Planes de Seguro Contratados
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1 Planes de Seguro Contratados A partir del 1. de junio de 2018, Children s Health SM tiene contrato con los siguientes planes de seguro en las instalaciones siguientes: Children s Medical Center Dallas Children s Medical Center Plano Children s Health SM Specialty Center Dallas Campus Children s Health SM Specialty Center Plano Campus Children s Health SM Specialty Center Bass Center Children s Health SM Specialty Center Richardson Seguros Comerciales Baylor Scott & White Health Plan (Employees) Baylor Scott & White Health Plan Quality Alliance (BSWQA ACO Network) CIGNA Healthcare of Texas, Inc. (CIGNA Great-West) Galaxy Health Network HealthSmart / HealthSmart ACCEL Children s Health SM Specialty Center Park Cities Children s Health SM Specialty Center Mesquite Children s Health SM Specialty Center Rockwall Children s Health Center for Autism & Developmental Disabilities Children s Health SM Specialty Center Cityville Children s Health SM Sleep Disorders Center, Inc. Regional Healthcare Alliance Scott & White Health Plan Stratose (formerly National Preferred Provider Network (NPPN)) Trinity Mother Frances (Employees & Their Dependents Only) UnitedHealthcare of Texas, Inc. USA Managed Care Organizations (USAMCO) Managed Medicaid (State of Texas Access Reform (STAR)) Parkland Community Health Plan (HEALTHfirst) FirstCare Health Plans (CMCHP) SUPERIOR Health Plan (TCHP) Managed Medicaid Foster Care (STAR Health) (Servicios de salud médica y conductual) Medicaid Rural Service Area (MRSA) (Central, Northeast and West) (Central, Northeast and West) Children s Health Insurance Program (CHIP, CHIP Perinate, and CHIP RSA) CHIP/CHIP Perinate CHIP/CHIIP Perinate CHIP/CHIP Perinate FirstCare Health Plans CHIP/CHIP Perinate *Includes CHIP Perinate & CHIP Perinate RSA **Includes CHIP Perinate Newborns Only CHIP/CHIP Perinate/CHIP RSA* Parkland Community Health Plan CHIP/CHIP Perinate (KIDSfirst)** CHIP/CHIP RSA 1
2 Planes de Seguro Contratados A partir del 1. de junio de 2018, Children s Health SM tiene contrato con los siguientes planes de seguro en las instalaciones siguientes: Children s Medical Center Dallas Children s Medical Center Plano Children s Health SM Specialty Center Dallas Campus Children s Health SM Specialty Center Plano Campus Children s Health SM Specialty Center Bass Center Children s Health SM Specialty Center Richardson (TMHP) (Texas Medicaid) Children with Special Health Care Needs (CSHCN) Arkansas Medicaid (CMC Dallas & Plano) Seguros de Salud Conductual (Solo comercial) Beacon Health Options (STAR, (comercial) (se excluye el HMO Blue) (STAR, CompCare (Solo comercial) Children s Health SM Specialty Center Park Cities Children s Health SM Specialty Center Mesquite Children s Health SM Specialty Center Rockwall Children s Health Center for Autism & Developmental Disabilities Children s Health SM Specialty Center Cityville Children s Health SM Sleep Disorders Clinic Mississippi Medicaid (CMC Dallas Only) Oklahoma Health Care Authority (OHCA) (CMC Dallas & Plano) Managed Health Network (MHN)*** OptumHealth Behavioral Solutions (Commercial) OptumHealth Behavioral Solutions (STAR, Scott & White Health Plan (Solo commercial para trastomos de la alimentación) Superior HealthPlan (STAR Health Solo tutela temporal) (TCHP) *Se excluyen las terapias y pruebas psicológicas si el paciente no está internado Redes de Trasplante Blue Distinction Centers for Transplant TMO, Corazón, Higado CIGNA LifeSOURCE Network TMO, Corazón, Riñón, Higado National Transplant Network TMO, Corazón, Riñón, Higado INTERLINK TMO, CHD, Corazón, Hígado LifeTrac TMO, Corazón, Intestino, Riñón, Hígado, Multivisceral OptumHealth TMO, CHD, Corazón, Riñón, Hígado, Multivisceral OptumHealth UnitedHealthcare Compass W500 (COE) Protocol Tertiary Network TMO, Corazón, Riñón, Hígado En caso de tener preguntas, por favor lea su tarjeta de seguro, la póliza o cualquier otro material que tenga a su disposición sobre su plan de seguro. Además, recomendamos que se comunique a la compañía de seguro o con el administrador de beneficios a los empleados para verificar la cobertura o para pedir más información sobre su plan de salud. AVISO: Los médicos tienen contratos por separado con las organizaciones de atención médica administrada. Por lo tanto, esta lista sirve solamente de referencia para los servicios del hospital. Por favor, comuníquese directamente con el médico para averiguar en cuales planes participa. 2
3 Salud de los Niños Afiliados (Proveedores del Hospital Base) Proveedores de Práctica Avanzada (APPs) Enfermera Practicante and Asistente Médico Seguros Comerciales Seguros Comerciales (Continuó) Managed Medicaid (STAR//MRSA/CHIP) AMERGROUP CIGNA Healthcare of Texas (TCHP) HealthSmart / HealthSmart ACCEL FirstCare Health Plan (STAR Health included) Seguros de Salud Conductual (STAR Trinity Mother Frances (Employees & Their Dependents Only) OptumHealth Behavioral Solutions (Commercial) OptumHealth Behavioral Solutions (STAR, Anesthesiologists para Niños (AFC / AFC-Pain Management) Seguros Comerciales Seguros Comerciales (Continuó) Three Rivers Network (TRPN) Managed Medicaid (STAR/MRSA/CHIP) CIGNA Healthcare of Texas (TCHP) HealthSmart / HealthSmart ACCEL (STAR Health included) Servicios de Atención Médica Compleja (CCMSC) Seguros Comerciales CIGNA Healthcare of Texas, Inc Managed Medicaid (STAR/MRSA/CHIP) Traditional Medicaid Seguros de Salud Conductual (Commercial) CIGNA Behavioral Health LifeSynch ( Behavioral Health) Magellan Behavioral Health Seguros de Salud Conductual (STAR/CHIP) 3
4 Salud de los Niños Afiliados (Proveedores del Hospital Base) Continuó Dallas Médico Los Servicios Médicos Para Los Niños (DPMSC Internistas) Seguros Comerciales Managed Medicaid (STAR/MRSA/CHIP) 1 CIGNA Healthcare of Texas (TCHP) (STAR Health included) HealthSmart / HealthSmart ACCEL 1 DPMSC s en el estado de la red miembros de es beneficio específico basado en el diseño de beneficios de miembros con su empleador. Por favor, póngase en contacto con su seguro para determinar el estado de participación. Dallas Médico Los Servicios Médicos Para Los Niños (DPMSC Orthodoncia) Aetna Dental DentaQuest for Superior HealthPlan CIGNA Dental Delta Dental Insurance Company (DDIC) Dental Benefit Providers (UnitedHealthcare) Dental DHMO Dental Network of America (DNOA) MCNA Dental Plans DentaQuest Clínica Dental de los Niños Aetna Dental CIGNA Dental Delta Dental Insurance Company (DDIC) Dental Benefit Providers (UnitedHealthcare) Dental Network of America (DNoA) DentaQuest Dental DHMO MCNA Dental Plans Atención de la Salud a Domicilio (HHC) Seguros Comerciales Managed Medicaid (STAR/MRSA/CHIP) (HHC Only) CareCentrix (TCHP) (STAR Health ONLY) HealthSmart / HealthSmart ACCEL 4
5 Salud de los Niños Afiliados (Proveedores del Hospital Base) Continuó Equipo Médico a Domicilio (HME) Seguros Comerciales Managed Medicaid (STAR/MRSA/CHIP) (HHC Only) CareCentrix (TCHP) HealthSmart / HealthSmart ACCEL 5
6 Salud de los Niños Afiliados (Clinica de Pacientes Ambulatorios) A partir del 1. de junio de 2018, Children s Health SM Pediatric Group tiene contrato con los siguientes planes de seguro en las instalaciones siguientes: Children s Health SM Pediatric Group Bachman Lake Children s Health SM Pediatric Group Carrollton Children s Health SM Pediatric Group Cedar Hill Children s Health SM Pediatric Group Celina Children s Health SM Pediatric Group Cockrell Hill Children s Health SM Pediatric Group DeSoto Children s Health SM Pediatric Group Garland Children s Health SM Pediatric Group Irving Children s Health SM Pediatric Group Lake Highlands Children s Health SM Pediatric Group Lancaster Kiest Children s Health SM Pediatric Group McKinney Children s Health SM Pediatric Group Medical District Children s Health SM Pediatric Group Oak Cliff Children s Health SM Pediatric Group Pleasant Grove Children s Health SM Pediatric Group St. Phillips Children s Health SM Pediatric Group Prosper Children s Health SM Pediatric Group West Plano Pediátrica de la Salud de los Niños (CHPG) antes MyChildren s Seguros Comerciales Managed Medicaid (STAR/MRSA/CHIP) Seguros de Salud Conductual (Comerciales) CIGNA Behavioral Health CIGNA Healthcare of Texas (STAR Health included) LifeSynch ( Behavioral Health) Magellan Behavioral Health MHNet Behavioral Health (Coventry) Seguros de Salud Conductual Integrated Health Plan (STAR/STAR+PLUS/CHIP) SUPERIOR Health Plan (STAR (TCHP) * (TCHP) *Tarrant County CHPG Locations ONLY 6
7 Casa de Nuestros Niños Como de September 20, 2015, Children s Health SM ahora incluye las siguientes Nuestros niños ubicaciones House: Our Children s House Dallas 1340 Empire Central, Dallas, TX Specialty Center Waxahachie 1540 N. Highway 77, Ste. 10, Waxahachie, TX Specialty Center Grapevine 1643 Lancaster Drive, Ste. 300, Grapevine, TX Specialty Center North Rockwall 2455 Ridge Road, Ste. 255, Rockwall, TX Specialty Center Irving 3337 Stovall Street, Irving, TX Specialty Center Frisco 7010 Preston Road, Ste. 240, Frisco, TX Specialty Center Plano 7000 W. Plano Parkway, Ste. 210, Plano, TX Specialty Center Las Colinas 7453 Las Colinas Blvd., Irving, TX Specialty Center Allen 8 Prestige Circle, Ste. 101, Allen, TX Casa de Nuestros Niños Seguros Comerciales Managed Medicaid (STAR/MRSA/CHIP) Redes de Transplante CIGNA LifeSOURCE LifeTrac Transplant Network CIGNA Healthcare of Texas HealthSmart Stratose (formerly NPPN) Trinity Mother Frances (Employees & Their Dependents Only) USA Managed Care Organizations (USAMCO) (STAR Health included) (TCHP) National Transplant Network INTERLINK Transplant Network OPTUM Health Protocol Tertiary Network Seguros de Salud Conductual (STAR OptumHealth Behavioral Solutions (Commercial) OptumHealth Behavioral Solutions (STAR, Oklahoma Health Care Authority (OHCA) 7
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