New York Eye and Ear Infirmary at Mount Sinai Listing of Contracted Insurance Carriers

Transcription

1 ew ork Eye and Ear Infirmary at Mount Sinai Listing of Contracted Insurance Carriers ew ork Eye and Ear Infirmary at Mount Sinai 1199 Union ADAP (opd only) S HIV program S HIV program Aetna U.S.Healthcare Insurance Co. HMO/POS/Indemnity MSBISLR non par with Indemnity C Community Plan Medicare Access Medicare Medicare PACE Affinity Medicaid/ Medicaid Exchange Product HIX QHP Alphacare FIDA American Case Mgmt (ACM) Specialty Behavioral Health Medicaid Amerigroup Community Care Medicaid HMO Medicaid Amerigroup ew ork (formerly Medicare CarePlus) p must secure an out of network authorization c AmidaCare Medicaid HMO SP HIV SP ArchCare Medicaid/ Senior Life/PACE BCE Emergis (up & up) Beech Street (Multiplan), Leased network Best Doctors, Leased network Centerlight medicare hmo Cigna, includes Great West Insurance Co. HMO/POS ChoiceCare, Leased network Multi Product plan. ou MUST verify insurance product to Connecticare, Inc.Connecticare of ew ork, Connecticare of Massachsetts HMO/POS Medicare Medicare SP February 2016 Contracted Payers.xlsx Page 1

2 ew ork Eye and Ear Infirmary at Mount Sinai ew ork Eye and Ear Infirmary at Mount Sinai Coventry ational etwork, Coventry Health Care Commercial, etwork Access, Worker's Compensation, Automobile Insurance Managed Care Devon Health Service, Leased network Dent Direct Care America (health smart Insurance Co., EPO network) Doral etwork Medicaid Dental OL Elderplan Emblem Insurance Co. CompreHealth HMO, CompreHealth, EmblemHealth /EPO Empire BC/BS Insurance Co. HMO POS/ Indemnity Medicare ( Senior Plan) Empire Plan S Employees Exchange Product Pathway & Pathway x Englewood Hospital self insured plan Fidelis Medicaid/ Medicaid p Multi Product plan. ou MUST verify insurance product to Multi Product plan. ou MUST verify insurance product to Fidelis Exchange Product State of Health HBX First Health (formerly Affordable) Access through Coventry at MSBI, BSBIB, MSR and MSSL ForMost, Leased network Glaxay Managed Care (MCI Ca based) Insurance Co. February 2016 Contracted Payers.xlsx Page 2

3 ew ork Eye and Ear Infirmary at Mount Sinai ew ork Eye and Ear Infirmary at Mount Sinai GHI HMO/POS etwork Acess Flex/Select Discontinued 4/1/2011 EPO/ Global Medical Management Insurance Co. HealthFirst Medicaid HMO Medicaid A+ essential Plan HealthFirst (cont'd) Life Improvement Plan, Increased Benefits Plan, Maximum Plan, Coordinated Benefits Plan, 65+ Multi Product plan. ou MUST verify insurance product to Exchange Product Leaf HHH CHOICES HEALTH PLA Special eeds Plan Medicare Medicare/ HHH Choices Gold. HealthPlus 5/1/2012. see Amerigroup Medicaid HMO Medicaid H.I.P. Insurance Co. HMO/POS Medicare HMO Medicare SP Medicaid Multi Product plan. ou MUST verify insurance product to Exchange Product Select Care Humana Medicare Advantage plan Independence Care System Medicaid HMO Medicaid (LIMITED SCOPE) FIDA Island Group Admin, Leased network Interlink Specialty Transplants Transplants LifeSource (CIGA) Specialty Transplants Transplants LifeTrac Specialty Transplants Transplants Magellan Specialty Behavioral Health Behavioral Health February 2016 Contracted Payers.xlsx Page 3

4 ew ork Eye and Ear Infirmary at Mount Sinai ew ork Eye and Ear Infirmary at Mount Sinai MagnaCare (ex local 272 and 348) Managed Health etwork (MH) Specialty Behavioral Health HMO Behavioral Health Behavioral Health Mastercare Insurance Co. MedCare International MetraComp (COVETR) Insurance Co. MetroPlus Medicaid HMO Medicaid MSH SPECIALT SERVICES OL (O PCP'S EROLLIG) medicare MSBISLR ALL SERVICES Exchange Plan Multiplan, Leased network MVP ( OL) Insurance Co. ational Health Plan Inc., Leased network ational Preferred provider network Insurance Co. HIV SP (Partnership in Care) MetroPlus Gold Citycaid Market Plus Oscar effective Plan will use Magnacare's provider network Exchange Prodcut Oxford Health Plan Insurance Co. Freedom, Liberty HMO/POS Freedom, Liberty p Multi Product plan. ou MUST verify insurance product to Exchange product SHOP PHA Group (formerly DMA group) International ppo PerfectHealth Insurance Co. HMO/POS * * February 2016 Contracted Payers.xlsx Page 4

5 ew ork Eye and Ear Infirmary at Mount Sinai ew ork Eye and Ear Infirmary at Mount Sinai *SEE HIP COTRACT * Medicare * POMCO Insurance Co. Private Healthcare System, Leased network (PHCS Mulitplan) Savility Proamerica Managed Care Insurance Co. Senior Health Partners Medicare Pace Program Select Health (VS Choice) Medicaid HMO SP HIV SP Select PRO Insurance Co. Senior Whole Health Special eeds Plan Medicare Medicare / Medicaid Advantage Medicare / Medicaid Advantage Plus Managed Long Term Care Plan Touchstone TravelCare United Health Care Insurance Co. HMO/POS MSH Employee Empire Plan S Employees essential Plan p United HealthCare Community Plan of ( formerly knows as Americhoice) Medicare HMO Medicaid HMO Medicaid HMO Exchange Product Compass United Resource etwork Specialty Transplants Transplants (OptumHealth) Vytra HMO/POS Discontinued Medicare HMO Medicare SP WellCare Insurance Co. Medicaid essential Plan eschange Medicare VS Special eeds Plan Medicare Choice Preferred Multi Product plan. ou MUST verify insurance product to February 2016 Contracted Payers.xlsx Page 5

6 ew ork Eye and Ear Infirmary at Mount Sinai ew ork Eye and Ear Infirmary at Mount Sinai Choice Enhanced Choice Total Any box identified either as "" or an HMO slot require an auth PRIOR to services being rendered. Possible one time contract depending on Carrier request. Emergent transfers should have a sole source designation if bypassing the authorization requirements PLEASE OTE: FOR THE MEDICAID HMO'S. EXCEPT FOR SEIOR HEALTH PARTERS, ICS AD HIP MEDICAID, FOR ALL HOSPITAL CLIICS, IDIVIDUAL PHSICIAS EED TO BE BE CREDETIALED WITH EACH PLA I ORDER FOR THEIR CLAIMS TO BE PAID (This applies to MSH andmsh Queens). Request for access utilizing a non ew ork State Medicaid program MUST be pre arranged and include the credentialling of both the Hospital AD physician Plans that are higlighted are provided under the Ferderal ACA Statute. ou MUST check with the individual providers to This listing is provided as a convenience and is subject to change. Please contact the carrier directly if there are any questions on a specific product line. February 2016 Contracted Payers.xlsx Page 6