2012 Provider Directory - Medicare Advantage - Buckeye ...
2012 Provider Directory - Medicare Advantage - Buckeye ...
2012 Provider Directory - Medicare Advantage - Buckeye ...
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Section 1 – IntroductionThis directory provides a list of <strong>Buckeye</strong>’s network providers. To get detailedinformation about your health care coverage, please see your Evidence of Coverage.You will have to choose one of our network providers who are listed in this directory tobe your Primary Care <strong>Provider</strong> (PCP). The term “PCP” will be used throughout thisdirectory. Generally, you must get your health care coverage from your PCP.The “network providers” listed in this directory have agreed to provide you with yourhealth care coverage. You may go to any of our network providers listed in thisdirectory; however, some services may require a referral. If you have been going to onenetwork provider, you are not required to continue going to that same provider. In somecases, you may get covered services from non-network providers.If you receive a bill from a non-contracted provider (out of network provider) for servicesrendered, do not pay the bill. Please forward the bill to our Member ServicesDepartment at 175 S. Third St., Columbus, OH 43215 or fax to 866-719-5435. We willreview the bill and determine if you have any financial liability. We will notify you of anyfinancial liability.Emergency care can always be obtained in or out of the service area from the nearestavailable provider. When in the service area you must use plan providers for urgentcare. When out of the service area, urgent care may be obtained from the first availableprovider. In addition, when out of the service area you can obtain dialysis treatmentfrom any qualified dialysis provider. If you obtain routine care from out-of-networkproviders neither <strong>Medicare</strong> nor <strong>Buckeye</strong> will be responsible for the costs.What is the service area for <strong>Buckeye</strong>?The counties in our service area are listed below.• Allen • Hancock • Sandusky• Ashtabula • Hardin • Seneca• Auglaize • Henry • Stark• Brown • Huron • Summit• Clermont • Lake • Tuscarawas• Cuyahoga • Lorain • Van Wert• Defiance • Lucas • Warren• Erie • Medina • Wayne• Fulton • Portage • Williams• Hamilton • Putnam • Wood