Contracted Insurance Plans As of March 1, 2018, Children s Health SM has contracts with the following health care insurance plans for the following locations: 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 Children s Health SM Specialty Center Park Cities Children s Health SM Specialty Center Mesquite Children s Health SM Specialty Center South Rockwall Children s Health Center for Autism & Developmental Disabilities Children s Health SM Specialty Center Cityville Children s Health SM Sleep Disorders Center Commercial (Private Health Insurance) Baylor Scott & White Health Plan (Employees) Baylor Scott & White Health Plan Quality Alliance (BSWQA ACO Network), Inc. (CIGNA Great-West) Galaxy Health Network, 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) (TCHP) Managed Medicaid Foster Care (STAR Health) (Medical & Behavioral Health) 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
Contracted Insurance Plans As of March 1, 2018, Children s Health SM has contracts with the following health care insurance plans for the following locations: 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 Children s Health SM Specialty Center Park Cities Children s Health SM Specialty Center Mesquite Children s Health SM Specialty Center South Rockwall Children s Health Center for Autism & Developmental Disabilities Children s Health SM Specialty Center Cityville Children s Health SM Sleep Disorders Center (TMHP) (Texas Medicaid) Children with Special Health Care Needs (CSHCN) Arkansas Medicaid (CMC Dallas & Plano) Mississippi Medicaid (CMC Dallas Only) Oklahoma Health Care Authority (OHCA) (CMC Dallas & Plano) Behavioral Health (Commercial Only) Managed Health Network (MHN)*** Beacon Health Options (STAR, STAR+PLUS, STAR Kids, CHIP) OptumHealth Behavioral Solutions (Commercial) (Commercial) (HMO Blue Excluded) OptumHealth Behavioral Solutions (STAR, STAR+PLUS, STAR Kids, CHIP) (STAR, STAR+PLUS, STAR Kids, CHIP) Scott & White Health Plan (Commercial Only) CompCare (Commercial Only) Superior HealthPlan (STAR Health Only) (TCHP) *** Therapy and Psychological Testing Excluded without Inpatient Stay Transplant Networks Blue Distinction Centers for Transplant BMT, Heart, Liver CIGNA LifeSOURCE Network BMT, Heart, Kidney, Liver National Transplant Network BMT, Heart, Kidney, Liver INTERLINK BMT, CHD, Heart, Kidney, Liver LifeTrac BMT, Heart, Intestine, Kidney, Liver, Multi-Organ OptumHealth BMT, CHD, Heart, Kidney, Liver, Multi-Organ OptumHealth UnitedHealthcare Compass W500 (COE) Protocol Tertiary Network BMT, Heart, Kidney, Liver If you have questions, please read your insurance card, policy or other available material from your health plan. We also recommend that you contact your health insurance carrier or employee benefits administrator to verify coverage and/or request additional information on your health plan. NOTE: Physicians contract with Managed Care Organizations separately from the hospital. Therefore, this list may be used as a reference for hospital services only. Please contact physicians directly to determine their plan participation. 2
Children s Health Affiliates (Hospital-Based Providers) Advanced Practice Providers (APPs) Nurse Practitioners and Physician Assistants Commercial (Private Health Insurance) Managed Medicaid (STAR//MRSA/CHIP) FirstCare Health Plans (TCHP) (STAR Health included) Behavioral Health (Commercial) (STAR, STAR+PLUS, STAR Kids, CHIP) Trinity Mother Frances (Employees & Their Dependents Only) OptumHealth Behavioral Solutions (Commercial) OptumHealth Behavioral Solutions (STAR, STAR+PLUS, STAR Kids, CHIP) Anesthesiologists for Children (AFC / AFC-Pain Management) Commercial (Private Health Insurance) Commercial (Continued) Three Rives Network (TRPN) (TCHP) Managed Medicaid (STAR/MRSA/CHIP) (STAR Health included) Complex Care Medical Services Corporation (CCMSC) Commercial (Private Health Insurance), Inc Managed Medicaid (STAR/MRSA/CHIP) Behavioral Health (Commercial) CIGNA Behavioral Health HealthSCOPE (DART ACO) LifeSynch ( Behavioral Health) Magellan Behavioral Health Behavioral Health (STAR/CHIP) 3
Children s Health Affiliates (Hospital-Based Providers) Continued Dallas Physician Medical Services for Children (DPMSC - Hospitalists) Commercial (Private Health Insurance) Commercial (Continued) 1 SUPERIOR Health Plan Managed Medicaid (STAR/MRSA/CHIP) (TCHP) (STAR Health included) Private Healthcare Systems (PHCS) 1 DPMSC s in-network status for Baylor SWHP Quality Alliance (BSWQA ACO Network) members is benefit-specific based on the member s benefit design with their employer. Please contact your plan directly to determine participation status. Dallas Physician Medical Services for Children (DPMSC - Orthodontics) Aetna Dental DentaQuest for Superior HealthPlan CIGNA Dental HealthSCOPE Benefits (DARTACO) Delta Dental Insurance Company (DDIC) Dental Benefit Providers (UnitedHealthcare) Dental DHMO Dental Network of America (DNOA) MCNA Dental Plans DentaQuest Dental Clinic Aetna Dental CIGNA Dental Delta Dental Insurance Company (DDIC) Dental Benefit Providers (UnitedHealthcare) Dental Network of America (DNoA) DentaQuest Dental DHMO MCNA Dental Plans Home Health Care (HHC) Commercial (Private Health Insurance) Managed Medicaid (STAR/MRSA/CHIP) (HHC Only) CareCentrix (TCHP) (STAR Health ONLY) 4
Children s Health Affiliates (Hospital-Based Providers) Continued Home Medical Equipment (HME) Commercial (Private Health Insurance) Managed Medicaid (STAR/MRSA/CHIP) (HHC Only) CareCentrix (TCHP) 5
Children s Health Affiliates (Outpatient Clinics) As of March 1, 2018, Children s Health SM Pediatric Group (CHPG) has contracts with the following health care insurance plans for the locations listed below: 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 Children s Health Pediatric Group (CHPG) - formerly MyChildren s Commercial (Private Health Insurance) Managed Medicaid (STAR/MRSA/CHIP) Behavioral Health (Commercial) CIGNA Behavioral Health (STAR Health included) LifeSynch ( Behavioral Health) Magellan Behavioral Health MHNet Behavioral Health (Coventry) Behavioral Health (STAR/STAR+PLUS/CHIP) Integrated Health Plan (TCHP) * (TCHP) *Tarrant County CHPG Locations ONLY 6
Our Children s House As of September 20, 2015 Children s Health SM now includes the following Our Children s House locations: Our Children s House Dallas 1340 Empire Central, Dallas, TX 75247 Specialty Center Waxahachie 1540 N. Highway 77, Ste. 10, Waxahachie, TX 75165-5207 Specialty Center Grapevine 1643 Lancaster Drive, Ste. 300, Grapevine, TX 76051-3593 Specialty Center North Rockwall 2455 Ridge Road, Ste. 255, Rockwall, TX 75087-5534 Specialty Center Irving 3337 Stovall Street, Irving, TX 75061-4035 Specialty Center Frisco 7010 Preston Road, Ste. 240, Frisco, TX 75034-5875 Specialty Center Plano 7000 W. Plano Parkway, Ste. 210, Plano, TX 75093-1632 Specialty Center Las Colinas 7453 Las Colinas Blvd., Irving, TX 75063-7561 Specialty Center Allen 8 Prestige Circle, Ste. 101, Allen, TX 75002-3435 Our Children s House Commercial (Private Health Insurance) Managed Medicaid (STAR/MRSA/CHIP) Transplant Networks CIGNA LifeSOURCE LifeTrac Transplant Network 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 Behavioral Health (STAR, STAR+PLUS, STAR Kids, CHIP) OptumHealth Behavioral Solutions (Commercial) OptumHealth Behavioral Solutions (STAR, STAR+PLUS, STAR Kids, CHIP) Oklahoma Health Care Authority (OHCA) 7