Tufts Medicare Preferred HMO Care Management List

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Transcription:

HMO Care Management List Bolded medical groups are externally managed and nonbolded medical groups are internally managed. The HMO Care Managers are assigned by medical group. In some cases, due to geography, medical group size and/or volume, there may be up to three care managers assigned to each medical group. Each medical group also has a designated primary care manager (PCM) who can be contacted for members who are not presently receiving acute care (CNL), extended care (CCP) or home care services (HC). In all cases, except groups 135 and 301, the acute care manager is also the medical group s PCM. Please note that externally managed medical group care management assignments may differ from this format. Please contact the administrative assistant for groups 009 and 064. Group 001 Mt. Auburn Med. Assoc. MACIPA 003 Belmont Medical Associates MACIPA ADMIN: Patrick Hart 1 st CALL Susan Sullivan (CNL/UM) Irene Signorello (CCM) Claudia DeLucia (CCM) ADMIN: Patrick Hart 1 st CALL Susan Sullivan (CNL/UM) Kristy Blaisdell (CCM) Holly Willis (Complex/Chronic CM) 617.259.2126 617.259.2199 617.259.2126 617.259.2199 005 Mt. Auburn Healthcare MACIPA ADMIN: Patrick Hart 1 st CALL Susan Sullivan (CNL/UM) Meaghan Flanigan (CCM) 617.259.2126 617.259.2199 006 Family Medicine Assoc. MACIPA 007 Reservoir & Cambridge Medical Associates MACIPA 011 Harbor Medical PCPO ADMIN: Patrick Hart 1 st CALL Susan Sullivan (CNL/UM) Laura Hogan (Complex/Chronic CM) ADMIN: Patrick Hart 1 st CALL Susan Sullivan (CNL/UM) Lee Machado-Dunham (Complex/Chronic CM) Tara Cunningham (ALL) Marianne Molina (CM) 617.259.2126 617.259.2199 617.259.2126 617.259.2199 978.354.4684 978.354.4659 978.740.4732 Revised 02/08/2018 1 HMO Care Management List

014 Riverside Primary Care Specialists Lowell General Hospital Kendra Guthrie (CNL) Cristina Murray (Inpatient CCP) Amy Price (Community Karen Jones (Community CCP/ CCM) Pamela Aho (Community 888.880.8699 ext. 48107 888.880.8699 ext. 48129 888.880.8699 ext. 48185 888.880.8699 ext. 48106 888.880.8699 ext. 53237 019 Puritan Medical Group PCPO Marianne Molina (CM) 978.354.4659 978.740.4732 020 Peabody Medical Group PCPO Chris Harris (All) 978.354.4683 978.740.4732 021 North Shore Medical Group PCPO Chris Harris (All) 978.354.4683 978.740.4732 030 Signature Healthcare Denise Daly (CNL) Kathy Stevens (Inpatient CCP) Kim McCarthy (CCM) Christina Sawelsky (CCM) 888.880.8699 ext 48102 888.880.8699 ext. 48135 888.880.8699 ext. 48311 888.880.8699 ext. 48195 038 Alliance for Quality Care, LLC NEQCA Nancee Miller (PCM/CNL/UM) 617.636.4882 617.636.9070 055 Mt. Auburn Primary Care Associates MACIPA ADMIN: Patrick Hart 1 st CALL Susan Sullivan (CNL/UM) Laura Pearson (Complex CCM) 617.259.2126 617-259-2199 067 Mystic Valley Karen Sandberg-Couture (CNL/Community ) Diane Hibbard (Inpatient CCP) 888.880.8699 ext. 48118 888.880.8699 ext. 53238 070 Southcoast Kerry St. Don (CCM) Karen DaSilva (CNL) Leanne Rosario (Community CCM) Karen DaSilva (Inpatient CCP) 888.880.8699 ext. 48021 888.880.8699 ext. 48117 888.880.8699 ext. 48316 888.880.8699 ext. 48117 073 CAP Doctors Jeannine Cormier (CNL) Maria Stanley (CCP) Michelle Antonelli (CCP/CNL) Susan Templeton (CCM) Jill McDowell (CCM) Jennifer Murray (CCM) 978.990.0419 978.990.0422 978.990.0418 978.990.0421 978.990.0423 978.990.0420 978.466.4012 074 Whittier Street Health Mary Finn (CCM) Revised 02/08/2018 2 HMO Care Management List

077 078 080 082 Merrimack Valley Regional Medical Group Community Health Ctr of Cape Cod Acton Medical Associates Emerson Hospital Medical Group Framingham 085 South Shore Medical Associates 086 087 Southboro Medical Associates Metrowest Framingham Plymouth Bay Primary Medical Associates 45 Resnick Road, Suite 202 Plymouth, MA 02360 093 Iora Health Malden 094 Iora Health Hyde Park 099 Primary Care Medical Associates/Norwood, Southwood, Inc. Riverside Sandra Ghom (CNL) Dianne Hibbard (Inpatient CCP) Dorothy DiBlasi (Community Amy Price (Community Mary Finn (Community Sandra Ghom (CNL) Diane Hibbard (Inpatient CCP) Karen Sandberg-Couture (Community 888.880.8699 ext. 48140 888.880.8699 ext. 53238 888.880.8699 ext. 48178 888.880.8699 ext. 48185 888.880.8699 ext. 48140 888.880.8699 ext. 53238 888.880.8699 ext. 48118 ADMIN: Amy Nussey 1st CALL Denise Daly (CNL) Kathleen Stevens (Inpatient CCP) Patricia McCluskey (CCM) Kathy Finn (CCM) ADMIN: Amy Deb Sabatalo 1 st CALL Cheryl Flynn Lauren Goellner 888.880.8699 ext. 48102 888.880.8699 ext. 48135 888.880.8699 ext. 48182 888.880.8699 ext. 48122 508.721.1105 508.620.4238 508.872.1107 508.620.6408 NEQCA Debra Zona (PCM/CNL/UM) 508.864.7591 508.747.1518 Karen Sandberg-Couture CNL/Community Diane Hibbard (Inpatient CCP) Karen Sandberg-Couture (CNLCommunity Diane Hibbard (Inpatient CCP) 888.880.8699 ext. 48118 888.880.8699 ext. 53238 888.880.8699 ext. 48118 888.880.8699 ext. 53238 NEQCA Patricia Kenney (PCM/CNL/UM) 781.762.1688 781.255.2049 Revised 02/08/2018 3 HMO Care Management List

101 Hallmark Health Systems NEQCA 103 105 110 112 113 Lincoln Bedford Medical Associates Tri County Medical Associates Boston University Affiliated Physicians Harbor Health Community Health Center Hyannis Harbor Health Community Health Ctr. Neponset (Geiger Gibson) 114 IPC Hospitalist of New England 115 IPC 116 117 118 Charles River Medical Framingham Charles River Medical Natick Charles River Medical Marlborough 127 Needham Family Practice First Contact ADMIN: Donna Dineen Mary Kelly Beirne Lynda Chase Barbara DeMatteo Lisa Flanagan Jean Holden Laurie Lakin Emmet Sutera Mary Williams 781.979.3641 781.338.7772 781.338.7747 781.338.7741 781.338.7744 781.338.7745 781.338.7746 781.338.7748 781.338.7740 781.338.7749 781.338.7712 PCPO Liz Cronin (all) 978.287.3186 978.287.3135 PCPO Harbor Health Harbor Health CRMA Diana Haynes Cindy Creely Mary Finn (Community JoAnn Ogilie (CNL) Mary Finn (Community JoAnn Ogilie (CNL) Mary Finn (Community Chris Ryan (CNL/Inpatient CCP) No Community CCM Chris Ryan (CNL/Inpatient CCP) No Community CCM Judith Rossi (CNL) June O Brien (CCM) Peggy Levas (CCM) Cathy Iadarola (CCM) 508.473.1480 ext. 165 774.235.5609 508.422.9538 888.880.8699 ext. 48188 888.880.8699 ext. 48188 508.881.3029 ext. 139 508.881.3029 ext. 12 508.655.0064 508.881.3029 ext. 14 508.881.7682 508.848.7030 508.848.7030 508.848.7030 CRMA Peggy Levas (all) 508.655.0064 508.848.7030 CRMA Judith Rossi (all) 508.881.3029 ext. 139 508.881.7682 Mary Finn (Community Revised 02/08/2018 4 HMO Care Management List

134 135 Family Care Center Winchester Hospital Middlesex Community Physicians Winchester Hospital James D Ambrosio (CNL) Lisa D Amico (Inpatient CCP) Elizabeth Curran (Community James D Ambrosio (CNL) Lisa D Amico (Inpatient CCP) Colleen Murphy (Community Elizabeth Curran (Community ( 888.880.8699 ext. 48103 888.880.8699 ext. 48176 888.880.8699 ext. 53115 888.880.8699 ext. 48103 888.880.9699 ext. 48176 888.880.8699 ext. 48115 888.880.8699 ext. 53115 136 Middlesex Medical Organization (MMO) Winchester Hospital James D Ambrosio (CNL) Lisa D Amico Inpatient CCP) Jennifer Modiszewski (Community 888.880.8699 ext. 48103 888.880.8699 ext. 48176 888.880.8699 ext. 48242 140 Highland Health NEQCA Nancy Barry (CM) 781.664.1485 781.664.5815 147 Community Internists Winchester Hospital 191 Family Practice (NEPHO) 192 North Shore Primary Care James D Ambrosio (CNL) Lisa D Amico (CCP) Jennifer Modiszewski (Community Christine Lee (CNL) Jodi Shaw (Inpatient CCP) Pam Hannon ( Christine Lee (CNL) Jodi Shaw (Inpatient CCP) Charles Bertoli (Community 888.880.8699 ext. 48103 888.880.8699 ext. 48176 888.880.8699 ext. 48242 888.880.8699 ext. 48101 888.880.8699 ext. 48130 888.880.8699 ext. 48133 888.880.8699 ext. 48125 888.880.8699 ext. 48101 888.880.8699 ext. 48133 888.880.8600 ext. 48130 888.880.8699 ext. 48113 193 North Shore Health Systems PCPO Chris Harris (all) 978.354.4683 978.740.4732 195 Family Doctors PCPO 196 North Shore Physician Group Rowley PCPO Chris Harris Tara Cunningham Chris Harris (all) Marianne Molina (CM) 978.354.4683 978.354.4684 978.354.4683 978.354.4659 978.740.4732 978.740.4732 Revised 02/08/2018 5 HMO Care Management List

197 204 South Boston Community Health Center Pioneer Valley Care Alliance Practices 219 Mercy Care Alliance Mary Finn (CCM) Margaret Hebert (CNL) Linda Minor (Inpatient CCP) Gail Kowalewski (Community Karen Adamo (Community Lisa Dostaler (Community Lisa Tallman (Community Wenona Dailey (CNL) Linda Minor (Inpatient CCP) Gail Kowalewski (Community Karen Adamo (Community Lisa Dostaler (Community Lisa Tallman (Community 888.880.8699 ext. 48108 888.880.8699 ext 48633 888.880.8699 ext. 48603 888.880.8699 ext. 48613 888.880.8699 ext. 48630 888.880.8699 ext. 48631 888.880.8699 ext. 48632 888.880.8699 ext. 48633 888.880.8699 ext. 48603 888.880.8699 ext. 48613 888.880.8699 ext. 48630 888.880.8699 ext. 48631 225 Milton Primary Care NEQCA Debra Zona (PCM/CNL/UM) 508.864.7591 781.303.4083 229 HVMA - Granite 230 HVMA Granite Weymouth 243 Boston Medical Ctr Faculty Associates CM PROGRAM ADMIN HOT LINE Laurie McPhillips Pauline Riley Mary Ellen Jordan CM PROGRAM ADMIN HOT LINE Laurie McPhillips Pauline Riley Mary Ellen Jordan Mary Finn (CCM) 617.376.4861 617.376.6687 617.376.6679 617.376.4861 617.376.6687 617.376.6679 Revised 02/08/2018 6 HMO Care Management List

244 Mercy Care Alliance Delegated Contracted 245 MCA Riverbend 273 Western Mass Independent Physicians 275 Middlesex County Specialists 284 BIDCO BI Jordan BIDCO Wenona Dailey (CNL) Linda Minor (Inpatient CCP) Gail Kowalewski (Community Karen Adamo (Community Lisa Dostaler (Community Lisa Tallman (Community Wenona Dailey (CNL) Linda Minor (Inpatient CCP) Gail Kowalewski (Community Karen Adamo (Community Lisa Dostaler (Community Lisa Tallman (Community Margaret Hebert (CNL) Cheryl Duval (CCM) Diane Sweet (HC Admin) Mary Finn (CCM) Mary Curtis (CNL) Kerry Ogilvie ( 888.880.8699 ext. 48632 888.880.8699 ext. 48633 888.880.8699 ext. 48603 888.880.8699 ext. 48613 888.880.8699 ext. 48630 888.880.8699 ext. 48631 888.880.8699 ext. 48632 888.880.8699 ext. 48633 888.880.8699 ext. 48603 888.880.8699 ext. 48613 888.880.8699 ext. 48630 888.880.8699 ext. 48631 888.880.8699 ext. 48108 888.880.8699 ext. 48114 888.880.8699 ext. 48109 285 Cape Cod Physicians, LLC NEQCA Lisa Walsh (PCM/CNL/UM) 508.362.0044 508.362.0313 286 BIDCO South Cove BIDCO 287 BIDCO Bowdoin Health Center BIDCO 288 BIDCO Dimock/Joseph Smith Health Center BIDCO Lynne Lucas (CNL/CCP) Kerry Ogilvie (CCM) Lynne Lucas (CNL/CCP) Kerry Ogilvie (CCM) Lynne Lucas (CNL/CCP) Kerry Ogilvie (CCM) Revised 02/08/2018 7 HMO Care Management List

289 BIDCO Outer Cape Health Services BIDCO 292 BIDCO BI Deaconess BIDCO 293 BIDCO BI Needham BIDCO 294 BIDCO BI Milton BIDCO 296 BIDCO Cambridge Health BIDCO 297 BIDCO Lawrence General BIDCO 298 BIDCO Anna Jacques BIDCO Lynne Lucas (CNL/CCP) Kerry Ogilvie (CCM) Lynne Lucas (CNL/Inpatient CCP) Vanessa Barbosa (Community Lynne Lucas (CNL/CCP) Kerry Ogilvie (CCM) Mary Curtis (CNL) Sheryl Fitzgerald (Inpatient CCP) Vanessa Barboza (Community Mary Curtis (CNL) Sheryl Fitzgerald (Inpatient CCP) Vanessa Barboza (Community Mary Curtis (CNL) Katherine Giannatsis (Community Mary Curtis (CNL) Katherine Giannatsis (Community 888.880.8699 ext. 48128 888.890.8699 ext. 48109 888.880.8699 ext. 48127 888.880.8699 ext. 48128 888.890.8699 ext. 48109 888.880.8699 ext. 48127 888.880.8699 ext. 48128 888.880.8699 ext. 48109 888.880.8699 ext. 48194 880.880.8699 ext. 48130 888.890.8699 ext. 48109 888.880.8699 ext. 48130 888.880.8699 ext. 48194 299 BIDCO Fenway Health BIDCO Lynne Lucas (CNL/CCP) Kerry Ogilvie (CCM) 300 Harvard Medical Associates Dedham Deb Girvin (CM) Janice Smith (CM) Denise Wallace (CM) Annie Fucci (Resource Specialist) 781.329.1400 ext. 1447 781.329.1400 ext. 1438 781.329.1400 ext. 1420 781.329.1400 ext. 1441 Revised 02/08/2018 8 HMO Care Management List

301 302 303 304 305 306 307 308 309 310 Harvard Medical Associates Norwood Assoc. Copley 165 Dartmouth Street, Boston, MA 02116 Assoc. Kenmore 133 Brookline Avenue, Boston, MA 02215 Assoc. PO Square 147 Milk Street, Boston, MA 02109 Assoc. Braintree 111 Grossman Drive, Braintree, MA 02184 Assoc. Burlington 20 Wall Street, Burlington, MA 01803 Assoc. Cambridge 1611 Cambridge Street, Cambridge, MA 02138 Assoc. Chelmsford 228 Billerica Road, Chelmsford, MA 01824 Assoc. Medford 26 City Hall Mall, Medford, MA 02155 Harvard Vanguard Med Assoc. Peabody/Lynnfield 2 Essex Center Drive, Peabody, MA 01960 Marita Tympanick (CM) Ellen Pothier (CM) Annie Fucci (Resource Specialist) Eileen Jenkins Mary Boike Pauline Riley Chris Roddy Eileen Jenkins Kathy Costello Kathy Grennon Teen Perron Maria Barranco Paula Keefe-Tyrrell Maryann Kane Kathy Boyd Gianna Regan Barbara Sullivan Helen Donato 781.292.7600 781.329.1400 ext. 1436 781.329.1400 ext. 2612 781.329.1400 ext. 1441 617.654.7326 617.421.2275 617.421.2333 617.421.2653 781.292.7663 781.849.2413 781.849.2408 978.287.9433 617.661.5218 978.250.6118 978.250.6409 781.306.5108 781.306.5206 781.306.5498 978.977.4478 Revised 02/08/2018 9 HMO Care Management List

311 312 313 314 315 316 319 Assoc. Quincy Presidents Place South Tower 1250 Hancock Street, Quincy, MA 02169 Assoc. Somerville 40 Holland Street, Somerville, MA 02144 Assoc. Watertown 485 Arsenal Street, Watertown, MA 02472 Assoc. Wellesley 230 Worcester Street, Wellesley, MA 02481 Assoc. Chestnut Hill, 291 Independence Drive, West Roxbury, MA 02167 Assoc. Concord 86 Baker Avenue Extension. Concord MA 01742 Assoc. Beverly 320 HVMA Billerica Maureen Briggette Pat Ialuna Pat Costello Terry Scafati Deborah Girvin Tricia Sawyer Teen Perron Melissa Moulaison Shelly Ludwick, RN (CCM) Midge Belyea, Manager 617.774.0958 617.629.6459 617.972.5274 781.431.5669 617.972.5277 617.541.6556 978.287.9433 978.287.9392 781.292.7604 321 HVMA Needham 322 Atrius Plymouth 325 329 SSTAR Stanley St. HC Medical Group Specialist Francine Shelly (CCM) Lynne Tinkham (CCM) Mary Finn (CCM) Dawn Richer 508.746.7082 ext. 35 508.746.7082 ext. 10 508.425.5486 508.453.8013 Revised 02/08/2018 10 HMO Care Management List

330 331 333 334 335 336 337 338 339 340 341 342 343 Medical Group, Inc. at Auburn Medical Group, Inc. at Fitchburg Medical Group, Inc. at Holden Medical Group, Inc. at Leominster Medical Group, Inc. at Milford Medical Group, Inc. at Millbury Medical Group, Inc. at Spencer Medical Group, Inc. at Webster Medical Group, Inc. at Westboro Medical Group, Inc. at Worcester May Street Medical Group, Inc. at Worcester Lake Ave Medical Group, Inc. at Worcester Plantation Street Medical Group, Inc. at Worcester Medical Center Loretta Dyer, RN (Chronic CM) Diane Aubin, RN (Complex CM) Kristen Gilchrist, RN (Chronic CM) Susan Lammi, RN (Chronic CM) Christine Polewarczyk, RN (Complex CM) Erin Forbes, RN (Chronic CM) Christine Polewarczyk, RN (Complex CM) Susan Lammi, RN (Chronic CM) Christine Polewarczyk, RN (Complex CM) Karen Kemp, RN (Chronic CM) Stacey Ploof, RN (Complex CM) Nicole White, RN (Chronic CM) Stacey Ploof, RN (Complex CM) Karen Kemp, RN (Chronic CM) Karen Kemp, RN (Chronic CM) Diane Aubin RN (Chronic CM) Joy Day, RN (Chronic CM) Kathy Granger, RN (Chronic CM) 508.721.1171 508.721.1120 508.671.4065 978.466.3329 508.721.1181 508.829.1896 508.721.1181 978.466.3329 508.721.1181 508.671.4065 508.721.1149 508.581.0037 508.721.1149 508.671.4065 508.671.4065 508.721.1120 508.871.0794 508.368.7830 508.453.8070 508.453.8143 508.453.8022 508.453.8078 508.453.8142 508.453.8014 508.453.8142 508.453.8078 508.453.8142 508.453.8081 508.453.8077 508.453.8083 508.453.8077 508.453.8081 508.453.8081 508.453.8143 508.453.8077 508.453.8095 Linda Basner, RN (Chronic CM) Joyce Deschenes, RN (Complex CM) 508.721.1185 508.453.8067 Revised 02/08/2018 11 HMO Care Management List

399 Congenial Health, LLC 400 Cooley Dickinson Mary Curtis (CNL) Katherine Giannatsis (Community Margaret Hebert (CNL) Cheryl Duval (Community 888.880.8699 ext. 48109 888.880.8699 ext. 48194 888.880.8699 ext. 48130 888.880.8699 ext. 48108 888.880.8699 ext. 48114 401 Lahey Beverly/Danvers/Ipswich Lisa Yarrow (Community Joanne Shaw (Inpatient CCP) 888.880.8699 ext. 48119 888.880.8699 ext. 48130 888.880.8699 ext. 48133 405 Lahey Burlington Melanie Redden (CNL) Maureen Neilly (Community Colleen Sterianos (Community Jeannie Petringa (Inpatient CCP) Beth Ducharme (Community 888.880.8699 ext. 48110 888.880.8699 ext. 48124 888.880.8699 ext. 48338 888.880.8699 ext. 48119 888.880.8699 ext. 48144 406 Lahey North Shore Martha MacDougall (Community Jodi Shaw (Inpatient CCP) 888.880.8699 ext. 48137 888.880.8699 ext. 48133 888.880.8699 ext. 48130 407 Lahey Arlington/Billerica Jeannie Petringa (Inpatient CCP) Rosa O Campo (CCM) Jennifer Modiszewski (CCM) 888.880.8699 ext. 48119 888.880.8699 ext. 48138 888.880.8699 ext. 48242 408 Lahey Amesbury/Merrimac Katherine Giannatsis (Community 888.880.8699 ext. 48194 888.880.8699 ext. 48130 Revised 02/08/2018 12 HMO Care Management List

409 Lahey Hamilton-Wenham 410 Lahey Wilmington Lisa Yarrow (Community Jodi Shaw (Inpatient CCP) Martha MacDougall (Community Jeannie Petringa (Inpatient CCP) 888.880.8699 ext. 48119 888.880.8699 ext. 48133 888.880.8699 ext. 48137 888.880.8699 ext. 48131 411 Lahey Lexington Rosa O Campo (CCM) Jeannie Petringa (Inpatient CCP) 888.880.8699 ext. 48138 888.880.8699 ext. 48131 415 NWPHO PCPO Patricia Corrigan (CNL) Erin Carven (Backup CNL) Jennie Wright (Backup CNL) 781.697.4815 781.400.4079 617.243.5076 617.243.6004 Attention: Erin Craven 416 Lahey Lynnfield Lisa Yarrow (Community Jeannie Petrings (Inpatient CCP) Dianne Sweet (HC admin) 888.880.8699 ext. 48119 888.880.8699 ext. 48131 427 Quincy Independent Physician Group Sabrena Worrell (CCP) Mary Finn (CCM) 888.880.8699 ext 48139 888.880.8699 ext 48121 430 Lahey Lowell Jeannie Revette (CCP) Lisa D Amico (CCP) Jen Modiszewski (CCM) Beth Curran (CCM) 888.880.8699 ext. 48131 888.880.8699 ext. 48176 888.880.8699 ext. 48242 888.880.8699 ext. 53115 888.860.8699 ext. 48158 431 Lahey Winchester Jeannie Revette (CCP) Lisa D Amico (CCP) Jen Modiszewski (CCM) Beth Curran (CCM) 888.880.8699 ext. 48131 888.880.8699 ext. 48176 888.880.8699 ext. 48242 888.880.8699 ext. 53115 888.860.8699 ext. 48158 Revised 02/08/2018 13 HMO Care Management List

OUT-OF-AREA HMO NETWORK JoAnn Ogilvie (CNL/CCP/HC) 617.972.1007 Key HC: Home Care CNL: Acute Care (includes tertiary facilities) PCM: Group Primary Care Manager CCP: Extended Care (includes SNF & Acute Rehab) Revised 02/08/2018 14 HMO Care Management List