Ucare Provider and Pharmacy Directory

[Pages:472]UCare Medicare with Fairview & North Memorial Health HMO-POS Plan

Provider and Pharmacy Directory 2019

This directory is current as of 11/21/2019. This directory provides a list of UCare Medicare with Fairview & North Memorial current network providers. This directory is for the UCare Medicare with Fairview & North Memorial service area that includes these Minnesota counties: Anoka, Carver, Chisago, Dakota, Hennepin, Isanti, Ramsey and Washington. To access the UCare Medicare with Fairview & North Memorial online Provider and Pharmacy Directory, you can search . For any questions about the information contained in this directory (hardcopy or online), please call our Customer Service Department at 612-676-6520 or 1-888-618-2595 toll free, 8 am - 8 pm, seven days a week. TTY users should call 612-676-6810 or 1-800-688-2534 toll free. Upon request, we can also give you information in Braille, in large print, or other alternate formats if you need it.

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Notice of Nondiscrimination

UCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. UCare does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. We provide aids and services at no charge to people with disabilities to communicate effectively with us, such as TTY line, or written information in other formats, such as large print. If you need these services, contact us at 612-676-3200 (voice) or toll free at 1-800-203-7225 (voice), 612-676-6810 (TTY), or 1-800-688-2534 (TTY). We provide language services at no charge to people whose primary language is not English, such as qualified interpreters or information written in other languages. If you need these services, contact us at the number on the back of your membership card or 612-676-3200 or toll free at 1-800-203-7225 (voice); 612-676-6810 or toll free at 1-800-688-2534 (TTY). If you believe that UCare has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file an oral or written grievance. Oral grievance If you are a current UCare member, please call the number on the back of your membership card. Otherwise please call 612-676-3200 or toll free at 1-800-203-7225 (voice); 612-676-6810 or toll free at 1-800-688-2534 (TTY). You can also use these numbers if you need assistance filing a grievance. Written grievance Mailing Address UCare Attn: Appeals and Grievances PO Box 52 Minneapolis, MN 55440-0052 Email: cag@ Fax: 612-884-2021 You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at , or by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Avenue SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 1-800-537-7697 (TDD) Complaint forms are available at .

Table of Contents

Chapter

Section 1 - Introduction.......................................................................... 7 What is the service area for UCare Medicare with Fairview & North Memorial?.......................................................................................................... 8 How do you find UCare Medicare with Fairview & North Memorial providers in your area?.................................................................................... 8 UCare Medicare with Fairview & North Memorial Network Pharmacies........................................................................................................8 Are you ready to enroll in UCare Medicare with Fairview & North Memorial? .........................................................................................................9

Section 2 - List of Network Providers ................................................... 11 Primary Care Clinics ......................................................................................... 13 Behavioral Health ............................................................................................. 47 Chiropractic Care.............................................................................................. 51 Convenience Care ............................................................................................ 177 Dental Care ....................................................................................................... 179 Hospitals............................................................................................................ 223 Nursing Homes................................................................................................. 225 Retail Pharmacy................................................................................................ 227 Mail Order Pharmacy....................................................................................... 333 Home Infusion Pharmacy................................................................................ 335 Long-Term Care Pharmacy ............................................................................. 337 Indian Health Service/Tribal/Urban Indian Health Program Pharmacy .... 361 Urgent Care Clinics........................................................................................... 365 Specialists .......................................................................................................... 367 Allergy/Immunology................................................................................... 367 Cardiology ................................................................................................... 369 Cardiovascular Disease ............................................................................. 370 Cardiovascular/Thoracic Surgery ............................................................. 374 Colon and Rectal Surgery .......................................................................... 376 Dermatology ............................................................................................... 377 Durable Medical Equipment ..................................................................... 381 Endocrinology ............................................................................................. 384 Family Medicine.......................................................................................... 385 Gastroenterology ....................................................................................... 386 General Surgery.......................................................................................... 389 Geriatrics ..................................................................................................... 393 Internal Medicine ....................................................................................... 394 Nephrology ................................................................................................. 416 Neurological Surgery ................................................................................. 418 Neurology.................................................................................................... 419 Obstetrics and Gynecology ....................................................................... 423 Occupational Medicine .............................................................................. 425 Occupational Therapy ............................................................................... 426 Oncology ..................................................................................................... 427

Table of Contents

Chapter

Ophthalmology........................................................................................... 432 Oral and Maxillofacial Surgery.................................................................. 438 Orthopedic Surgery.................................................................................... 439 Orthopedics ................................................................................................ 441 Otolaryngology (ENT)................................................................................. 450 Pain Management ...................................................................................... 452 Perinatology................................................................................................ 455 Physical Medicine and Rehab ................................................................... 456 Plastic and Reconstructive Surgery.......................................................... 457 Pulmonary Medicine .................................................................................. 458 Radiation Oncology.................................................................................... 461 Radiology..................................................................................................... 462 Rehabilitation Medicine............................................................................. 464 Rheumatology ............................................................................................ 465 Sleep Disorder ............................................................................................ 466 Sports Medicine.......................................................................................... 467 Urology ........................................................................................................ 468

Section 1 - Introduction

This directory provides a list of UCare Medicare with Fairview & North Memorial network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage. You will have to choose one of our network providers listed in this directory to be your Primary Care Clinic (PCC). The term "PCC" will be used throughout this directory. Generally, you must get your health care services from your PCC. You can see any Primary Care Physician (PCP) at your clinic. The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. You can get all covered services on your own, without a referral. If you have been going to one network provider, you are not required to continue going to that same provider. Sometimes, even network doctors are not aware that they should send you to a network hospital for inpatient care. If you need to go to a hospital, work closely with your doctor to choose the most appropriate facility for your needs from the hospitals in the UCare Medicare with Fairview & North Memorial network. In some cases, you may get covered services from out-of-network providers. The Point-of-Service (POS) benefit provides access to non-contracted, out-of-network Medicare providers. You do not need a referral from your PCC to use the POS benefit. For details about POS refer to your Evidence of Coverage for details. With the exception of emergencies, or urgent care, or out-of-service-area renal dialysis, or some other services, it may cost more to get care from out-of-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 UCare Medicare with Fairview & North Memorial will be responsible for the costs.

When you receive needed care from a provider who is not part of the plan network, you are only responsible for paying your share of the cost, not for the entire cost. l If you pay the entire amount yourself at the time

you receive care, you need to ask us to pay you back for our share of the cost. Send us the bill, along with documentation of any payments you have made. l At times you may get a bill from a provider asking for payment that you think you do not owe. Send us this bill, along with documentation of any payments you have already made.

- If the provider is owed anything, we will pay the provider directly.

- If you have already paid more than your share of the cost of the service, we will determine how much you owed and pay you back for our share of the cost.

l Mail your request for payment together with any bills or receipts to us at this address: UCare Medicare with Fairview & North Memorial Attn: DMR Department P.O. Box 52 Minneapolis, MN 55440-0052

Emergency and Urgently Needed Care/Renal Dialysis Please note: Emergency care, urgently need care, and out-of-service-area renal (kidney) dialysis are required under the Medicare program to be covered at in-network cost-sharing for both plan and non-plan providers. You can obtain emergency care in or out of the service area from the nearest available provider. When in the service area, you must use plan providers for urgent care. When you are out of the service area and cannot get care from a network

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provider, we will cover urgently needed care that you get from any provider. When out of the service area you can obtain dialysis treatment from any qualified dialysis provider. If you obtain routine care, except for the Point-of-Service coverage described on the previous page, from out-of-network providers, neither Medicare nor UCare Medicare

with Fairview & North Memorial will be responsible for the costs. UCare Medicare with Fairview & North Memorial provides worldwide emergency and urgently needed care coverage with copays.

What is the service area for UCare Medicare with Fairview & North Memorial? The counties in our service area are listed below.

Anoka, Carver, Chisago, Dakota, Hennepin, Isanti, Ramsey and Washington.

How do you find UCare Medicare with Fairview & North Memorial providers in your area?

In the Primary Care section, the plan providers are listed in alphabetical order first by state, then county, and then city. See the Table of Contents on page 5. If you have questions about UCare Medicare with Fairview & North Memorial or require assistance in

selecting a PCC, please call our Customer Service Department at 612-676-6520 or 1-888-618-2595 toll free, 8 am - 8 pm, seven days a week. TTY users should call 612-676-6810 or 1-800-688-2534 toll free. Or, visit .

UCare Medicare with Fairview & North Memorial Network Pharmacies

We call the pharmacies on this list our "network pharmacies" because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under UCare Medicare with Fairview & North Memorial only if they are filled at a network pharmacy or through our mail order pharmacy service. Once you go to one pharmacy, you are not required to continue going to the same pharmacy to fill your prescription but can switch to any other of our network pharmacies. We will fill prescriptions at non-network pharmacies under certain circumstances as described in your Evidence of Coverage. All network pharmacies may not be listed in this directory. Pharmacies may have been added or removed from the list after this directory was printed. This means the pharmacies listed here may no longer be in our network, or there may be newer pharmacies in our network that are not listed. This

list is current as of 11/21/2019. For the most current list, please contact us. Our contact information appears on the front and back cover pages. You can go to all the pharmacies on this list, but your costs for some drugs may be less at pharmacies on this list that offer preferred cost-sharing. We have marked these pharmacies with a ? to distinguish them from other pharmacies in our network that offer standard cost-sharing. You can get prescription drugs shipped to your home through our network mail order delivery program, which is called Express Scripts. For more information, please contact us or see the mail order pharmacy section of this directory.

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