Alphabetical Listing - Volusia County Government

193 Pages·2013·0.5 MB·English

Provider Directory

Health Partnership Plan
And
Behavioral Health

2013 Plan Year
(Updated August 15, 2013)

County of Volusia

Group No. 2081
Health Partnership Plan

Contact Information
County of Volusia
(Group 2081)

Claims Information & Plan Inquiries

MedSave USA, Inc. (formerly FSAI)
Insurance-Benefit Offices
3035 Lakeland Hills Boulevard [phone]
Lakeland, FL 33805 [phone] Personnel Division [phone]
Claims Fax: [phone] Benefits Section [phone]

Website: https://www.medsaveadmin.com Website: http://volusia.org/personnel/benefits or
http://enn.co.volusia.fl.us/
Provider Network

For questions regarding physician providers you have
Medical Pre-certification Requirements
several networks at your disposal. Please call any of the
networks listed below.

24-HOUR NURSE HELP LINE

[phone]
• Florida Memorial Health Network

[phone]
KePRO Pre-certification [phone]
[phone]

You must pre-certify with KePRO the following
Website: http://www.fmhn.org
procedures before services are rendered by your

• Complete Health Network for Osceola, provider in order to avoid a penalty.

Lake, Seminole or Orange
In-patient Hospital Stay – call 7 days prior to admis-
Counties Only
sion or the next working day after an emergency admis-
[phone]
sion.
[phone]

Outpatient surgical and medical services which
Website: http://www.fhhsonline.com
require pre-certification
- excluding chiropractic
(Refer to your insurance card or call KePRO 7

days prior to date of service).
• Volusia Health Network

(386) 425-4VHN (4846)
Option 3 for Provider Relations Dept. Employee Assistance Program (EAP)

Website: http://www.myvhn.com Corporate Care Works {CCW}

Stratose – Client #3893 • 24/7 Helpline – [phone]
[phone] • No pre-cert, no co-pay for Short Term Counseling
• 1-10 visits per issue per year
• Online services with videos, articles and online
Pharmacy Network training courses
Catalyst Rx Customer Care Center [phone] • Available to employees & family in household

Website--WalgreensHealth.com • Website: www.corporatecareworks.com
• Use Company Name: Volusia County

Chiropractic Network – DPSC
Dental Information
Inquiry Information [phone]
Appointments & Referrals Maverest Dental Alliance, Inc.
MedSave USA, Inc. Customer Service – Call:
[phone] or [phone]
Claims Fax: [phone]

Website: http:--www.maverest.com
PLEASE NOTE:

The information contained in this Provider Directory is subject
to change, and the continuation of services provided by a
physician, hospital or other provider of services is not
guaranteed. Please contact one of the network providers listed
below before engaging services to verify providers are still
active in a network, or for any other provider-related questions
you may have.

Florida Memorial Health Network, Provider Relations,

386-231-4398
888-839-7430

Volusia Health Network
386-425-4846, Option 3

EMPLOYEE ASSISTANCE PROGRAM (EAP) SERVICES ARE PROVIDED BY CORPORATE CARE WORKS, INC. THEY MAY BE
CONTACTED AT 800-327-9757 OR 904-296-9436.

Please refer to page i of this Directory for more information.

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HEALTH PARTNERSHIP PLAN DIRECTORY

HOSPITALS.......................................................................................................................1
SPECIALTY HOSPITALS (PRE-CERT REQUIRED)...............................................................3
REGIONAL REFERRAL HOSPITALS...............................................................................5
AMBULATORY SURGERY CENTERS.............................................................................6
AUDIOLOGY-REHABILITATION (PEDIATRIC)...................................................................7
CARDIAC DIAGNOSTIC TESTING...................................................................................8
DIABETES EDUCATION...................................................................................................9
DIALYSIS ........................................................................................................................10
DME (DURABLE MEDICAL EQUIPMENT) (ALSO SEE ORTHO MEDICAL BELOW) ........................11
HOME HEALTH CARE....................................................................................................13
HOME HEALTH (PEDIATRIC).........................................................................................14
HOME INFUSION-IV MEDICATIONS..............................................................................15
HOSPICE.........................................................................................................................16
LABORATORY................................................................................................................17
LABORATORY................................................................................................................19
LABORATORY-GENETIC TESTING ONLY....................................................................20
MENTAL & BEHAVIORAL..............................................................................................21
MENTAL HEALTH (EMPLOYEE ASSISTANCE COUNSELING - CCW).......................21
BEHAVIORAL HEALTH..................................................................................................21
ONCOLOGY....................................................................................................................22
ORTHOPAEDIC MEDICAL EQUIPMENT .......................................................................23
ORTHOTICS (PEDORTHIST)..........................................................................................24
ORTHOTICS AND PROSTHETICS.................................................................................25
OUTPATIENT SURGERY................................................................................................26
PHYSICAL THERAPY (SEE REHABILITATION)...................................................................27
PRIMARY CARE OFFICES WITH EXTENDED HOURS..................................................28
PROSTHETICS (MASTECTOMY)...................................................................................29
RADIOLOGY...................................................................................................................30
REHABILITATION (PHYSICAL THERAPY)..........................................................................32
SKILLED NURSING FACILITIES....................................................................................35
SLEEP STUDY................................................................................................................36
SPECIALTY PHARMACY ...............................................................................................37
URGENT CARE CENTER ...............................................................................................38
VENTILATOR DEPENDENT FACILITY ..........................................................................40
WALK-IN FACILITIES.....................................................................................................41
WOUND CARE................................................................................................................42
GLOSSARY OF PHYSICIANS BY SPECIALTY..............................................................43
ALLERGY & IMMUNOLOGY...........................................................................................44
CARDIOLOGY.................................................................................................................45
CARDIOVASCULAR-THORACIC SURGERY.................................................................50
CHIROPRACTIC..............................................................................................................51
COLON & RECTAL SURGERY.......................................................................................54
DERMATOLOGY.............................................................................................................55
ENDOCRINOLOGY.........................................................................................................58
FAMILY PRACTICE.........................................................................................................60
GASTROENTEROLOGY.................................................................................................76
GENERAL PRACTICE ....................................................................................................80
GENERAL SURGERY.....................................................................................................81
GYNECOLOGY...............................................................................................................84
HAND SURGERY............................................................................................................86
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HEAD AND NECK SURGERY.........................................................................................87
HEMATOLOGY...............................................................................................................88
INFECTIOUS DISEASES ................................................................................................91
INTERNAL MEDICINE.....................................................................................................92
MATERNAL-FETAL MEDICINE....................................................................................100
NEONATAL – PERINATAL MEDICINE.........................................................................107
NEPHROLOGY..............................................................................................................108
NEUROLOGY................................................................................................................110
NEUROSURGERY........................................................................................................113
OB-GYN.........................................................................................................................114
ONCOLOGY, MEDICAL................................................................................................117
ONCOLOGY-HEMATOLOGY.......................................................................................119
ONCOLOGY-RADIATION.............................................................................................122
OPHTHALMOLOGY......................................................................................................125
OPHTHALMOLOGY - VITREO RETINAL .....................................................................129
OPTOMETRY................................................................................................................131
ORAL-MAXILLOFACIAL SURGERY............................................................................134
ORTHOPAEDICS..........................................................................................................135
OTOLARYNGOLOGY...................................................................................................140
PAIN MANAGEMENT....................................................................................................142
PEDIATRIC ALLERGY & IMMUNOLOGY.....................................................................144
PEDIATRIC CARDIOLOGY...........................................................................................145
PEDIATRIC GASTROENTEROLOGY...........................................................................146
PEDIATRIC ORTHOPAEDICS......................................................................................147
PEDIATRIC PULMONOLOGY.......................................................................................148
PEDIATRIC SLEEP STUDY..........................................................................................149
PEDIATRICS.................................................................................................................150
PHYSICAL MEDICINE & REHAB..................................................................................155
PLASTIC SURGERY.....................................................................................................157
PODIATRY ....................................................................................................................158
PSYCHIATRY................................................................................................................161
PSYCHOLOGY..............................................................................................................163
PULMONOLOGY...........................................................................................................165
REPRODUCTIVE ENDOCRINOLOGY & INFERTILITY................................................169
RHEUMATOLOGY........................................................................................................170
SLEEP MEDICINE.........................................................................................................171
UROLOGY.....................................................................................................................173
VASCULAR SURGERY.................................................................................................176

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WELCOME
TO THE HEALTH PARTNERSHIP PLAN

Welcome to the Health Partnership Plan (HPP). The HPP offers the highest quality network
of physicians, hospitals and other health care providers. Florida Memorial Health Network
(FMHN) and Volusia Health Network (VHN) and Florida Health Care Plan (FHCP) are your
network providers. Participating in this coordinated self funded health care system provides
you with quality services that promotes, enhances and maintains cost effective care while
ensuring the health of our community.

Member ID Card
In order to expedite processing, we encourage you to carry your HPP ID card with you at all
times. Present this card whenever you receive medical, dental or prescription services.
This card contains important information, including addresses and phone numbers,
necessary for discount claims payment, hospital admissions and pre-authorization of
covered services.

You have the option of using this directory to select and obtain direct access to a physician
of your choice. If you have questions regarding the status of any provider of healthcare
services listed in this directory, please call either FMHN or VHN. If you elect to call a
physician’s office directly to arrange an appointment, please identify yourself as a HPP
participant. When you arrive at your appointment be sure to present your identification card.
Depending on the service provided, you may be responsible for an office visit co-payment at
the time of service.

What services need to be pre-certified?
At least seven (7) days before an elective admission to the hospital, your physician must call
“KePRO”Utilization Department. The telephone number is [phone]. The utilization
review staff will evaluate your treatment plan to determine the medical necessity of your
admission. This process is called pre-certification. Please refer to Pre-certification of the
HPP Summary Plan Description.

Inpatient Services:
All non-emergency, hospital inpatient services must be authorized prior to admission.

Outpatient Procedures:
Some surgical procedures must be performed on an outpatient basis to obtain coverage.
Your physician must contact KePRO for pre-authorization of such procedures.

Specialty RX Pharmacy Benefit with Catalyst Rx Customer Care Center:
(cid:1) Certain medications used for treating complex health conditions must be Pre-
certified, such as, Neulasta, Aranesp, Eloxatin, Taxol, Avastin, Zometa, Gemzar,
Aloxi, Zofran, and Hylan, to name a few.
(cid:1) Call KePRO at [phone] for pre-certification for Specialty drugs
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(cid:1) To obtain the medication, call the Specialty Pharmacy at [phone]
(cid:1) Access order forms at www.WalgreensHealth.com and just follow the Specialty
Pharmacy Links

Other Services
HPP also requires pre-certification of certain outpatient tests. Review your Summary Plan
Description provided by the County for specific utilization review requirements. Your
physician must also contact KePRO for pre-authorization of such services.

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PARTICIPATING FACILITIES

HOSPITALS

Bert Fish Medical Center, Inc.
401 Palmetto St. New Smyrna Beach, FL 32170 386-427-3401

Florida Hospital Altamonte
601 E. Altamonte Dr. Altamonte Springs, FL 32701 407-303-2200

Florida Hospital Apopka
201 N. Park Ave. Apopka, FL 32703 407-889-1000

Florida Hospital Celebration Health
400 Celebration Pl. Celebration, FL 34747 407-303-4000

Florida Hospital DeLand
701 W. Plymouth Ave. DeLand, FL 32720 386-943-4522

Florida Hospital East Orlando
7727 Lake Underhill Rd. Orlando, FL 32822 407-303-8110

Florida Hospital Fish Memorial
1055 Saxon Blvd. Orange City, FL 32763 386-917-5000

Florida Hospital – Flagler
60 Memorial Medical Pkwy. Palm Coast, FL 32164 386-586-2000

Florida Hospital Kissimmee
2450 N. Orange Blossom Trial Kissimmee, FL 34744 407-846-4343

Florida Hospital Memorial Medical Center
301 Memorial Medical Pkwy. Daytona Beach, FL 32117 386-231-6000

Florida Hospital Orlando
601 E. Rollins St. Orlando, FL 32803 407-303-6611

Florida Hospital Waterman
1000 Waterman Way Travares, FL 32778 352-253-3333

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PARTICIPATING FACILITIES

Halifax Medical Center
303 N. Clyde Morris Blvd. Daytona Beach, FL 32114 386-254-4000

Halifax Hospital Port Orange
1041 Dunlawton Ave., Port Orange, FL 32127 386-322-4700

Putnam Community Medical Ctr.
Highway 20 West Palatka, FL 32177 386-328-5711

Winter Park Memorial Hospital
200 N. Lakemont Ave. Winter Park, FL 32792 407-646-7000
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PARTICIPATING FACILITIES

SPECIALTY HOSPITALS (Pre-Cert Required)

H. Lee Moffitt Cancer Center & Research Institute
12092 Magnolia Drive Tampa, FL 33612 888-663-3488

Kindred Hospital North Florida
801 Oak Street Green Cove Springs, FL 32043 904-284-9230

Mayo Clinic in Jacksonville
4500 San Pablo Rd. Jacksonville, FL 32224 904-953-2000

Nemours Children's Clinic – Jacksonville
807 Children's Way Jacksonville, FL 32207 904-390-3788

Nemours Children's Clinic – Orlando
83 W. Columbia St. Orlando, FL 32806 407 650-7455

ORH - Arnold Palmer Hospital
92 West Miller St. Orlando, FL 32806 407-649-9111

ORH - Orlando Regional Lucerne Hospital
318 Main Lane` Orlando, FL 32801 407-649-6111

ORH - Orlando Regional Medical Center
1414 S. Kuhl Ave. Orlando, FL 32806 407-841-5111

ORH - Sand Lake Hospital
9400 Turkey Lake Rd. Orlando, FL 32819 407-351-8500

ORH - South Lake Hospital
1099 Citrus Tower Blvd. Clermont, FL 34711 352-394-4071

ORH - South Seminole Hospital
555 State Rd. 44 Longwood, FL 32750 407-767-1200

ORH - St. Cloud Hospital
2906 17th St. St. Cloud, FL 34769 407-892-2135
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