| Revised 04/21/2008 |
| Accountable Health Plan |
All physicians contracted |
| Aetna TRS |
All physicians contracted |
| Aetna PPO & HMO |
All physicians contracted |
| Aetna
Plans that do NOT require a
Referral: |
| Aetna - Erika Travel Insurance, LTD -
Student Health Plan |
| Aetna HealthFund Plan |
| Aetna QPOS requires PCP selection but
does NOT require a referral |
| Aetna Open Access-HMO Plan |
| Aetna Open Access - Elect Choice (EPO)
Plan |
| Aetna Managed Choice (POS) Plan-Requires
PCP but does NOT require referral |
| Aetna USAccess |
| Aetna Choice POS and Aetna Choice POS II |
| Aetna Open access Managed Choice (POS)
Plan |
| Aetna Open Choice (PPO) Plan |
| Aetna Traditional Choice Indemnity Plan |
| Aetna Medicare "Open" PFFS
Plan Only |
| Aetna
Plans that Require a Referral: |
| Aetna HMO-Requires Referral from PCP |
| Aetna Elect Choice (EPO) - Requires
Referral from PCP |
| Aetna Medicare |
NOT PARTICIPATING |
| Affiliated PPO |
Not in Texas as of
1/1/2007 |
| AmCare |
Not Participating |
| ARIA/Mediview |
ARIA Employees (Covenant) must have numeric Referral |
| Assurant
(Fortis) PPO (PHCS) |
PHCS PPO Only - NOT PHCS Open Access or POS |
| Assured |
All physicians contracted |
| Beechstreet |
All physicians contracted |
| Benefit Planners |
All physicians contracted |
| BlueChoice Solutions |
Not Participating -
Patient will be billed as out-of-network by BCBS |
| BCBS |
All Physicians contracted
- Dr. Farady's panel closed to NPs 6/1/08 |
| Blue Choice |
All Physicians contracted
- Dr. Farady's panel closed to NPs 6/1/08 |
| BCBS Par Plan |
All Physicians contracted
- Dr. Farady's panel closed to NPs 6/1/08 |
| BCBS POS |
Needs Referral-all physicians contracted - Dr. Farady's panel closed to NPs
6/1/08 |
| BCBS TRS |
All Physicians contracted
- Dr. Farady's panel closed to NPs 6/1/08 |
| Blue Cross PPO |
All Physicians contracted
- Dr. Farady's panel closed to NPs 6/1/08 |
| CCN |
All physicians contracted |
| CHIPS-Triage Schedules |
Seton Needs Ref; Panel Closed to NPs however,NPs Triaged for
UC |
| Cigna PPO & HMO |
Through SPHN (Seton)-all
physicians contracted |
| Cigna POS |
All physicians contracted |
| Cigna
POS Open Access & Plus or POS-OA, EPO - All physicians contracted |
| Cigna
HMO,Cigna Flexcare/-HMO - All
physicians contracted |
| Cigna
Healthcare of TX, Cigna Select-"C" on card - all physicians contracted |
| Cigna Indemnity |
all physicians contracted |
| COBRA |
Make sure it is insurance
we are contracted with. Benefits must be verified. |
| Covenant Mgt Sys |
Requires Referral - all
physicians contracted |
| First Health |
All physicians
participating thru SPHN |
| Guardian |
All physicians contracted |
| GEHA |
all physicians contracted |
| Great West |
NOT CONTRACTED |
| Health Select |
Needs Blue Link
Referral-DR. SPECIFIC-all physicians contracted |
| HealthSelect Traditional |
All physicians contracted |
| Healthy Equations |
Needs Referral: ARC-all physicians contracted |
| HealthSmart PPO |
All physicians contracted
through SPHN |
| HMO Blue |
Dr. BUSHORE TAKING NEW
PATIENTS-NEEDS Dr Specific REFERRAL |
| Not Participating:
Farady, Kaiser, & Jackson |
| Dr. Curry's Panel closed
to new patients |
| Humana Military HMO |
Must have out-of network
referral faxed over first, physician specific |
| Humana Military PPO |
Out-of-Network. Patient
will pay greater portion of cost share. |
| Humana
Medicare Advantage |
All physicians participating - no referral |
| Humana ChoiceCare |
All physicians contracted |
| Humana Emphesys |
All physicians contracted |
| Humana
PPO, Humana ASO, Humana Open Access - All physicians contracted |
| Humana Freedom |
all physicians contracted |
| Humana HMO |
All physicians contracted |
| Humana
Preferred PPO and Humana Preferred POS-Open Access - All physicians |
| John Alden PPO (PHCS) |
All physicians contracted
with PPO ONLY-NOT OPEN ACCESS/POS |
| Medcorp |
All physicians contracted |
| Medicaid |
See
"NHIC"-Triage schedules/No Star plans |
| No Medicaid for Jackson,
Kaiser or Bushore |
| Medicaid Star Plans |
Do not take - We are NOT contracted with Superior or Amerigroup |
| Medicare |
All physicians contracted - check secondary insurance |
| Medicare-Humana
Advantage |
All physicians contracted |
| Medicare-Railroad |
All physicians contracted |
| Medical Control |
All physicians contracted |
| Mega Life PPO |
All physicians contracted |
| Multiplan/PHCS |
All physicians contracted
through SPHN |
| National
Healthcare Alliance |
All physicians contracted |
| NHIC
- MUST GO TO TRIAGE NURSE TO SCHEDULE-UC NP ONLY |
| NHIC (Medicaid) |
Dr. Jackson, Dr. Kaiser,
and Dr. Bushore not contracted |
| NHIC
(Medicaid) - Needs current month's card (letter) at every visit |
| NHIC-(Superior) |
Not on Superior-out of
network referral through triage |
| One Health Plan |
Not Participating |
| PacifiCare HMO |
All physicians contracted
- Merged with UHC |
| PHCS
POS/Open Access--Not participating |
| PHCS-PPO - ASO |
All Physicians contracted-No Scott & White PHCS |
| PHCS HMO Plans |
Requires referral - All physicians contracted |
| Preferred Network PPO |
All physicians contracted |
| Project Access/I Care |
Scheduled through Triage
Nurse |
| Pronet |
All physicians contracted |
| Railroad Medicare |
All physicians contracted |
| Scott & White Plan |
Not contracted-Not even
if PHCS |
| SPHN |
All physicians contracted |
| Seton Health Plan(HMO) |
All physicians contracted |
| SHP - Diocese |
All physicians contracted |
| Seton Chips |
Triage Schedules-Limited
New Patients |
| Star Plans |
No NHIC Star Plans |
| Sterling (Medicare) |
all physicians
contracted |
| Superior Medicaid |
Not Contracted -Triage
Schedules - Out-of-network referral |
| TML PPO |
all physicians contracted |
| Tx True Choice PPO |
All physicians contracted
through SPHN |
| TriCare |
Is Now HUMANA
MILITARY-See HUMANA MILITARY |
| TRS Care |
All Physicians Contracted |
| Unicare |
Not Participating |
| United HealthCare |
Global referral - All
physicians contracted |
| USA Managed Care |
All physicians contracted
through SPHN |
| UT Select-BCBS |
All physicians contracted BUT if change to HMO Blue see
"HMO Blue" |
| UT-HMO Blue |
Bushore accepting NPs.
Curry EPs only. |
| Zenith |
All physicians contracted
- is AMD |
