2013 Provider Directory - .2013 Provider Directory January 1, 2013 ... Check with your provider

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  • h4209_mbs2013pd cms accepted 12285m-2013

    2013 Provider Directory

    January 1, 2013 December 31, 2013 BlueCross BlueShield of South Carolina contracts with the federal government. Contract # h4209

    (PPO)

  • TABLE OF CONTENTSPROVIDER DIRECTORYSECTION 1 - INTRODUCTION iiSECTION 2 - LIST OF PLAN PROVIDERS

    PRIMARY CARE PHYSICIANS 1SPECIALISTS 137HOSPITALS 387SKILLED NURSING FACILITIES 391OUTPATIENT MENTAL HEALTH PROVIDERS 398CHIROPRACTORS 434ANCILLARY PROVIDERS 453

    AMBULANCE SERVICE 453AMBULATORY SURGICAL CENTER 455CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) 458DIABETIC EDUCATOR 458DIALYSIS CENTERS 459DURABLE MEDICAL SUPPLY COMPANY 463FREESTANDING IMAGING FACILITY 472HOME HEALTH INSTITUTION 472INDEPENDENT LABORATORY 475INDEPENDENT PHYSIOLOGICAL LABORATORY 476INFUSION THERAPY 476MED SUPPLY CO WITH CERT PROSTHETIST/ORTHOTIST 477MINUTE CLINIC 479NURSE PRACTITIONER 481OCCUPATIONAL THERAPY GROUPS 481PHARMACY & DME SUPPLIERS 482PHYSICAL THERAPIST GROUPS 483REHABILITATION 495URGENT CARE 497

    HOSPITAL IDENTIFIER CODES 500ROUTINE VISION SERVICE PROVIDERS V iDENTAL DIRECTORY D iPROVIDER INDEX I 1

  • BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.

    Medicare BlueSM Saver

    PPO Plan

    Provider Directory

    This directory provides a list of Medicare BlueSM Saver (PPO)s network providers. This directory is for the state of South Carolina. This directory is current as of July 2012. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about Medicare Blue Savers network providers in your area, you can visit www.scbluesmedadvantage.com/mbs13 or call our Customer Service Department at 1-888-645-6025. Hours are 8 a.m. to 8 p.m. Eastern Time, Monday through Friday; from October 1, 2012 to February 14, 2013, 8 a.m. to 8 p.m., seven days a week. Beginning February 15, 2013, our automated telephone system handles calls received after 8 p.m. and on Saturdays, Sundays and holidays. TTY/TDD users should call 1-888-645-6023. Medicare Blue Saver is a PPO plan with a Medicare contract. This document is available in alternate formats. To get this information in other formats, please call 1-888-645-6025. TTY/TDD users should call 1-888-645-6023. H4209_MBS2013PD CMS ACCEPTED 12285M-2013

  • ii

    Section 1 Introduction This directory provides a list of Medicare Blue Savers network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage. The network providers listed in this directory have agreed to provide you with your health care coverage. You may go to any of our network providers listed in this directory. If you have beengoing to one network provider, you are not required to continue going to that same provider. Insome cases, you may get covered services from non-network providers. Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area, you must use plan providers for urgent care. When out of the service area, urgent care may be obtained from the first available provider. In addition, when out of the service area, you can obtain dialysis treatment from any qualified dialysis provider. If you obtain routine care from out-of-network providers, neither Medicare nor Medicare Blue Saver will be responsible for the costs. A medical emergency, when you believe that your health is in serious danger, includes severe pain, a bad injury, a sudden illness, or a medical condition that is quickly getting much worse. If you have a medical emergency, get medical help as quickly as possible. Call 911 for help or go to the nearest emergency room, hospital, or urgent care center. You do not need to get approval or a referral first from your doctor or other network provider. You may get covered emergency medical care whenever you need it, anywhere in the United States. As soon as possible, make sure that we know about your emergency; call your doctors regular office number. While you are a member of our Plan, you may use either network providers or out-of-network providers. However, your out-of-pocket costs may be higher if you use out-of-network providers, except for emergency care or out-of-area dialysis services. You do not need to get a referral or prior authorization when you get care from out-of-network providers; however, before getting services from out-of-network providers, you may want to confirm with us that the services you are getting are covered by us and are medically necessary. If an out-of-network provider sends you a bill that you think we should pay, please contact Customer Service or send the bill to us for payment. We will pay your doctor for our share of the bill and will let you know what, if anything, you must pay. You will not have to pay an out-of- network provider any more than what he or she would have gotten if you had been covered with the Original Medicare Plan. It is best to ask an out-of-network provider to bill us first; but if you have already paid for the covered services, we will reimburse you for our share of the cost. (Please note that we can not pay a provider who has opted out of the Medicare program. Check with your provider before receiving services to confirm that they have not opted out of Medicare.) If we later determine that the services are not covered or were not medically necessary, we may deny coverage and you will be responsible for the entire cost.

  • iii

    What is the service area for Medicare Blue Saver? Our service area is the state of South Carolina.

    How do you find Medicare Blue Saver providers in your area? This directory lists our Plans primary care physicians, specialists, hospitals, skilled nursing facilities, and outpatient mental health providers in the state of South Carolina. To select a physician from this directory, find the county you live in or a county that is convenient for you. Under the counties are cities; under the cities are the physicians and types of practice (such as Family Medicine, Internal Medicine or Surgery), with their addresses and telephone numbers. The counties, cities and physicians are arranged alphabetically. If the physician you choose belongs to a group practice, the name of the group practice will also appear under his or her name. Typically, your primary care doctor will provide most of your health care; but you may also see any specialist without a referral. This directory lists primary care doctors and specialists. To provide quality service to our members, we have asked our plan physicians to identify foreign languages they or their office staffs speak in addition to English. The additional languages a doctor or his/her office staff speaks are noted under the office location in the Primary Care and Specialists sections of this directory. We have also asked our Plan physicians to identify hospitals where they have admitting privileges. The hospital identifier codes are listed under the providers name throughout the Primary Care and Specialists sections. The key for hospital identifiers is located at the end of the Provider Directory. Medicaid-participating providers are identified with an asterisk and an accompanying explanatory footnote. If you have questions about Medicare Blue Saver, please call our Customer Service Department at 1-888-645-6025. Hours are 8 a.m. to 8 p.m. Eastern Time, Monday through Friday; from October 1, 2012 to February 14, 2013, 8 a.m. to 8 p.m., seven days a week. Beginning February 15, 2013, our automated telephone system handles calls received after 8 p.m. and on Saturdays, Sundays and holidays. TTY/TDD users should call 1-888-645-6023. Or visit www.scbluesmedadvantage.com/mbs13.

  • Primary Care PhysiciansABBEVILLE - ABBEVILLE AIKEN - AIKEN

    ABBEVILLE

    ABBEVILLEAdams Steven D MDFamily MedicineFamily Medicine Associates901 W Greenwood St Ste 9Abbeville,SC 29620(864) 366-9681

    Gonzalez Evangeline G MDInternal MedicineHospital Identifier(s):1Abbeville Internal Medicine901 W Greenwood St Ste 5Abbeville,SC 29620(864) 366-9938Scdr Lang: PHILIPPINE

    Johnston Bruce S MD*Family MedicineHospital Identifier(s):1Family Medicine Associates901 W Greenwood St Ste 9Abbeville,SC 29620(864) 366-9681

    Kolb Charles A MD*Family MedicineHospital Identifier(s):1Family Medicine Associates901 W Greenwood St Ste 9Abbeville,SC 29620(864) 366-9681

    Oxendine Christopher L MDFamily MedicineFamily Medicine Associates901 W Greenwood St Ste 9Abbeville,SC 29620(864) 366-9681

    Rodillo Heidi E MDInternal MedicineHospital Identifier(s):1Abbeville Internal Medicine901 W Greenwood St Ste 5Abbeville,SC 29620(864) 366-9938

    AIKEN

    AIKENBesson William T III MDInternal MedicineHospital Identifier(s):2Aiken Internal Medicine Assoc410 University Pkwy Ste 2500Aiken,SC 29801(803) 648-7888

    Bryan Gasnel E MD*Obstetrics & GynecologyHospital Identifier(s):2Gasnel E Bryan MD209 Abbeville AveNWAiken,SC 29801(803) 648-0874

    Daniels Brandon L MDObstetrics & GynecologyHospital Identifier(s):2Brandon L Daniels MD LLC953 Dougherty Rd Unit AAiken,SC 29803(803) 644-1970

    Goldberg Susan M MDPediatricsHospital Identifier(s):2Palmetto Pediatrics60 Physician DrAiken,SC 29801(803) 641-5437

    Gordineer Dale R MD*Family MedicineHospital Identifier(s):23Doctors Care1029 York St NeAiken,SC 29801(803) 648-4119

    Hashmi Asif A MDInternal MedicineAsif A Hashmi MD60 Physician Dr Ste 200Aiken,SC 29801(803) 644-1027

    Hesse Raymond D MDInternal MedicineHospital Identifier(s):2Aiken Internal Medicine Assoc410 University Pkwy Ste