par 11/01/2011 United: Commercial s (HMO & NON HMO) United: Managed Medicare (Medicare+Choice) United: Commercial s (HMO & NON HMO) 08/01/2006 amendment on file NON Par 12/31/2004 UPIN Page 6 of 8
7 ates PC US DOL (Office of Workers Comp) US DOL (Office of Workers Comp) Wellcare Wellcare: Medicare Managed Care zz-closed 11/25/ SJH OH 4900 Broad Road Status N Worker's Comp (NYS) zz-healthbest IPA - Plan dissolved HB: (Term'd 9/30/05) HealthBest IPA - HNNY HMO Plan Dissolved 9/30/05 09/30/2005 HB: (Term'd 9/30/05) HealthBest Direct - MultiPlan PPO 09/30/2005 zz-multiplan - PHCS - Statewide Independent PPO (a div of PHCS) 07/01/2006 Absorbed by PHCS eff 7/1/06 - Statewide Contract dissolved zz-multiplan - Quality Health Network - (was Upstate Admin - MVP) zz-no NYS HEX eff1/1/15 - American Progressive - Todays Options (Universal American) MultiPlan Network Page 7 of 8
8 ates PC zz-syrahealth -- CLOSED 4/1/08 Syra: Aetna HMO & NON HMO Status Syra: Choice Care/Humana Syra: BCBS CNY Excellus (Incl: HMO, PPO, Indem, MCR PPO) Syra: HNNY HMO & NON HMO Syra: (TERM'd 4/1/06) Statewide Independent PPO (PHCS) Syra: (TERM'd 12/31/04) United Healthcare HMO & NON HMO Page 8 of 8
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