Planes de Seguro Contratados

(1)

Planes de Seguro Contratados

A partir del 1.° de julio de 2017, Children’s HealthSM tiene contrato con los siguientes planes de seguro en las instalaciones siguientes:  Children’s HealthSM_{Children’s Medical Center Dallas}

 Children’s HealthSM_{Children’s Medical Center Plano}

 Children’s HealthSM

Specialty Center Dallas Campus  Children’s HealthSM

Specialty Center Plano Campus  Children’s HealthSM

Specialty Center Bass Center

Specialty Center Park Cities  Children’s HealthSM

Specialty Center Mesquite  Children’s HealthSM

Urology Center Rockwall

Specialty Center for Autism & Developmental Disabilities  Children’s HealthSM

Specialty Center Cityville

Seguros Comerciales

Aetna Health Inc. Imagine Health

Baylor Scott & White Health Plan (Employees) MultiPlan

Baylor Scott & White Health Plan Quality Alliance (BSWQA ACO Network) Private Health Care Systems (PHCS)

BlueCross BlueShield of Texas Regional Healthcare Alliance

ChoiceCare Scott & White Health Plan

CIGNA Healthcare of Texas, Inc. (CIGNA Great-West) Stratose (formerly National Preferred Provider Network (NPPN))

CIGNA LocalPlus Texas Health Aetna Joint Venture Provider Networks (Aetna/THR)

Coventry Health Care, Inc. (First Health) Trinity Mother Frances (Employees & Their Dependents Only)

Galaxy Health Network UnitedHealthcare of Texas, Inc.

HealthSmart / HealthSmart ACCEL USA Managed Care Organizations (USAMCO)

Humana, Inc.

Seguros Comerciales (Planes Individuales Y Familiares)

CIGNA LocalPlus (Vantage Plans) HumanaOne (Humana Bronze 6450 Commercial PPO)

Managed Medicaid (State of Texas Access Reform (STAR))

Aetna Better Health Molina Healthcare of Texas

AMERIGROUP Parkland Community Health Plan (HEALTHfirst)

BlueCross BlueShield of Texas SUPERIOR HealthPlan

CookChildren’s Health Plan Texas Children’s Health Plan

FirstCare Health Plans

Managed Medicaid (STAR+PLUS)

AMERIGROUP Molina Healthcare of Texas

BlueCross BlueShield of Texas SUPERIOR Health Plan

Managed Medicaid (STAR Kids)

Aetna Better Health CookChildren’s Health Plan

AMERIGROUP Texas Children’s Health Plan (TCHP)

BlueCross BlueShield of Texas UnitedHealthcare (UHC) Community Plan

Children’s Medical Center Health Plan (CMCHP)

Managed Medicaid Foster Care (STAR Health)

SUPERIOR HealthPlan (Servicios médicos de salud) Cenpatico (Salud conductual)

Medicaid Rural Service Area (MRSA)

AMERIGROUP (Central, Northeast and West) SUPERIOR HealthPlan (Central, Northeast and West)

Children’s Health Insurance Program (CHIP, CHIP Perinate, and CHIP RSA)

Aetna Better Health CHIP/CHIP Perinate Molina Healthcare of Texas CHIP/CHIP Perinate/CHIP RSA* AMERIGROUP CHIP/CHIIP Perinate Parkland Community Health Plan CHIP/CHIP Perinate (KIDSfirst)**

BlueCross BlueShield of Texas SUPERIOR HealthPlan CHIP/CHIP RSA

CookChildren’s Health Plan CHIP/CHIP Perinate Texas Children’s Health Plan FirstCare Health Plans CHIP/CHIP Perinate

*Includes CHIP Perinate & CHIP Perinate RSA

(2)

Planes de Seguro Contratados

A partir del 1.° de julio de 2017, Children’s HealthSM tiene contrato con los siguientes planes de seguro en las instalaciones siguientes:  Children’s HealthSM_{Children’s Medical Center Dallas}

 Children’s HealthSM_{Children’s Medical Center Plano}

Specialty Center Dallas Campus  Children’s HealthSM

Specialty Center Plano Campus  Children’s HealthSM

Specialty Center Bass Center

Specialty Center Park Cities  Children’s HealthSM

Specialty Center Mesquite  Children’s HealthSM

Urology Center Rockwall

 Children’s HealthSM _{Specialty Center for Autism & Developmental Disabilities}

Specialty Center Cityville

Medicaid Tradicional

Texas Medicaid & Healthcare Partnership (TMHP) (Texas Medicaid) Mississippi Medicaid (CMC Dallas Only)

Children with Special Health Care Needs (CSHCN) Oklahoma Health Care Authority (OHCA) (CMC Dallas & Plano) Arkansas Medicaid (CMC Dallas & Plano)

Seguros de Salud Conductual

Aetna Health Inc. (Solo comercial) CompCare (Solo comercial)

AMERIGROUP Managed Health Network (MHN)***

Beacon Health Options (STAR, STAR+PLUS, STAR Kids, CHIP) OptumHealth Behavioral Solutions (Commercial)

BlueCross BlueShield of Texas (comercial) (se excluye el HMO Blue) OptumHealth Behavioral Solutions (STAR, STAR+PLUS, STAR Kids, CHIP) BlueCross BlueShield of Texas (STAR, STAR+PLUS, STAR Kids, CHIP) Scott & White Health Plan (Solo commercial para trastomos de la alimentación) Cenpatico (STAR Health – Solo tutela temporal) Texas Children’s Health Plan (TCHP)

*Se excluyen las terapias y pruebas psicológicas si el paciente no está internado

Redes de Trasplante

Blue Distinction Centers for Transplant – TMO, Corazón, Higado LifeTrac – TMO, Corazón, Intestino, Riñón, Hígado, Multivisceral CIGNA LifeSOURCE Network – TMO, Corazón, Riñón, Higado OptumHealth – TMO, CHD, Corazón, Riñón, Hígado, Multivisceral Humana National Transplant Network – TMO, Corazón, Riñón, Higado OptumHealth – UnitedHealthcare Compass W500 (COE)

INTERLINK – TMO, CHD, Corazón, Hígado Protocol Tertiary Network – TMO, Corazón, Riñón, Hígado

En caso de tener preguntas, por favor lea su tarjeta de seguro, la póliza o cualquier otro material que tenga a su disposición sobre su plan de seguro. Además, recomendamos que se comunique a la compañía de seguro o con el administrador de beneficios a los empleados para verificar la cobertura o para pedir más información sobre su plan de salud.

AVISO: Los médicos tienen contratos por separado con las organizaciones de atención médica administrada. Por lo tanto, esta lista sirve solamente de

(3)

Salud de los Niños Afiliados (Proveedores del Hospital Base)

Proveedores de Práctica Avanzada (APPs) –

Enfermera Practicante and Asistente Médico

Seguros Comerciales Commercial (Planes Individuales Y Familiares) Managed Medicaid (STAR Kids)

Aetna Health Inc. CIGNA LocalPlus (Vantage Plans) Aetna Better Health

Baylor SWHP (Employees)

Baylor SWHP Quality Alliance (ACO) BlueCross BlueShield of Texas ChoiceCare

HumanaOne (Humana Bronze 6450 PPO) Managed Medicaid (STAR//MRSA/CHIP) Aetna Better Health

AMERIGROUP

BlueCross BlueShield of Texas Children’s Medical Center Health Plan CookChildren’s Health Plan

CIGNA Healthcare of Texas AMERGROUP Texas Children’s Health Plan (TCHP)

CIGNA LocalPlus BlueCross BlueShield of Texas UnitedHealthcare (UHC) Community Plan

Coventry Health Care, Inc. (First Health) HealthSmart / HealthSmart ACCEL

CookChildren’s Health Plan

FirstCare Health Plan Seguros de Salud Conductual

Humana Parkland Community Health Plan (PCHP) BlueCross BlueShield of Texas (STAR

Imagine Health SUPERIOR HealthPlan (STAR Health included) STAR+PLUS, STAR Kids, CHIP) MultiPlan

Private Health Care Systems (PHCS) Scott & White Health Plan (SWHP) Texas Health Aetna Joint Venture Provider Networks (Aetna/THR) Trinity Mother Frances

Texas Children’s Health Plan Managed Medicaid (STAR+PLUS) AMERIGROUP

OptumHealth Behavioral Solutions (Commercial) OptumHealth Behavioral Solutions (STAR, STAR+PLUS, STAR Kids, CHIP) Medicaid Tradicional

Children with Special Healthcare Needs (Employees & Their Dependents Only) Texas Medicaid & Healthcare Partnership UnitedHealthcare of Texas Inc.

Anesthesiologists para Niños (AFC / AFC-Pain Management)

Baylor SWHP Quality Alliance (ACO) BlueCross BlueShield of Texas

HumanaOne (Humana Bronze 6450 PPO) Managed Medicaid (STAR/MRSA/CHIP)

AMERIGROUP

BlueCross BlueShield of Texas Children’s Medical Center Health Plan

ChoiceCare Aetna Better Health CookChildren’s Health Plan

CIGNA Healthcare of Texas AMERIGROUP Texas Children’s Health Plan (TCHP)

CIGNA LocalPlus

BlueCross BlueShield of Texas CookChildren’s Health Plan

Parkland Community Health Plan (PCHP)

UnitedHealthcare (UHC) Community Plan Medicaid Tradicional

Humana SUPERIOR HealthPlan (STAR Health included) Children with Special Healthcare Needs Imagine Health

MultiPlan

Private Health Care Systems (PHCS) Scott & White Health Plan (SWHP) Texas Health Aetna Joint Venture Provider Networks (Aetna/THR)

Texas Children’s Health Plan Managed Medicaid (STAR+PLUS) AMERIGROUP

Texas Medicaid & Healthcare Partnership

Three Rivers Network (TRPN) UnitedHealthcare of Texas Inc.

Servicios de Atención Médica Compleja (CCMSC)

Seguros Comerciales

Aetna Health Inc.

Baylor SWHP Quality Alliance (ACO) BlueCross BlueShield of Texas ChoiceCare

CIGNA Healthcare of Texas

Commercial (Planes Individuales Y Familiares) CIGNA LocalPlus (Vantage Plans)

HumanaOne (Humana Bronze 6450 PPO) Managed Medicaid (STAR/MRSA/CHIP) AMERIGROUP

CookChildren’s Health Plan

Managed Medicaid (STAR Kids) AMERIGROUP

Children’s Medical Center Health Plan CookChildren’s Health Plan

Texas Children’s Health Plan

UnitedHealthcare (UHC) Community Plan

CIGNA LocalPlus Texas Children’s Health Plan Seguros de Salud Conductual (Commercial)

Humana, Inc Imagine Health

Texas Health Aetna Joint Venture Provider Networks (Aetna/THR)

Managed Medicaid (STAR+PLUS) AMERIGROUP

Aetna Health Inc. CIGNA Behavioral Health

LifeSynch (Humana Behavioral Health) Magellan Behavioral Health

Scott & White Health Plan (SWHP) Traditional Medicaid

UnitedHealthcare of Texas Inc. Children with Special Healthcare Needs Texas Medicaid & Healthcare Partnership

Seguros de Salud Conductual (STAR/CHIP) Texas Children’s Health Plan

(4)

Salud de los Niños Afiliados (Proveedores del Hospital Base) Continuó

Dallas Médico Los Servicios Médicos Para Los Niños (DPMSC – Internistas)

Baylor SWHP Quality Alliance (ACO)1 BlueCross BlueShield of Texas

AMERIGROUP

ChoiceCare Aetna Better Health CookChildren’s Health Plan

CIGNA Healthcare of Texas AMERIGROUP Texas Children’s Health Plan (TCHP)

CIGNA LocalPlus

UnitedHealthcare (UHC) Community Plan

Medicaid Tradicional

Humana SUPERIOR HealthPlan (STAR Health included) Children with Special Healthcare Needs Imagine Health Texas Children’s Health Plan Texas Medicaid & Healthcare Partnership MultiPlan

Private Health Care Systems (PHCS) Managed Medicaid (STAR+PLUS) Scott & White Health Plan (SWHP) AMERIGROUP

Texas Health Aetna Joint Venture BlueCross BlueShield of Texas Provider Networks (Aetna/THR)

UnitedHealthcare of Texas Inc.

SUPERIOR HealthPlan

1_{DPMSC’s en el estado de la red miembros de Baylor SWHP Quality Alliance (ACO) es beneficio específico basado en el diseño de beneficios de miembros con}

su empleador. Por favor, póngase en contacto con su seguro para determinar el estado de participación.

Dallas Médico Los Servicios Médicos Para Los Niños (DPMSC – Orthodoncia)

Aetna Dental DentaQuest

CIGNA Dental DentaQuest for Superior HealthPlan

Delta Dental Insurance Company (DDIC) Humana Dental DHMO

Dental Benefit Providers (UnitedHealthcare) MCNA Dental Plans Dental Network of America (DNOA)

Clínica Dental de los Niños

Aetna Dental Dental Network of America (DNOA)

CIGNA Dental DentaQuest

Delta Dental Insurance Company (DDIC) Humana Dental DHMO

Dental Benefit Providers (UnitedHealthcare) MCNA Dental Plans

Atención de la Salud a Domicilio (HHC)

Baylor SWHP Quality Alliance (ACO) BlueCross BlueShield of Texas (HHC Only)

AMERIGROUP

CareCentrix Aetna Better Health CookChildren’s Health Plan

ChoiceCare AMERIGROUP Texas Children’s Health Plan (TCHP)

CIGNA LocalPlus

Coventry Health Care, Inc. (First Health)

UnitedHealthcare (UHC) Community Plan HealthSmart / HealthSmart ACCEL Molina Healthcare of Texas Medicaid Tradicional

Humana Imagine Health

Parkland Community Health Plan (PCHP) SUPERIOR HealthPlan (STAR Health ONLY)

Children with Special Healthcare Needs Texas Medicaid & Healthcare Partnership

MultiPlan Texas Children’s Health Plan

Private Health Care Systems (PHCS)

Texas Health Aetna Joint Venture Managed Medicaid (STAR+PLUS) AMERIGROUP

BlueCross BlueShield of Texas Molina Healthcare of Texas

(5)

Salud de los Niños Afiliados (Proveedores del Hospital Base) Continuó

Equipo Médico a Domicilio (HME)

Baylor SWHP Quality Alliance (ACO) BlueCross BlueShield of Texas (HHC Only)

AMERIGROUP

CareCentrix Aetna Better Health CookChildren’s Health Plan

ChoiceCare AMERIGROUP Texas Children’s Health Plan (TCHP)

CIGNA LocalPlus

UnitedHealthcare (UHC) Community Plan HealthSmart / HealthSmart ACCEL Molina Healthcare of Texas Medicaid Tradicional

Humana Imagine Health

Parkland Community Health Plan (PCHP) Texas Children’s Health Plan

Children with Special Healthcare Needs Texas Medicaid & Healthcare Partnership MultiPlan

Private Health Care Systems (PHCS) Managed Medicaid (STAR+PLUS) Scott & White Health Plan (SWHP) AMERIGROUP

Texas Health Aetna Joint Venture Provider Networks (Aetna/THR) UnitedHealthcare of Texas Inc.

BlueCross BlueShield of Texas Molina Healthcare of Texas

(6)

Salud de los Niños Afiliados (Clinica de Pacientes Ambulatorios)

A partir del 1.° de julio de 2017, Children’s HealthSM Pediatric Group tiene contrato con los siguientes planes de seguro en las instalaciones siguientes:

 Children’s HealthPediatric Group Bachman Lake  Children’s HealthPediatric Group Carrollton  Children’s HealthPediatric Group Cedar Hill  Children’s Health Pediatric Group Celina  Children’s HealthPediatric Group Cockrell Hill  Children’s Health Pediatric Group DeSoto  Children’s Health Pediatric Group Garland  Children’s Health Pediatric Group Grapevine  Children’s Health Pediatric Group Irving

 Children’s Health Pediatric Group Lake Highlands  Children’s HealthPediatric Group Lancaster Kiest  Children’s HealthPediatric Group McKinney  Children’s Health Pediatric Group Medical District  Children’s HealthPediatric Group Oak Cliff  Children’s HealthPediatric Group Pleasant Grove  Children’s HealthPediatric Group St. Phillips  Children’s Health Pediatric Group Prosper  Children’s Health Pediatric Group West Plano

Pediátrica de la Salud de los Niños (CHPG) – antes MyChildren’s

Seguros Comerciales Commercial (Planes Individuales Y Familiares) Seguros de Salud Conductual (Comerciales) Aetna Health Inc.

CIGNA LocalPlus (Vantage Plans) HumanaOne (Humana Bronze 6450 PPO) Managed Medicaid (STAR/MRSA/CHIP)

Aetna Health Inc.

BlueCross BlueShield of Texas CIGNA Behavioral Health Magellan Behavioral Health CIGNA Healthcare of Texas

CIGNA LocalPlus

Aetna Better Health AMERIGROUP

BlueCross BlueShield of Texas

MHNet Behavioral Health (Coventry) LifeSynch (Humana Behavioral Health) MultiPlan

Humana CookChildren’s Health Plan Private Health Care Systems (PHCS)

Imagine Health Integrated Health Plan

Molina Healthcare of Texas

Parkland Community Health Plan (PCHP) Seguros de Salud Conductual MultiPlan

Private Health Care Systems (PHCS)

SUPERIOR HealthPlan (STAR Health included) Texas Children’s Health Plan

(STAR/STAR+PLUS/CHIP) AMERIGROUP

Texas Health Aetna Joint Venture

Provider Networks (Aetna/THR) Managed Medicaid (STAR+PLUS)

BlueCross BlueShield of Texas (STAR STAR+PLUS, STAR Kids, CHIP)

Scott & White Health Plan (SWHP) AMERIGROUP Molina Healthcare of Texas

UnitedHealthcare of Texas Inc. BlueCross BlueShield of Texas Molina Healthcare of Texas SUPERIOR Health Plan

Managed Medicaid (STAR Kids) Aetna Better Health

Texas Children’s Health Plan (TCHP) Medicaid Tradicional

Children with Special Healthcare Needs Texas Medicaid & Healthcare Partnership AMERIGROUP

BlueCross BlueShield of Texas Children’s Medical Center Health Plan CookChildren’s Health Plan*

Texas Children’s Health Plan (TCHP) UnitedHealthcare (UHC) Community Plan

(7)

Casa de Nuestros Niños

Como de September 20, 2015, Children’s HealthSM

ahora incluye las siguientes Nuestros niños ubicaciones House:

 Our Children’s House 1340 Empire Central, Dallas, TX 75247 Inpatient Services

 Our Children’s House at Dallas 1208 N. Hall Street, Dallas, TX 75204-6016 Outpatient Services  Our Children’s House at Waxahachie 1540 N. Highway 77, Ste. 10, Waxahachie, TX 75165-5207 Outpatient Services  Our Children’s House at Grapevine 1643 Lancaster Drive, Ste. 300, Grapevine, TX 76051-3593 Outpatient Services  Our Children’s House at Rockwall 2455 Ridge Road, Ste. 255, Rockwall, TX 75087-5534 Outpatient Services  Our Children’s House at Irving 3337 Stovall Street, Irving, TX 75061-4035 Outpatient Services  Our Children’s House at Frisco 7010 Preston Road, Ste. 240, Frisco, TX 75034-5875 Outpatient Services  Our Children’s House at Plano 7000 W. Plano Parkway, Ste. 210, Plano, TX 75093-1632 Outpatient Services  Our Children’s House at Las Colinas 7453 Las Colinas Blvd., Irving, TX 75063-7561 Outpatient Services  Our Children’s House at Allen 8 Prestige Circle, Ste. 101, Allen, TX 75002-3435 Outpatient Services

Casa de Nuestros Niños

Seguros Comerciales Commercial (Planes Individuales Y Familiares) Redes de Transplante

Aetna Health Inc. CIGNA LocalPlus (Vantage Plans) CIGNA LifeSOURCE

Humana National Transplant Network INTERLINK Transplant Network LifeTrac Transplant Network CIGNA Healthcare of Texas

CIGNA LocalPlus

Aetna Better Health AMERIGROUP

OPTUM Health

Protocol Tertiary Network ChoiceCare

Coventry Health Care, Inc. (First Health) HealthSmart

Humana

BlueCross BlueShield of Texas CookChildren’s Health Plan Molina Healthcare of Texas

Seguros de Salud Conductual BlueCross BlueShield of Texas (STAR STAR+PLUS, STAR Kids, CHIP) Imagine Health

MultiPlan

Private Health Care Systems (PHCS) Stratose (formerly NPPN)

Scott & White Health Plan (SWHP) Trinity Mother Frances

(Employees & Their Dependents Only) UnitedHealthcare of Texas Inc.

USA Managed Care Organizations (USAMCO)

SUPERIOR HealthPlan (STAR Health included) Texas Children’s Health Plan

Managed Medicaid (STAR+PLUS) AMERIGROUP

BlueCross BlueShield of Texas Molina Healthcare of Texas SUPERIOR HealthPlan

Managed Medicaid (STAR Kids) Aetna Better Health

AMERIGROUP

BlueCross BlueShield of Texas Children’s Medical Center Health Plan CookChildren’s Health Plan

Texas Children’s Health Plan (TCHP) UnitedHealthcare (UHC) Community Plan

OptumHealth Behavioral Solutions (Commercial) OptumHealth Behavioral Solutions (STAR, STAR+PLUS, STAR Kids, CHIP) Medicaid Tradicional

Children with Special Healthcare Needs Oklahoma Health Care Authority (OHCA) Texas Medicaid & Healthcare Partnership