Better Health 2011 Provider Directory - Medicare Advantage

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Advantage by Buckeye Community Health Plan (HMO SNP)Provider DirectoryThis directory provides a list of the Advantage by Buckeye (HMO SNP)(Buckeye) network providers and pharmacies.This directory is for the East Central Region, including the following counties:Portage, Stark, Summit, Tuscarawas, and Wayne.This directory is current as of October 1, 2010. Some network providers andpharmacies may have been added or removed from the list after this directorywas printed. We do not guarantee that each provider is still accepting newmembers. To get the most up-to-date information about the Buckeye networkproviders and pharmacies in your area, you can visit www.bchpohio.com or callour Member Service Department at 866-389-7690, 8:00AM to 8:00PM, 7 days aweek. TTY/DDD users should call 800-750-0750.Note: All providers in this directory accept fee-for-service Medicaid. As amember with full Medicaid, you should not have to pay anything for medicalcare. If a provider is asking you to pay, make sure they have a copy of bothyour Buckeye Advantage ID card and your Ohio Medicaid ID card – they willneed to bill us for any Medicare-covered services and Medicaid for anyMedicaid-covered services (including your Medicare copays and coinsurance).This directory is available in alternative formats and languages, includingSpanish. To request information in alternative formats or languages please callour Member Services Department at 866-389-7690 (TTY 800-750-0750) 8:00AMto 8:00PM, 7 days a week.Este directorio está disponible en formatos e idiomas alternativos, inclusive enespañol. Para solicitar información en formatos e idiomas alternativos sírvasellamar a nuestro Departamento de Servicios para los Miembros al 866-389-7690(TTY 800-750-0750) de 8:00 a.m. a 8:00 p.m., los 7 días de la semana.
Section 1 – IntroductionThis directory provides a list of the Buckeye network providers andpharmacies. To get detailed information about your health carecoverage, please see your Evidence of Coverage.You will have to choose one of our network providers that are listedin this directory to be your Primary Care Provider (PCP). The term“PCP” will be used throughout this directory. Generally you mustget your health care coverage from your PCP.The “network providers” listed in this directory have agreed toprovide you with your health care and pharmacy coverage. Youmay go to any of our network providers listed in this directory;however, some services may require a referral. If you have beengoing to one network provider, you are not required to continuegoing to that same provider. In some cases, you may get coveredservices from non-network providers. Other providers are availablein our network.If you receive a bill from a provider for services rendered, do notpay the bill. Please forward the bill to our Member ServicesDepartment at Buckeye Community Health Plan, 175 South ThirdStreet, Suite 1200, Columbus, Ohio 43215 or fax to 866-786-1036.We will review the bill and determine if you have any financialliability. We will notify you of any financial liability.You must receive all routine care from plan providers.Emergency care can always be obtained in or out of the servicearea from the nearest available provider. When in the service areayou must use plan providers for urgent care. When out of theservice area urgent care may be obtained from the first availableprovider. In addition, when out of the service area you can obtaindialysis treatment from any qualified dialysis provider. If youobtain routine care from out-of-network providers, without priorauthorization, neither Medicare nor Buckeye will be responsible forthe costs.
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Better Health 2011 Provider Directory - Medicare Advantage

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