Better Health 2011 Provider Directory - Medicare Advantage
Better Health 2011 Provider Directory - Medicare Advantage
Better Health 2011 Provider Directory - Medicare Advantage
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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 <strong>Provider</strong> (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 <strong>Health</strong> 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 <strong>Medicare</strong> nor Buckeye will be responsible forthe costs.