STAR Provider Directory

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  • Your Health Plan Your Choice P R O G R A M

    Provider irectoryDirectorio de proveedores

    Denton, Hood, Johnson, Parker, Tarrant and Wise counties

    Your local home town health plan. Proudly serving North Texas since 1998. Su plan de salud local. Orgullosamente sirviendo el Norte de Texas desde 1998.

    Call us toll-free. Were ready to help!Llamenos gratis. Estamos listos para ayudar!

    1-800-964-2247

    TA66-C-1213

    D

    TA66-1217

  • valora a nuestra comunidad. Nuestro plan de salud ofrece atencin mdica para miembros de STAR en el rea de servicio de Tarrant.

    Los condados incluyen:

    Tarrant Johnson

    Denton Wise

    Parker Hood

    Su salud es nuestra prioridad. Nuestra meta es ofrecer atencin de calidad y una gran red de proveedores mdicos. Si tiene preguntas, por favor, comunquese con Servicios para Miembros al 1-800-964-2247, de 8:00 a.m. a 5:00 p.m., de lunes a viernes.

    Cmo inscribirse en STAR del Plan de Salud de Cook Childrens (CCHP) Una vez que llene los requisitos, un agente de inscripcin le enviar un paquete de inscripcin. El paquete de inscripcin incluye informacin sobre el Plan de Salud de Cook Childrens.

    Puede escoger a un doctor de cuidado primario diferente para cada miembro de su familia que tiene cobertura de CCHP.

    Cuando escoja a su doctor de cuidado primario, llame a un agente de inscripcin al 1-800-647-6558 y dgales:

    Su nombre y nmero de STAR.

    Que quiere escoger el Plan de Salud de Cook Childrens.

    El nombre del doctor de cuidado primario que escogi.

    Bienvenido al Plan de Salud de Cook Childrens

    our community. Our health plan provides health care for STAR members in the North Texas area, including: Tarrant Johnson Denton Wise Parker Hood

    We put your health rst. Cook Childrens Health Plan staff members are local, bilingual and always ready to help you with your health care needs and questions. Its our goal to provide quality care and a great network of providers. Our network providers care for all ages, not just children.

    How to use this directoryThis directory helps you select a doctor, also known as a primary care provider (PCP), for each covered family member and gives you information on other services available through the Cook Childrens Health Plan.

    If you have any questions about this directory or Cook Childrens Health Plan, please call Member Services at 1-800-964-2247 from 8 a.m. to 5 p.m., Monday through Friday.

    Welcome to Cook Childrens Health Plan!

    Page 2 Paginacin 2

  • Table of Contents Tabla de ContenidoCook Childrens Health Plan network facilitiesCentros de la red del Plan de Salud de Cook Childrens ...................................................... 8

    Cook Childrens Health Plan doctors (primary care providers) Doctores (proveedores de cuidado primario) del Plan de Salud de Cook Childrens ..........10

    Cook Childrens Health Plan obstetricians and gynecologists Obstetras y gineclogos del Plan de Salud de Cook Childrens ......................................... 29

    Cook Childrens Health Plan specialty care providersEspecialistas del Plan de Salud de Cook Childrens ........................................................... 37

    Cook Childrens Health Plan network ancillary services and providersServicios y proveedores auxiliares de la red del Plan de Salud de Cook Childrens .......... 52

    Network laboratory draw sites Ubicacin de laboratorios de la red para hacer anlisis de sangre .................................... 58

    National Vision Administrators (NVA) eye exam providersProveedores de exmenes de la vista NVA ......................................................................... 60

    Cook Childrens Health Plan behavioral health providers Proveedores de servicios de salud mental y abuso de sustanciasdel Plan de Salud de Cook Childrens .................................................................................. 62

    Participating hospitals and map ...........................................................inside back coverHospitales que participan y mapa al dorso de la contraportada ............ En la contraportada de atrs

    Cook Childrens Health Plan1-800-964-2247

    STAR HelplineLinea se Ayuda de STAR

    1-800-964-2777

    Behavioral (Mental Health and Substance Abuse)Servicios de salud mental y abuso de sustancias

    1-855-481-7045

    Page 3 Paginacin 3

    Retail PharmaciesFarmacias Minorista................................................................................................................66

  • How to choose your primary care provider (PCP)

    A PCP provides or coordinates all of your or your childs health care services. A PCP can be a doctor, nurse or clinic that gives you most of your health care. Our PCPs are listed in the Primary Care Provider section of the directory. They are list-ed by city and then by the kind of provider. Pediatricians see children. A family practice doctor sees all ages. Internal medi-cine doctors see family members 18 years old and above. Age limits are listed for some providers to help you pick one for you and your child. If you have any questions or need help choos-ing a PCP, contact Member Services at 1-800-964-2247.

    You will see each PCP is open, closed or EO. Open means they are accepting new patients, closed means they are not accepting new patients and EO means they are willing to see existing patients only. You can pick any PCP listed as open for yourself or your child.

    Each covered family member can pick a different PCP within the Cook Childrens Health Plan network.

    When you pick your PCP, call 1-800-647-6558 and let them know:

    Your name and Medicaid number. That you choose Cook Childrens Health Plan. The name of the PCP that you picked.

    Once you have enrolled in Cook Childrens Health Plan and chosen your PCP, you can call your PCP whenever you or your child need any medical services.

    Services availableTexas Health Steps for your childTexas Health Steps is for children from birth through 20 years old who have Medicaid. It provides children with medical and dental checkups based on their age. Its important to have these checkups. You should schedule a checkup with your primary care provider when you first enroll. You can get Texas Health Steps checkups from your primary care provider or any other Texas Health Steps provider. Texas Health Steps providers are listed in the primary care provider section of this directory.

    OB/GYN careYou can pick an OB/GYN (doctor for womens health) without asking your PCP or getting a referral. You can pick any OB/GYN from this directory that is taking new patients.

    You can see your OB/GYN for: One well-woman checkup per year. Care related to pregnancy. Care for any female medical condition. Referral to other specialists.

    For the best care, you should go to the same OB/GYN each time you need services. This is so he/she can get to know you and take care of you the best way possible.

    Family planningYou do not need to ask your PCP for these services and sup-plies. If you are under 21, you do not have to ask for your par-ents permission before getting help. You can go to any family planning provider, in or out of network. You do not need a refer-ral from your PCP. You may get family planning services from your PCP or other provider listed in this directory. If you have questions or need help finding a family planning provider, you can call Member Services at 1-800-964-2247.

    Mental health and substance abuse You do not need permission or a referral from your PCP to receive these services. Call Beacon health Strategies at 855-481-7045, 24 hours a day, seven days a week.

    Vision careMembers under the age of 21 can get an eye exam each year through National Vision Administrators. You do not need to ask your PCP or get a referral. For members over the age of 21, Medicaid will pay for one eye exam and one pair of glasses every 24 months. If you have questions or need help finding an eye doctor near you, call National Vision Administrators (NVA) at 877-236-0661.

    Prescription drugs Your STAR (Medicaid) pharmacy benefits are coordinated by Cook Childrens Health Plan. Prescriptions should be filled at a pharmacy thats part of our network. To find a listing of phar-macies in our network, visit www.cookchp.org or call Member Services at 1-800-964-2247.

    If you need medicine, your doctor will choose one from the list of approved drugs. Ask your doctor to make sure that the drug is on the list. Some prescription drugs require a prior authorization before they can be filled. Your doctor will take care of this for you.

    When you get a prescription from your doctor be sure to let him/her know about any other medications you are taking (prescrip-tion, over the counter or herbal supplements).

    Other services Other services, also known as ancillary providers, include labs, radiology centers and medical equipment.

    Your Cook Childrens doctor (primary care physician or a specialist) will arrange for these services.

    You may request a list of Cook Childrens ancillary providers by calling Member Services at 1-800-964-2247.

    Health care close to home

    Page 4 Paginacin 4

  • Como escoger su proveedor de cuidado primario (PCP)Un PCP le ofrece y le coordina todos sus servicios de atencin mdica o los de su nio o nia. UN PCP puede ser un doc-tor, una enfermera o una clnica que le ofrece la mayora de su atencin mdica. Nuestros PCPs se muestran en la seccin de Proveedor de Cuidado Primario del directorio. Estn enu-merados por ciudad y luego por el tipo de proveedor. Pediatras miran a nios. Un doctor de la prctica de familia mira a todas las edades. Los doctores de medicina interna mira a miemb