ERTX18HM4110807_000.pdfErickson Advantage® Champion (HMO-POS SNP) Erickson Advantage® Freedom (HMO-POS) Erickson Advantage® Guardian (HMO-POS SNP) Texas For more information, please contact Customer Service at: Toll-Free 1-866-314-8188, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.EricksonAdvantage.com Y0066_170626_143320_NM Introduction Your plan PROVIDER DIRECTORY This directory provides a list of your plan’s network providers. This directory is for the plans listed on the cover. It is not a complete list of network providers available to you. You can search for a network provider and print a directory online, which is updated weekly and available 24 hours a day, 7 days a week. This directory is current as of September 1, 2017. 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. For the most up-to-date information about the plan’s network providers in your area: Visit www.EricksonAdvantage.com or call Customer Service toll-free at 1-866-314-8188, TTY 711, 8 a.m. - 8 p.m. local time, 7 days a week. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plan’s contract renewal with Medicare. Providers are prohibited from discriminating against any member, with regard to quality of service or accessibility of services, on the basis of race, ethnicity, national origin, religion, sex, age, mental or physical disability or medical condition, sexual orientation, claims experience, medical history, evidence of insurability, disability, genetic information, or source of payment. This information is available for free in other languages. Please call Customer Service toll-free at the number listed above. Esta información está disponible sin costo en otros idiomas. Llame a nuestro Servicio al Cliente al número gratuito indicado arriba. This document may be available in an alternate format such as Braille, larger print or audio. Please call Customer Service at the toll-free phone number listed above. The provider network may change at any time. You will receive notice when necessary. Y0066_170626_143320_NM Introduction Introduction This directory provides a list of the plan’s network providers. You must be a resident of an Erickson community to enroll in this plan. You may also receive services from out-of-network providers. You do not need a referral to see any network or out-of-network provider for covered services. You can see any provider (network or out-of-network) that participates in Medicare and accepts the plan. To get detailed information about your health care coverage, please see your Evidence of Coverage. What is a primary care provider? A primary care provider (PCP) is the health care professional who provides most of your care. Your PCP can help you: ·Make smart lifestyle choices to help improve and maintain your health ·Get preventive care and health screenings ·Better understand your medical conditions ·Coordinate any specialist care to help avoid duplicate and expensive tests. · Manage your prescriptions and identify possible harmful interactions Select a primary care provider (PCP) You will need to choose one of our network providers to be your primary care provider (PCP). PCPs are listed in the Primary Care Provider section of this directory. The term PCP will be used throughout this directory. You may also receive services from out-of-network providers. Members who live in a skilled nursing facility may have a limited selection of PCPs. Please call Customer Service at the toll-free number listed on the cover of this directory for help finding a PCP. Your PCP plays an important role in your health care and we want you to be comfortable with the provider you choose. Your local Erickson Advantage Customer Service Advocate can help you choose a PCP - simply call the toll-free number on your member ID card, or visit the Member Services office within your community. The difference between network and out-of-network providers Network providers are providers that your plan works with to provide your care. If you use a network provider, your out-of-pocket costs, which are costs paid by you, may be lower. Out-of-network providers are providers that we currently do not work with, so your out-of-pocket costs may be higher. The network providers listed in this directory have agreed to provide you with your health care coverage. You can see a network specialist without getting a referral. In some cases, you may get covered services from out-of-network providers. If you have been going to one network provider, you are not required to continue going to that same provider. Check your Evidence of Coverage to make sure your plan includes additional benefits or that you've signed up for optional supplemental riders before making appointments for dental, vision or hearing services. Introduction If I need emergency or urgent care A medical emergency is when you, or any other ordinary person with an average knowledge of health and medicine, believe that you have symptoms that require immediate medical care to prevent death, loss of a limb, or loss of function of a limb. The medical symptoms may be an illness, injury, severe pain, or a medical condition that is quickly getting worse. If you have a medical emergency, get help as quickly as possible. Call 911 or go to the nearest emergency room or hospital. Emergency care can always be obtained in or out of the service area from the nearest available provider. Emergency services are also covered whether a provider is in our network or not. You or someone else should call and tell us about your emergency care, usually within 48 hours. Urgently needed services is a non-emergency, unforeseen medical illness, injury, or condition, that requires immediate medical care. When out of the service area, urgent care may be obtained from the first available provider whether the provider is in our network or not. In addition, when out of the service area, you can obtain dialysis treatment from any qualified dialysis provider. Out-of-network providers are under no obligation to treat Plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our customer service number or see your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services and which out-of- network services are covered. If you get a bill There may be times when you get a bill from a provider for the full cost of medical care you have received. If you get a bill, contact us. In many cases, you should send this bill to us instead of paying it. We will look at the bill and decide whether the services should be covered. If we decide they should be covered, we will pay the provider directly. Please see your Evidence of Coverage for more information. If you’re on Medicare and Medicaid If you’re a Qualified Medicare Beneficiary (QMB), your doctor may not bill you for deductibles, copays or coinsurance for Medicare-covered services, except for Part D prescription drug copays. Please show your member ID card and your state-issued Medicaid member ID card when you see the doctor or use other plan services. This will help ensure you’re billed for the correct amount. Routine hearing and vision care coverage To get the most out of your benefits, choose a network provider for a routine hearing exam and vision care services. Your local Erickson Advantage Customer Service Advocate can help you find a provider — simply call the toll-free number on your member ID card, or visit the Member Services office within your community. Dental services Members whose plan includes additional dental benefits should refer to the Dental section of this directory to choose a dental provider. Introduction Organ transplant services Your plan has a nationwide network of facilities that perform organ transplants (including the heart, lung, liver, intestine, kidney, bone marrow and/or pancreas). Solid organ transplants must be performed at a facility that is currently Medicare-approved for your specific type of transplant. The plan’s hospital network for organ transplant services is different than the network shown in the “Hospitals” section of this provider directory. Some hospitals in the plan’s network for other medical services are not in the plan’s network for transplant services. The complete list of Medicare-approved facilities in your plan’s network may change throughout the year. For information on network facilities for transplant services, please call Customer Service toll-free at 1-866-314-8188, TTY 711 or refer to the transplant vendor website information listed in the “National Vendors” section of this provider directory. What is the service area for your plan? Your service area is listed below. Erickson Advantage® Freedom (HMO-POS) Massachusetts - Essex and Plymouth counties Michigan - Oakland county North Carolina - Mecklenburg county Erickson Advantage® Signature with Drugs (HMO-POS) Colorado - Douglas county Kansas - Johnson county Massachusetts - Essex and Plymouth counties Michigan - Oakland county North Carolina - Mecklenburg county Introduction Colorado - Douglas county Kansas - Johnson county Massachusetts - Essex and Plymouth counties Michigan - Oakland county North Carolina - Mecklenburg county Colorado - Douglas county Kansas - Johnson county Massachusetts - Essex and Plymouth counties Michigan - Oakland county North Carolina - Mecklenburg county Colorado - Douglas county Kansas - Johnson county Massachusetts - Essex and Plymouth counties Michigan - Oakland county North Carolina - Mecklenburg county Introduction How do you find network providers in your area? Network providers in your area are listed in the following sections of this directory. To find a provider using this directory, turn to the Table of Contents on the next page and see where each section begins. Go to the section of the type of provider you are looking for. Once you are in that section, locate the city you live in. Under each city you will find a list of providers in alphabetical order. You may have more providers to choose from if the service area shown above is larger than the service area shown on the front of this directory. You can also search online at www.EricksonAdvantage.com, which is updated weekly and available 24 hours a day, 7 days a week. If you have questions about your plan or require assistance in selecting a PCP, please call our Customer Service Department toll-free at 1-866-314-8188, TTY 711. Or visit www.EricksonAdvantage.com. National Vendors............................................................................................................................................................................. 3
National Vendors The following national vendors are available to provide services to UnitedHealthcare customers throughout the United States regardless of where you receive the services. Provider(s) Phone Number WebSite LifeWatch 1-877-774-9846 www.lifewatch.com CardioNet 1-888-312-2328 www.cardionet.com Convenience Care Clinic Walgreens Healthcare Clinic (f/k/a Take Care Health) 1-866-825-3227 www.walgreens.com/topic/pharma cy/healthcare-clinic Fresenius Medical Care 1-866-434-2597 www.fmcna.com DME - AED - wearable defibrillator ZOLL Lifecore 1-800-543-3267 www.zoll.com DME - Ambulatory Infusion Pumps InfuSystem Inc 1-800-962-9656 www.infusystem.com DME - Bone Growth Stimulator DME - Commodity, oxygen, respiratory Lincare - may be known locally by a different name; refer to website See website www.lincare.com Rotech Healthcare - may be known locally by a different name; refer to website See website www.rotech.com Apria Healthcare 1-800-277-4288 www.apria.com Kinex Medical Company 1-800-845-6364 www.kinexmedical.com Otto Bock Healthcare 1-800-328-4058 www.ottobockus.com DME - Diabetic glucometer and supplies Arriva Medical 1-800-580-1871 www.arrivamedical.com MiniMed Distribution 1-877-576-6113 www.minimed.com DJO 1-800 321-9549 www.djortho.com DME - Home PT/INR DME - Incontinence, diapers, soft goods and wound care supplies Medline Industries 1-800-633-5463 www.medline.com Byram Healthcare 1-877-902-9726 www.byramhealthcare.com McKesson Patient Care Solutions Hoveround Corporation 1-888-225-1547 www.hoveround.com/MobilityNow KCI USA 1-888-275-4524 www.kci1.com Advanced Respiratory 1-800-426-4224 www.thevest.com DME - TENS units DME - Wound care supplies for residents of nursing homes Gordian Medical, Inc 1-800-568-5514 www.amtwoundcare.com DME - Wound care surfaces Hill Rom 1-800-445-3730 www.hill-rom.com www.bayada.com Maxim Health Care Services Provider(s) Phone Number WebSite Home Health Care and Home Infusion - Women’s health - high risk OB / prenatal care Optum Women's and Children's Health 1-800-950-3963 www.alere.com Home Infusion Biologics 1-800-856-1984 www.biologicsinc.com BriovaRx Infusion Services 1-855-275-9647 www.optioncare.com Heartland Healthcare Services 1-800-736-4427 / 1-419- 252-5500 www.hcr-manorcare.com or www.heartlandhomehealth.com 1-877-273-5534 www.optumhospice.com Bako Integrated Physician Solutions AmeriPath 1-800-354-3449 www.ameripath.com StrataDx Pathology 1-800-325-7284 www.stratadx.com Laboratory - BRCA for breast & ovarian cancer; COLARIS for colon & endometrial cancer; MELARIS for melanoma & pancreatic cancer; Theraguide 5-FU Myriad Genetic Laboratories ARUP Labs 1-800-522-2787 www.aruplab.com www.dominiondiagnostics.com www.genomichealth.com Invitae Corporation 1-800-436-3037 invitae.com Poplar Healthcare 1-888-244-7284 www.poplarhealthcare.com Agendia 1-888-321-2732 www.agendia.com CardioDx 1-866-941-4996 www.cardiodx.com Laboratory - Prenatal testing Medical Diagnostic Laboratories Integrated Oncology 1-800-447-5816 www.integratedoncology.com Aegis Sciences Corporation Concentra Health Services See website www.concentra.com Caremark 1-877-287-1234 www.caremark.com Specialty Pharmacy - Xolair only Specialty Pharmacy and Home Infusion - Enzyme Deficiency, Immune Globulins (IVIG), Pulmonary Hypertension Accredo Health Group 1-866-296-4513 www.accredo.com Transplant MedExpress Urgent Care See website www.medexpress.com Vaccine Program - Influenza (Trivalent, Quadrivalent, High Dose, Intradermal), Pneumonia, Zostavax, Tdap, Meningococcal, Hepatitis B, HPV, TDAP (Tetanus, Diphtheria & Pertussis), Shingles (Zostavax), Meningitis, HPV, and Hepatitis B (age 15 and up). Worksite Clinics and Retail locations H-E-B 1-210-938-8357 www.heb.com/pharmacy/services/i mmunizations.jsp Meijer Pharmacy 1-877-363-4537 www.meijer.com/pharmacy 1-855-798-7267 www.jewelosco.com/pharmacy/im munizations-3/ New Albertsons (d/b/a Acme Sav-on, Jewel-Osco, Star Markets, Shaws Osco, Safeway) 1-855-798-7267 www.acmemarkets.com/pharmacy /immunizations/ Publix Pharamcy 1-800-242-1227 www.publix.com/pharmacy- wellness/pharmacy/preventive- care/vaccinations Safeway, Inc. d/b/a Safeway, Carrs, Pak'N Save, Pavilions, Randalls, Thom Thumb 1-855 798 7267 www.safeway.com/shopstores/phar macy ShopKo Pharmacy 1-800-791-7333 http://pharmacy.shopko.com/flush ots.php The Kroger Co. (d/b/a Fred Meyer, Smith’s Food & Drug Center, Ralphs Grocery, Dillons, Tom Thumb, Kwik Shop, Frys, King Soopers, Jay C, QFC, Bakers, City Market, Owens, Payless, Gerbes, Roundy's, Copps, Mariano's, Metro Market, Pick 'N Save) See website www.kroger.com/topic/pharmacy/ #/vaccinations-made-easy 1-855-798-7267 www.unitedsupermarkets.com Vaccine Program - Influenza (Trivalent, Quadrivalent, High Dose, Intradermal), Pneumonia, Zostavax, Tdap, Meningococcal, Hepatitis B, TDAP (Tetanus, Diphtheria & Pertussis), Shingles (Zostavax), Meningitis, and Hepatitis B (age 18 and up). Worksite Clinics and Retail locations CVS Pharmacy (d/b/a CVS Pharmacy, Long’s Drug, CarePlus Pharmacy) 1-888-358-7468 www.cvs.com www.riteaid.com 10 1-800-925-4733 https://www.walgreens.com/pharm acy/immunization/immunization_i ndex.jsp See website www.walmart.com DME - DURABLE MEDICAL EQUIPMENT is certain medical equipment that is ordered by your doctor for use at home. DME includes but is not limited to: wheelchairs, crutches, hospital bed, IV infusion pump, oxygen equipment, nebulizer, and walker. HOME HEALTH/HOME INFUSION CARE can either be a licensed facility or medical personnel that can provide health care services in the home. Services include but are not limited to nursing visits for infusion services or wound care. LABORATORY means diagnostic testing including routine blood and urine analysis, anatomic pathology, surgical pathology, and specialty or esoteric services. SPECIALTY PHARMACY PROVIDER provides specific drug products directly to customers or physicians. WOMEN'S HEALTH is limited to home uterine monitoring services. 11 12
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Geriatric Medicine Strickland, Richard M, MD3,8, M Provider #00040260829 8000 Frankford Rd Dallas, TX 75252 (972) 232-8080 Studley, Jill L, MD8, F Provider #00040299016 8000 Frankford Rd Dallas, TX 75252 (972) 232-8080 Tremaine, Brian N, MD3,8, M Provider #00040116365 8000 Frankford Rd Dallas, TX 75252 (972) 232-8080 Internal Medicine Chandra, Nagaleela M, MD8, F Provider #00040227476 8000 Frankford Rd Dallas, TX 75252 (972) 232-8080 Norman, Mary A, MD3,8, F Provider #00040039764 8000 Frankford Rd Dallas, TX 75252 (972) 232-8080 Hours: M-F 8:00AM-5:00PM Patel, Raina, MD3,8, F Provider #00040032947 8000 Frankford Rd Dallas, TX 75252 (972) 232-8080 Strickland, Richard M, MD3,8, M Provider #00040260829 8000 Frankford Rd Dallas, TX 75252 (972) 232-8080 Studley, Jill L, MD8, F Provider #00040299016 8000 Frankford Rd Dallas, TX 75252 (972) 232-8080 Tremaine, Brian N, MD3,8, M Provider #00040116365 8000 Frankford Rd Dallas, TX 75252 (972) 232-8080 15 Texas - Collin
Texas Bexar Cardiology Moore, Scott A, MD8, M 502 Madison Oak, Ste 310 San Antonio, TX 78258 (469) 893-6114 NPI #1639149263 Cardiovascular Disease Moore, Scott A, MD8, M 502 Madison Oak, Ste 310 San Antonio, TX 78258 (469) 893-6114 NPI #1639149263 Paudel, Rajiv, MD8, M 3327 Research Plaza, Ste 310 San Antonio, TX 78235 (469) 893-6114 NPI #1023240132 Reich, Stephen S, MD8, M 875 Village Drive, Ste 608 San Antonio, TX 78217 (469) 893-6114 Clinical Cardiac Electrophysiology Reich, Stephen S, MD8, M 875 Village Drive, Ste 608 San Antonio, TX 78217 (469) 893-6114 Internal Medicine Moore, Scott A, MD8, M 502 Madison Oak, Ste 310 San Antonio, TX 78258 (469) 893-6114 NPI #1639149263 Paudel, Rajiv, MD3,8, M 3327 Research Plaza, Ste 310 San Antonio, TX 78235 (469) 893-6114 NPI #1023240132 Reich, Stephen S, MD8, M 875 Village Drive, Ste 608 San Antonio, TX 78217 (469) 893-6114 Collin Acupuncture Lu, Zhanping, MA8, M 425 Maplelawn Dr Ste 101 Plano, TX 75075 (972) 519-8488 Provider Language(s): Chinese Hours: M-SA 9:00AM-6:30PM NPI #1528070281 Nguyen, James, DC8, M 5858 W Main St Ste 115 Frisco, TX 75033 (469) 701-1112 Provider Language(s): Vietnamese Hours: TU-F 10:00AM-6:00PM SA 9:00AM-1:00PM NPI #1538463245 Stokes, Ralph D JR, DC8, M 6020 W Parker Rd Ste 200 Plano, TX 75093 (972) 608-5000 NPI #1598794844 Zhang, Lei, DC, LAC8, M 2411 Coit Rd Ste 110 Plano, TX 75075 (972) 769-7345 Provider Language(s): Chinese Hours: SU 11:00AM-6:00PM M-SA 9:00AM-6:00PM Allergy Gupta, Sandeep K, MD8, M 4708 Alliance Blvd Ste 610 Plano, TX 75093 (972) 596-4383 NPI #1457406423 Santilli, Gregg M, MD3,8, M 6100 Windcom Ct Ste 101 Plano, TX 75093 (972) 398-3500 Provider Language(s): Spanish NPI #1023099082 7785 Eldorado Pkwy Ste 500 McKinney, TX 75070 (972) 542-0500 NPI #1023099082 Allergy and Immunology Allergy Partners Of Dallas-fort Worth8 3140 Legacy Dr Ste 120 Frisco, TX 75034 (972) 566-7788 4500 Hillcrest Rd Ste 150 Frisco, TX 75035 (972) 566-7788 5056 Tennyson Pkwy Ste 200 Plano, TX 75024 (972) 272-4463 Allergy Partners Of El Paso8 3140 Legacy Dr Ste 120 Frisco, TX 75034 (972) 566-7788 4500 Hillcrest Rd Ste 150 Frisco, TX 75035 (972) 566-7788 Allergy Partners Of Texas8 5056 Tennyson Pkwy Ste 200 Plano, TX 75024 (828) 209-0594 17
Specialists Specialists Alvares, Michael L, MD8, M 5056 Tennyson Pkwy Plano, TX 75024 (828) 209-0594 Hours: M 8:30AM-12:00PM NPI #1306055264 Chinoy, Birjis D, MD3,8, M 8000 Warren Pkwy Ste 200 Frisco, TX 75034 (469) 633-1313 Hours: M-F 8:00AM-6:00PM NPI #1811960461 Crisp, Howard C, MD8, M 4708 Alliance Blvd Ste 485 Plano, TX 75093 (972) 596-4383 NPI #1760608442 El-hag, Aly A, MD3,8, M 8941 Coit Rd Ste 100 Plano, TX 75024 (972) 668-2200 NPI #1790880268 Garg, Nikki, MD3,8, F 6100 Windcom Ct Ste 101 Plano, TX 75093 (972) 398-3500 Hours: M 8:30AM-5:00PM TU-W 8:30AM-6:00PM TH 8:30AM-5:00PM F 7:30AM-4:00PM NPI #1801030135 7785 Eldorado Pkwy Ste 500 McKinney, TX 75070 (972) 398-3500 Provider Language(s): Spanish Hours: M 8:30AM-6:00PM TU-F 8:30AM-5:00PM NPI #1801030135 Gupta, Sandeep K, MD3,8, M 4708 Alliance Blvd Ste 610 Plano, TX 75093 (972) 596-4383 NPI #1457406423 John Allen Van Wagoner Md8 6101 Windcom Ct Ste 400 Plano, TX 75093 (972) 398-3500 Kavosh, Eric R, MD3,8, M 5904 Chapel Hill Blvd Ste 103 Plano, TX 75093 (972) 473-2532 Hours: M-F 8:00AM-5:00PM NPI #1164683249 Khan, Amanullah, MD3,8, M 5948 W Parker Rd Ste 100 Plano, TX 75093 (972) 548-9690 Provider Language(s): Spanish, Hindi, Urdu Hours: M-F 8:00AM-4:30PM NPI #1245265099 Lin, Joanne H, MD3,8, F 2251 W Eldorado Pkwy Ste 150 McKinney, TX 75070 (972) 548-2797 Provider Language(s): Mandarin Hours: M 7:30AM-4:00PM TU 9:00AM-6:00PM W 7:30AM-4:00PM TH 9:00AM-6:00PM F 7:30AM-1:00PM NPI #1043232564 Morgan, Matt, MD3,8, M 2770 Virginia Pkwy Ste 201 Mc Kinney, TX 75071 (972) 540-0777 Provider Language(s): Chinese Hours: M-F 8:45AM-4:45PM NPI #1962403154 Narayan, Archana R, MD3,8, F 4708 Alliance Blvd Ste 485 Plano, TX 75093 (972) 596-4383 NPI #1285830935 Neaville, William A, MD3,8, M 1105 Central Expy N Ste 2120 Allen, TX 75013 (972) 359-0030 NPI #1326009614 North Texas Allergy And Asthma Associates8 4708 Alliance Blvd Ste 610 Plano, TX 75093 (972) 596-4383 Page, Richard A, MD3,8, M 2740 Virginia Pkwy Ste 300 McKinney, TX 75071 (972) 548-1145 Provider Language(s): Spanish Hours: TU 8:15AM-6:00PM TH 9:15AM-5:00PM NPI #1649279670 Rahimi, Rafiquddin S, MD3,8, M 3409 Spectrum Blvd Ste 300 Richardson, TX 75082 (972) 907-1140 NPI #1386713329 Rao, Seshagiri A, MD3,8, M 3016 Communications Pkwy…
