2016 Provider/Pharmacy Directory

400 Pages·2016·1.46 MB·English

HealthNow New York
SelectSaver HMO (HMO-POS)
2016 Provider/Pharmacy
Directory
This directory was updated
on June 6, 2016.
For more recent information or other
questions, please contact us, HealthNow
New York Customer Service, at:
1-888-787-2390
or, for TTY users 711
October 1-February 14
8 a.m. to 8 p.m., 7 days a week
February 15-September 30
8 a.m. to 8 p.m., Monday-Friday
or visit
healthnowny.com/medicare
HealthNow New York is a Medicare Advantage plan with a
Medicare contract. Enrollment in HealthNow New York depends
on contract renewal.
The pharmacy network and/or provider network may change at any time.
You will receive notice when necessary.
Y0086_MRK1613 Accepted
HealthNow New York
SelectSaver HMO-POS Plan
Provider/Pharmacy Directory
This directory provides a list of SelectSaver HMO-POS's network providers and
pharmacies.
The directory is for Monroe and Wayne counties, New York.

This directory is current as of June 6, 2016. 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 SelectSaver HMO-POS’s network providers in your area,
you can visit www.healthnowny.com/medicare or call our Customer Service
Department at 1-888-787-2390. TTY users should call 711, October 1-February 14 8
a.m. to 8 p.m., 7 days a week. February 15-September 30 8 a.m. to 8 p.m.,
Monday-Friday. TTY users should call 711.
HealthNow New York is a Medicare Advantage plan with a Medicare contract.
Enrollment in HealthNow New York depends on contract renewal.
This document may be available in other formats such as Braille, large print or other
alternate formats.
The pharmacy network and/or provider network may change at any time. You will
receive notice when necessary.
Y0086_MRK1613 Accepted
HN_SSHMO_06/05/2016
Section 1 - Introduction
This directory provides a list of SelectSaver HMO-POS’s network providers. To get
detailed information about your health care coverage, please see your Evidence of
Coverage. To get a complete description of your prescription coverage, including how
to fill your prescriptions, please review the Evidence of Coverage and SelectSaver
HMO-POS’s formulary.
SelectSaver HMO-POS
You will have to choose one of our network providers who are listed in this directory to
be your Primary Care Physician (PCP). The term "PCP" will be used throughout this
directory. Generally, you must get your health care coverage from your PCP.
Participating SelectSaver HMO-POS providers are listed in the directory.
The “network providers” listed in this directory have agreed to provide you with your
health care services. You may go to any of our network providers listed in this
directory. If you have been going to one network provider, you are not required to
continue to go to that same provider. In some cases, you may get covered services
from non-network providers.
If you are a member of SelectSaver HMO-POS, you have the option to obtain care
outside of the service area for an additional cost. There is a limit to what our plan will
cover under your Point-of-service (POS) benefit. Not all services are available under
your Point-of-service (POS) benefit. Please reference your Evidence of Coverage
(EOC) for more details.
If your service does not fall under the Point-of-service benefit you must use a plan
provider. The exception to this rule is for emergency or urgently needed care
situations or for out-of-area renal dialysis. We will cover this care out-of-network when
network providers are temporarily unavailable or inaccessible. If you obtain routine
care that is not covered under your Point-of-service benefit from out-of-network
providers, neither Medicare nor SelectSaver HMO-POS will be responsible for the
costs.
When you receive a bill from a non-contracted Medicare participating provider, you are
only responsible for paying your share of the cost, not for the entire cost. You should
submit the bill to the plan first to determine what your share of the cost will be.
To get detailed information about out of area coverage and emergency coverage;
including, the processes and procedures to obtain emergency services, please see
your Evidence of Coverage.
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Pharmacies
We call the pharmacies on this list our "network pharmacies" because we have made
arrangements with them to provide prescription drugs to plan members. A network
pharmacy is a pharmacy where beneficiaries obtain prescription drug benefits
provided by SelectSaver HMO-POS. In most cases, your prescriptions are covered
under SelectSaver HMO-POS only if they are filled at a network pharmacy or through
our mail order pharmacy service. Once you go to one pharmacy, you are not required
to continue going to the same pharmacy to fill your prescription. You can go to any of
our network pharmacies. We will fill prescriptions at non-network pharmacies under
certain circumstances as described in your Evidence of Coverage.
All network pharmacies may not be listed in this directory. Pharmacies may have been
added or removed from the list after this directory was printed. This means the
pharmacies listed here may no longer be in our network, or there may be newer
pharmacies in our network that are not listed. This list is current as of June 6, 2016.
For the most current list, please contact us. Our contact information appears on the
front and back cover pages.
You can go to all the pharmacies on this list, but your costs for some drugs may be
lower at pharmacies in this list that offer preferred cost sharing. We have marked
these pharmacies with 'P' to distinguish them from other pharmacies in our network
that offer standard cost sharing. Cost sharing information can be found in the
Summary of Benefits.
You can get prescription drugs shipped to your home through our network mail order
delivery service. For more information, please contact us or see the mail order section
of this directory.
We also list pharmacies that are in our network but are outside Monroe and Wayne
counties, New York, the area in which you live. You may also fill your prescriptions at
these pharmacies. For more information, please see the section in this pharmacy
directory on Network Pharmacies outside the Monroe and Wayne counties, New York,
or call our Customer Service Department at 1-888-787-2390, October 1-February 14 8
a.m. to 8 p.m., 7 days a week. February 15-September 30 8 a.m. to 8 p.m.,
Monday-Friday. TTY users should call 711.
If you have questions about any of the above, including for instructions on how to
submit claims for prescriptions that you had to fill at a non-network pharmacy, please
see the first and last cover pages of this directory for information on how to contact us.
What is the service area for SelectSaver HMO-POS?
The counties in our service area are listed below:
Monroe and Wayne counties, New York counties.
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How do you find SelectSaver HMO-POS providers in your area?
We've organized this directory of physicians and pharmacies by county so you can
easily find a physician or pharmacy whose location is close to your home or place of
employment. If you would like to view the full provider/pharmacy directory or are in
need of one, simply visit our website at www.healthnowny.com/medicare or call
customer service.
If you have questions about SelectSaver HMO-POS or require assistance in selecting
a PCP, please call our Customer Service Department at 1-888-787-2390. TTY users
should call 711, October 1-February 14 8 a.m. to 8 p.m., 7 days a week. February
15-September 30 8 a.m. to 8 p.m., Monday-Friday. TTY users should call 711. Or, visit
www.healthnowny.com/medicare.
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To assist you in using our directory we have illustrated a provider listing.
Provider Name & Title
123 Street Address
City, State 12345
[phone]
Other Languages: All
provider offices speak PCP # 123456789012 AM/FP
English.
Only additional languages Other Languages:
spoken in provider's office
by either the provider éìx n ý-˜%oüA B C D E SB FB P S
or provider's office staff
are listed
Please use this table as a reference for the symbols used throughout this directory
PCP # PCP Number: This number identifies the provider in our system. For example, through our
automated system, members can change their primary care physicians by indicating the
identification number of the physician they want to select.
P Preferred pharmacy.
S Standard pharmacy.
é Wheelchair accessible
ì Board certification. A (ì) indicates certification by the ABMS (American Board of Medical
Specialties) or American Board of Osteopathic Physicians. The Physician has successfully
completed an approved educational program and passed an exam designed to assess the
knowledge, skills and experience required to provide quality care in that specialty.
You'll notice that some providers are listed as Board Certified in the specialty listed. Board
Certification is a voluntary process of additional testing and evaluation in a specialty area that
some providers choose to undergo. A physician should not be considered more qualified or
unqualified based solely on certification. There are many certification boards in the United
States and other countries. To be identified as Board Certified in this directory, a Practitioner
must be Board Certified in one of the following Boards:
The American Board of Medical Specialties
The American Board of Oral & Maxillofacial Surgery
The American Board of Podiatric Surgery
The American Board of Podiatric & Primary Podiatric Medicine
The American Osteopathic Association Board
x Current Patients Only
n Practitioner is sponsoring physician for mid-level practitioners. Mid-level practitioners available
at the office listed include the following practitioners: Nurse Practitioners (NP), Physician
Assistants (PA) and Certified Nurse Midwife (CNM).
ý 90 day supply at retail pharmacy
˜ Provider is designated as a Patient Centered Medical Home (PCMH)
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% Member of the Association for Medical Ethics (AME)
- AIDS Designated Centers
o Accepting Developmental Disabled Patients Only
ü Accepting Native American Patients Only
A Location is not wheelchair accessible. Provider will refer to a local hospital that is wheelchair
accessible. Please contact the office for additional details.
B Location is not wheelchair accessible. Provider will perform services at member's residence.
Please contact the office for additional details.
C Location is not wheelchair accessible. Provider will refer to a local clinic that is wheelchair
accessible. Please contact the office for additional details.
D Location is not wheelchair accessible. Provider will service member at a facility that is
wheelchair accessible. Please contact the office for additional details.
E Location is not wheelchair accessible. Provider will refer to another office or location that is
wheelchair accessible. Please contact the office for additional details.
Primary Care Physician (PCP) Abbreviations
AM - Adolescent Medicine GER - Geriatric Medicine IM - Internal Medicine
FP - Family Practice GP - General Practice PED - Pediatrics
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TABLE OF CONTENTS
PRIMARY CARE 13 Interventional Cardiology 72 Orthopedic Surgery 75
PHYSICIANS - Totals by Neurology 72 Otolaryngology 75
County
Obstetrics/Gynecology 72 Pediatric Nephrology 76
PRIMARY CARE 14 Occupational Therapy 72 Physical Medicine & Rehab 76
PHYSICIANS Ophthalmology 72 Physical Therapy 76
ALLEGANY 14 Optometry 72 Podiatry 76
Orthopedic Surgery 72 Pulmonary Disease 77
CAYUGA 14
Otolaryngology 72 Radiation Oncology 77
GENESEE 15
Pain Management 72 Radiology 77
LIVINGSTON 16
Physical Therapy 72 Radiology/MRI 78
MONROE 18 Pulmonary Disease 72 Residential Treatment 78
Radiology 72 Facility
ONONDAGA 45
Skilled Nursing Facility 73 Skilled Nursing Facility 78
ONTARIO 56
Transportation (Land) 73 Sleep Medicine 78
ORLEANS 57
Urology 73 Speech Therapy 78
OSWEGO 57 Sports Medicine 79
CAYUGA 73
Urology 79
SENECA 59 Allergy & Immunology 73
STEUBEN 59 Audiology 73 GENESEE 79
Cardiovascular Disease 73 Allergy & Immunology 79
WAYNE 60
Certified Nurse Midwife 73 Audiology 79
WYOMING 62
Chiropractor 73 Cardiovascular Disease 79
YATES 63
Dermatology 73 Certified Nurse Midwife 79
SPECIALISTS & OTHER 64 Diabetic Education 73 Child Neurology 79
PARTICIPATING Services Chiropractor 80
PROVIDERS - Totals by Dialysis Facility 73 Dermatology 80
County and Specialty
Durable 74 Diabetic Education 80
Medical/Respiratory Services
SPECIALISTS & OTHER 71
PARTICIPATING Equipment Dialysis Facility 80
PROVIDERS Endocrinology & 74 Durable Medical Equipment 80
Metabolism
Gastroenterology 80
ALLEGANY 71
Gastroenterology 74
Audiology 71 General Surgery 80
General Surgery 74
Cardiovascular Disease 71 Home Health Agency - 81
Gynecology Only 74 Licensed
Certified Nurse Midwife 71
Hand Surgery 74 Medical Oncology 81
Chiropractor 71
Hospice 74 Nephrology 81
Community Flu Clinics 71
Infectious Disease 74 Neurological Surgery 81
Diabetic Education 71
Services Nephrology 74 Neurology 81
Durable Medical Equipment 71 Neurological Surgery 74 Obstetrics/Gynecology 81
General Surgery 71 Neurology 74 Oncology/Hematology 82
Home Health Agency - 71 Obstetrics/Gynecology 75 Ophthalmology 82
Certified Occupational Therapy 75 Optometry 82
Home Health Agency - 72 Ophthalmology 75 Orthopedic Surgery 82
Licensed Optometry 75 Orthotics/Prosthetics 82
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Otolaryngic Allergy 82 Allergy & Immunology 88 Home Infusion/Durable 112
Otolaryngology 83 Ambulatory Surgery Center 89 Medical Equipment
Pain Management 83 Audiology 89 Hospice 112
Physical Medicine & Rehab 83 Cardiac Electrophysiology 90 Infectious Disease 112
Physical Therapy 83 Cardiac Surgery 90 Infusion Center 113
Podiatry 83 Cardio Thoracic 90 Interventional Cardiology 113
Pulmonary Disease 83 Cardiovascular Disease 90 Long Term Care Pharmacy 113
Radiation Oncology 83 Certified Diabetic Providers 95 Maternal & Fetal Medicine 113
Radiology 84 Certified Nurse Midwife 95 Medical Genetics 114
Skilled Nursing Facility 84 Child Neurology 98 Medical Oncology 114
Urology 84 Chiropractor 99 Medical Toxicology 116
Vasc Interventional 84 Colon and Rectal Surgery 100 Neonatal-Perinatal 116
Radiology Community Flu Clinics 100 Medicine
Vascular Surgery 84 Critical Care Medicine 101 Nephrology 117
Neuro Ophthalmology 118
LIVINGSTON 84 Dermatology 101
Neuro-Oncology 118
Audiology 84 Dermatopathology 103
Neurodevelopmental 118
Cardiovascular Disease 85 Developmental Pediatrics 103
Disability
Certified Nurse Midwife 85 Diabetic Education 103
Neurological Surgery 118
Services
Chiropractor 85
Neurology 119
Diagnostic Pediatrics 103
Dermatology 85
Neuroradiology 125
Dialysis Facility 103
Durable Medical Equipment 85
Nuclear Medicine 125
Durable Medical Equipment 103
General Surgery 86
Obstetrics/Gynecology 125
Durable 104
Hearing Aid 86
Medical/Respiratory Occupational Medicine 134
Home Health Facility 86
Equipment Occupational Therapy 135
Hospice 86
Endocrinology 104 Oncology/Hematology 135
Interventional Cardiology 86
Endocrinology & 104 Ophthalmology 136
Nephrology 86
Metabolism Optometry 139
Neurological Surgery 86
Facial Plastic Surgery 104 Oral & Max Surgery 144
Neurology 86
Gastroenterology 105 Orthopedic Surgery 144
Obstetrics/Gynecology 86
General Surgery 106 Orthotics/Prosthetics 146
Ophthalmology 86
Geriatric Specialist 109 Otolaryngology 147
Optometry 86
Gynecologic Oncology 109 Pain Management 148
Orthopedic Surgery 87
Gynecology Only 109 Pediatric Allergy & 149
Otolaryngology 87
HIV Experienced 110 Immunology
Pain Management 87
Hand Surgery 110 Pediatric Cardiology 149
Physical Therapy 87
Head and Neck Surgery 110 Pediatric Critical Care 149
Podiatry 87
Hearing Aid 110 Pediatric Dermatology 150
Pulmonary Disease 87
Hematology 111 Pediatric Endocrinology 150
Radiology 87
Home Health Agency - 111 Pediatric Gastroenterology 150
Skilled Nursing Facility 87
Certified Pediatric 150
Urology 87
Home Health Agency - 111 Hematology/Oncology
MONROE 88 Licensed Pediatric Infectious 151
Adolescent Medicine 88 Home Infusion - Licensed 112 Diseases
Specialist Pediatric Nephrology 151
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Pediatric Neurological 151 Cardio Thoracic 192 Neurodevelopmental 211
Surgery Cardiovascular Disease 192 Disability
Pediatric Ophthalmology 152 Certified Nurse Midwife 195 Neurological Surgery 211
Pediatric Orthopedic 152 Child Abuse Pediatrics 196 Neurology 211
Surgery
Chiropractor 196 Neuroradiology 212
Pediatric Otolaryngology 152
Colon and Rectal Surgery 197 Nuclear Medicine 212
Pediatric Pulmonary 152
Critical Care Medicine 198 Obstetrics/Gynecology 212
Disease
Dermatology 199 Occupational Therapy 217
Pediatric Radiology 152
Dermatopathology 199 Oncology/Hematology 217
Pediatric Rheumatology 152
Diabetic Education 199 Ophthalmology 217
Pediatric Surgery 152
Services Optometry 219
Pediatric Urology 152
Dialysis Facility 199 Orthopedic Surgery 222
Physical Medicine & Rehab 153
Durable Medical Equipment 199 Orthotics/Prosthetics 227
Physical Therapy 154
Durable 200 Otolaryngology 227
Plastic Surgery 158 Medical/Respiratory
Pain Management 229
Podiatry 159 Equipment
Pediatric Critical Care 230
Preventive Medicine 161 Endocrinology 200
Pediatric Endocrinology 230
Pulmonary Disease 162 Endocrinology & 200
Pediatric Gastroenterology 231
Radiation Oncology 163 Metabolism
Pediatric 231
Radiology 166 Gastroenterology 201 Hematology/Oncology
Reproductive 181 General Surgery 203 Pediatric Infectious 231
Endocrinology Geriatric Specialist 206 Diseases
Rheumatology 181 Gynecologic Oncology 206 Pediatric Nephrology 231
Skilled Nursing Facility 182 Gynecology Only 206 Pediatric Ophthalmology 231
Sleep Medicine 183 HIV Experienced 206 Pediatric Orthopedic 232
Speech Therapy 183 Hand Surgery 207 Surgery
Sports Medicine 184 Hematology 207 Pediatric Otolaryngology 232
Surgical Critical Care 184 Home Health Agency - 208 Pediatric Physical Medicine 232
Surgical Oncology 184 Certified Pediatric Pulmonary 232
Therapeutic Radiology 184 Home Health Agency - 208 Disease
Thoracic Surgery 185 Licensed Pediatric Rheumatology 232
Trauma Surgery 185 Home Infusion - Licensed 208 Pediatric Surgery 232
Urgent Care Center 185 Home Infusion/Durable 208 Pediatric Urology 233
Medical Equipment
Urology 185 Physical Medicine & Rehab 233
Hospice 208
Urology Gynecology 187 Physical Therapy 235
Hospice Physicians 208
Vasc Interventional 188 Plastic Surgery 240
Infectious Disease 209
Radiology Podiatry 240
Interventional Cardiology 209
Vascular Surgery 189 Preventive Medicine 242
Maternal & Fetal Medicine 209
Pulmonary Disease 242
ONONDAGA 190
Medical Genetics 209
Radiation Oncology 243
Allergy & Immunology 190
Medical Oncology 210
Radiology 244
Ambulatory Infusion Center 190
Medical Toxicology 210
Radiology/MRI 265
Ambulatory Surgery Center 190
Neonatal-Perinatal 210
Reproductive 265
Audiology 191
Medicine
Endocrinology
Cardiac Electrophysiology 191
Nephrology 210
Cardiac Surgery 192
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