Allwell Medicare Essentials (HMO)

260 Pages·2017·2.52 MB·English

Bridgeway Health Solutions
Allwell Medicare Essentials
(HMO)
PROVIDER & PHARMACY DIRECTORY
This provider and pharmacy directory is current as of October 1, 2018.
This directory provides a list of Allwell’s current network providers and pharmacies.
This directory is for Maricopa and Pinal counties, AZ.
To access Allwell’s online provider directory, you can visit allwell.azcompletehealth.com. For any
questions about the information contained in this directory (hard copy or online), please call our
Member Service Department at 1-877-935-8020. From October 1 to March 31, you can call us 7 days a
week from 8 a.m. to 8 p.m. From April 1 to September 30, you can call us Monday through Friday from
8 a.m. to 8 p.m. A messaging system is used after hours, weekends, and on federal holidays. TTY
users should call 711.
Allwell is contracted with Medicare for HMO, HMO SNP and PPO plans, and with some state Medicaid
programs. Enrollment in Allwell depends on contract renewal.
This information is available for free in other languages. Please call our Member Services number at
1-877-935-8020 (TTY: 711).
Changes to our provider and pharmacy network may occur during the benefit year. An updated
provider and pharmacy directory is located on our website at allwell.azcompletehealth.com.
You may also call Member Services for updated provider information.
The pharmacy and provider network may change at any time. You will receive notice when necessary.
This information is also available in different formats, including larger print and audio. Please call
Member Services at the number listed above if you need plan information in another format.
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Bridgeway Health Solutions
Allwell Medicare Essentials
(HMO)
DIRECTORIO DE PROVEEDORES Y FARMACIAS
Este directorio de proveedores y farmacias tiene vigencia a partir del 1 de octubre de 2018.
Proporciona una lista de los proveedores y farmacias de la red actuales de Allwell.
Corresponde a los condados de Maricopa y Pinal, AZ.
Si desea acceder al directorio de proveedores en línea de Allwell, puede visitar
allwell.azcompletehealth.com. Para hacer cualquier pregunta sobre la información que contiene
este directorio (copia impresa o en línea), llame a nuestro Departamento de Servicios al Afiliado al
1-877-935-8020. Desde el 1 de octubre hasta el 31 de marzo, puede llamarnos los 7 días de la semana,
de 8:00 a.m. a 8:00 p.m. Desde el 1 de abril hasta el 30 de septiembre, puede llamarnos de lunes
a viernes, de 8:00 a.m. a 8:00 p.m. Después del horario de atención, los fines de semana y los días
feriados federales, se utiliza un sistema de mensajería. Los usuarios de TTY deben llamar al 711.
Allwell tiene un contrato con Medicare para ofrecer planes HMO, HMO SNP y PPO, y con los
programas Medicaid de algunos estados. La inscripción en Allwell depende de la renovación
del contrato.
Esta información está disponible en forma gratuita en otros idiomas. Comuníquese con el número de
nuestro Departamento de Servicios al Afiliado al 1-877-935-8020 (TTY: 711).
Los cambios en nuestra red de proveedores y farmacias pueden producirse durante el año de
beneficios. Encontrará un directorio de proveedores y farmacias actualizado en nuestro sitio Web en
allwell.azcompletehealth.com. También puede llamar al Departamento de Servicios al Afiliado para
obtener información actualizada sobre los proveedores.
La red de farmacias y proveedores puede cambiar en cualquier momento. Recibirá un aviso cuando
sea necesario.
Esta información también está disponible en formatos diferentes, incluyendo letra más grande y
audio. Llame al Departamento de Servicios al Afiliado al número que se indica anteriormente si
necesita información sobre el plan en otro formato.
Table of Contents / Tabla de Contenido
Section 1 – Introduction...............................................................................................................5
What Is the Service Area for Allwell Medicare Essentials?..............................................................................7
How Do You Find Allwell Medicare Essentials Providers in Your Area?........................................................9
Sección 1 – Introducción............................................................................................................11
¿Cuál Es el Área de Servicio de Allwell Medicare Essentials?.......................................................................13
¿Cómo Puede Encontrar a los Proveedores de Allwell Medicare Essentials de Su Área?..............................15
Section 2 – List of Network Providers / Sección 2 – Lista de Proveedores de la Red...........25
Primary Care Provider / Proveedores de cuidado personal (PCP)...................................................................27
Specialist / Especialistas...................................................................................................................................69
Hospital / Hospitales......................................................................................................................................125
Ancillary / Auxiliar........................................................................................................................................129
Urgent Care / Cuidado de urgencia................................................................................................................157
Specialty Clinic / Clínica especializada.........................................................................................................165
Dental / Dental................................................................................................................................................189
Vision / Visión................................................................................................................................................191
Section 3 - Pharmacy Information / Información sobre Farmacias....................................211
Pharmacy / Farmacia......................................................................................................................................219
Mail Order Pharmacy / Farmacia de pedidos por correo...............................................................................233
Specialty Pharmacies / Las farmacias especializadas....................................................................................235
INDEX / Índice..............................................................................................................................................237
Bridgeway Health Solutions
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SECTION I
Introduction
This directory provides a list of Allwell Medicare Essentials network providers. To get detailed
information about your healthcare coverage, please see your Evidence of Coverage (EOC).
You will have to choose one of our network providers listed in this directory to be your primary care
provider (PCP). Generally, you must get your healthcare services from your PCP. Your PCP is the
primary provider who manages your general healthcare and is trained to give you basic medical
care. Generally, you see your PCP first for most of your routine healthcare needs. Your PCP can also
coordinate the rest of the covered services you need.
The network providers listed in this directory have agreed to provide you with your healthcare, vision
and dental services. You may go to any of our network providers listed in this directory; however,
some services may require a referral (written permission). 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.
You must use network providers except in emergency or urgent care situations or for out-of-area
renal dialysis or other services. If you obtain routine care from out-of-network providers, neither
Medicare nor Allwell will be responsible for the costs.
Even though your PCP is trained to handle the majority of your common healthcare needs, there may
be a time when you need to see a specialist. Specialists are doctors who provide healthcare services
for a specific disease or part of the body. A few examples include oncologists who care for people
with cancer, cardiologists who care for people with heart conditions, and orthopedists who care for
people with certain bone, joint or muscle conditions. For some specialists, you will need to get a
referral from your PCP before you can schedule an appointment with them. There are some services
that require your PCP or other provider to get prior authorization (prior approval). Please see your
Evidence of Coverage for more information about services that may require prior authorization.
If you receive a bill for the full cost of medical care you received from a provider who is not in our
network, do not pay the bill but rather send it to us. When you send us the bill, we look at it and
decide whether the services should be covered. If we decide they should be covered, we will pay
the provider directly. (We cannot pay a provider who has opted out of the Medicare program.) If we
determine that the services you received are not covered or were not medically necessary, we may
deny the bill, and you will be responsible for the full cost. The address to send your bill to is located
on the back of your membership card.
You may get emergency medical care whenever you need it, anywhere in the United States or
its territories. (This plan does not cover worldwide emergency or urgent care.) Our plan covers
ambulance services in situations where getting to the emergency room in any other way could
endanger your health. Please refer to your Evidence of Coverage for details. If you have an
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emergency, we will talk with the doctors who are giving you emergency care to help manage and
follow up on your care. The doctors who are giving you emergency care will decide when your
condition is stable and the medical emergency is over. After the emergency is over, you are entitled
to follow-up care to be sure your condition continues to be stable. Your follow-up care will be
covered by our plan. If your emergency care is provided by out-of-network providers, we will try
to arrange for network providers to take over your care as soon as your medical condition and the
circumstances allow.
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What Is the Service Area for
Allwell Medicare Essentials?
The counties in our service area are listed below.
Maricopa and Pinal
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How Do You Find Allwell Medicare
Essentials Providers in Your Area?
We have arranged the information in several different ways. If you are interested in a
particular PCP or specialist, turn to Section 2. If you’d like to see who is available in your
community, then turn to the City Index.
Use this directory to select a primary care provider (PCP): You can find a particular PCP by name or
location.
If you are looking for a PCP by name:
1. Go to the Index located in the back of the directory.
2. The Index is arranged in alphabetical order. Find the doctor by last name and the page number(s)
he/she is listed.
3. Find more detailed information about that PCP by going to the page(s).
If you are looking for a PCP by location:
1. Go to the Primary Care Providers section. The Table of Contents can help you locate the section
within the directory.
2. Find your county and city, and choose your PCP.
Use this directory to find a specialist and other providers/facilities. You can find particular specialists
and other providers/facilities by name or location.
If you are looking for specialists and other providers/facilities by name:
1. Go to the Index located in the back of the directory.
2. The Index is arranged in alphabetical order. Find the provider by last name or the facility by name
and the page number(s) the provider or facility is listed.
3. Find more detailed information about that provider or facility by going to the pages.
If you are looking for specialists and other providers/facilities by location:
1. Go to the Table of Contents to find the starting page number of the provider type or facility you seek.
2. Find your county and city, and select the provider or facility.
If you have questions about Allwell or require assistance in selecting a PCP, please call our Member
Service Department at 1-877-935-8020. From October 1 to March 31, you can call us 7 days a week
from 8 a.m. to 8 p.m. From April 1 to September 30, you can call us Monday through Friday from
8 a.m. to 8 p.m. A messaging system is used after hours, weekends, and on federal holidays. TTY
users should call 711. You can also visit allwell.azcompletehealth.com.
You can also call the Member Service Department phone number to schedule a visit with your
doctor or to get help finding a new doctor. We welcome your feedback too! If you find a mistake in a
listed doctor’s contact information, please call the Member Service Department at 1-877-935-8020
(TTY: 711) to report it.
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