Medical Customer Service
Resume:
Convenience Care
Clinic
Minuteclinic
Castle Hills, TX 78213
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
San Antonio, TX 78251
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Rediclinic
1150 N Loop 1604 W
San Antonio, TX 78248
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
16580 Huebner Rd
San Antonio, TX 78248
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Rediclinic
8503 NW Military Hwy
San Antonio, TX 78230
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
120 E Sonterra Blvd
San Antonio, TX 78258
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
9140 Guilbeau Rd
San Antonio, TX 78250
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Rediclinic
20935 US Hwy 281 N #A
San Antonio, TX 78258
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
12980 Bandera Rd
Helotes, TX 78023
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
23530 Wilderness Oak
San Antonio, TX 78258
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
5301 Alamo Pky
San Antonio, TX 78253
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
22202 Bulverde Rd
San Antonio, TX 78261
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
22135 W IH 10
San Antonio, TX 78257
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Minuteclinic
2693 FM 3009
Schertz, TX 78154
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Rediclinic
20725 Hwy 46 W
Spring Branch, TX 78070
Participates in: LocalPlus, OAP,
OAPC, PPO, HMO
Additional questions or problems with this transmission? Call us toll-free at 1-800-Cigna24 (1-800-***-****). Information contained in this directory is updated six days per week, excluding holidays, Sundays, or interruptions due to system maintenance, upgrades or unplanned outages. This information is subject to change at any time. Providers may delay communicating to Cigna that they no longer accept new patients so we cannot guarantee that each provider is still accepting new patients. Please check with the health care professional before scheduling your appointment or receiving services or call Cigna Customer Service at the toll-free number on your Cigna ID card to confirm he or she is participating in Cigna's network. Provider information was last updated on 07/17/2018 Source of Information and Frequency of Validation
Medical health care professional information addressing specialty, hospital affiliations, medical group affiliations, board certification, acceptance of new patients and languages spoken is obtained from an application that is completed and signed by the health care professional/facility (during credentialing). Physician board certification is validated through the American Board of Medical Specialties
(ABMS), American Medical Association (AMA) or American Osteopathic Association (AOA). Information on the application is updated when the medical health care professional/facility notifies Cigna of changes or at least every three years. Dental health care professional information addressing specialty, dental office/practice affiliations, acceptance of new patients and languages spoken is obtained from an application that is completed and signed by the health care professional (during credentialing). Information on the application is updated when the dental health care professional notifies Cigna of changes or at least every three years. 7/17/2018 11:42:51 AM Page 1 of 1
Find out more about the doctors and services listed in the Cigna directory and read important notices and disclosures for your state, https://hcpdirectory.cigna.com/assets/docs/hcpdirectory/disclaimer.html? WT.mc_id=PDF_DIR_Disclaimer&WT.z_dir_cc=HDC001
Introduction 1
You choose
your doctor.
This guide
can help.
www.cigna.com
Introduction
WHO WE ARE
n Cigna strives to keep you healthy. We are committed to giving you access to information, technology and support in making informed health care decisions. n We are where you are. Cigna has a national presence, but we also have a local focus in most areas. This means local medical directors and health services representatives work to provide you with access to quality care. WHAT YOU CAN EXPECT
n Convenient access to quality health care. Before joining the Cigna network, health care professionals must meet Cigna standards through a process called credentialing. We regularly review credentials to help ensure they continue to meet these standards.
n Responsive customer service. Whether on our website, www.cigna.com, by phone when you talk to a representative or through our automated telephone system, you have access to consistent and timely information about your plan – when it’s convenient for you.
ABOUT THIS DIRECTORY
The following pages list the doctors and other health care professionals in this area who participate in the Cigna network. An updated listing is always available at www. cigna.com. You can use our online directory to:
n search for participating physicians, hospitals and other health care professionals. n download your own personalized directory to have on hand when you need it. n find hospital scores for specific conditions/procedures through Cigna “Centers of Excellence.”
The online directory is updated often, so visit it often. For more information, please visit www.cigna.com or call Cigna Customer Service at the toll-free number on your Cigna ID card.
PLEASE NOTE: The term “health care professional” includes the term “provider”. 2
Your
personal
doctor can
serve as a
source for
advice and
direction.
Visit www.cigna.com to search for participating doctors, find information on preventive care and other health topics, and learn more about your plan’s benefits and programs. Introduction
WORKING WITH YOUR DOCTOR
We encourage you to choose a primary care physician (PCP) to be your personal doctor.
n Your personal doctor can serve as a “home base” for basic care – your source for advice and direction.
n Your personal doctor also coordinates your care - from preventive checkups and routine medical care to specialized care and hospitalizations. YOUR SUMMARY OF BENEFITS
Your Summary of Benefits gives you important information on the medical benefits and other types of services your plan covers. You should read your Summary of Benefits to determine whether you have prescription drug coverage, coverage for mental health and substance abuse, and/or vision care coverage as a part of your Cigna plan.
The listing of a doctor in this directory does not guarantee that the services provided by that doctor are covered under your specific medical plan. Check the materials which describe your particular plan benefits, or call Cigna Customer Service, for information about the services covered under your plan benefits. If you have questions or need assistance, please contact Customer Service at the toll-free telephone number listed in your enrollment materials or on your Cigna ID card.
Cigna LifeSOURCE Transplant Network 3
Respected
hospitals
and medical
centers
throughout
the United
States.
Cigna LifeSOURCE
Transplant Network®
As a Cigna customer, you have access to the Cigna LifeSOURCE Transplant Network®, a network of participating organ and tissue transplant centers. The transplant network includes over 600 transplant programs at more than 150 independent transplant facilities that are nationally recognized for their clinical outcomes.
Each transplant facility is evaluated for minimum annual volumes, one-year graft and patient outcomes, time on the wait list, support services and “patient friendly” environments before it is included in the Cigna LifeSOURCE Transplant Network. Programs that meet or exceed Cigna’s national Guidelines for Network Inclusion are included as a Program of Excellence. Transplant programs that do not meet Cigna’s national Guidelines for Network Inclusion may be contracted as a Supplemental Program. You will need to understand your benefits to know if you have coverage for a transplant at a Supplemental Program. For more information, please visit www. cignalifesource.com, and click on the “our network” tab. Cigna LifeSOURCE participants are managed by our in-depth transplant case management unit. This unit consists of nurses with clinical experience in transplant, hematology/oncology, home health care, dialysis, critical care and/or community care. They are specially trained to manage complex transplant cases. Transplant case management unit offers the following benefits: n Clinical collaboration with health care professionals n Consistency in service and benefit administration n Dedicated resources for complex areas of medicine n Advocacy for the patient’s benefit
n Administrative efficiency
In some instances, a travel benefit is available if you select a Program of Excellence and meet other eligibility requirements. Please be aware that most of these expenses are considered taxable income.
As a Cigna customer, you can have access to these services when they are coordinated through your physician and your transplant case manager. You may not receive the in-network level of benefits for all types of transplants at all facilities. In addition, our network of facilities changes frequently. For the most current listings of the Programs of Excellence and Supplemental Programs, please visit www.cignalifesource.com, click on the tab “Our Network” or call Cigna LifeSOURCE Customer Service at 800-***-****. Not all Cigna LifeSOURCE Transplant Network facilities are available to participants in all plans. Please call Customer Service at 800-***-**** for more information. If you are already in transplant case management, please call your case manager directly.
4 Cigna LifeSOURCE Transplant Network
Alabama
University of Alabama
at Birmingham
Medical Center
Arizona
Banner Good Samaritan
Medical Center,
Phoenix
Mayo Clinic Scottsdale
Phoenix Children’s
Hospital
Scottsdale Healthcare
Virginia G. Piper
Cancer Center
Cancer Transplant
Institute
St. Joseph’s Hospital
and Medical Center,
Phoenix
University of Arizona
Health Sciences
Center, Tucson
Arkansas
University of Arkansas
for Medical
Sciences, Little
Rock
California
California Pacific
Medical Center, San
Francisco
Cedars-Sinai Medical
Center, Los Angeles
Childrens Hospital Los
Angeles
Children’s Hospital at
Oakland
Children’s Hospital of
Orange County
City of Hope National
Medical Center,
Duarte
Keck Hospital of USC
(formerly known
as USC University
Hospital), Los
Angeles
Loma Linda University
Medical Center
Lucile Salter Packard
Children’s Hospital,
Palo Alto
Rady Children’s
Hospital, San Diego
Scripps Green Hospital,
La Jolla
Sharp Memorial
Hospital, San Diego
Stanford University
Medical Center
Sutter Medical Center,
Sacramento
UC Davis Medical
Center, Sacramento
UCSD Medical Center,
San Diego
UCSF Medical Center,
San Francisco
Colorado
Children’s Hospital
Colorado, Aurora
Porter Adventist
Hospital, Denver
Presbyterian St. Luke’s
Medical Center,
Denver
University of Colorado
Hospital, Denver
Connecticut
Hartford Hospital,
Hartford
Yale-New Haven
Hospital, New
Haven
Delaware
Alfred I. duPont
Hospital for
Children
(Nemours),
Wilmington
District of
Columbia
Children’s National
Medical Center
Georgetown University
Hospital
Washington Hospital
Center
Florida
All Children’s Hospital,
St. Petersburg
Broward Health
Medical Center,
Fort Lauderdale
Florida Hospital,
Orlando
H. Lee Moffitt Cancer
Center, Tampa
Jackson Memorial
Hospital, Miami
Mayo Clinic,
Jacksonville
Shands Hospital,
Gainesville
Tampa General
Hospital
University of Miami
Hospital and Clinics
Georgia
Children’s Healthcare
of Atlanta
Emory University
Hospital, Atlanta
Northside Hospital/The
Blood and Marrow
Transplant Group of
Georgia, Atlanta
Piedmont Hospital,
Atlanta
Illinois
Lurie Children’s
Hospital of Chicago
(formerly Children’s
Memorial)
Northwestern Memorial
Hospital, Chicago
Rush University
Medical Center,
Chicago
University of Chicago
Medical Center and
Comer Children’s
Hospital at the
University of
Chicago
University of Illinois
Medical Center,
Chicago
Indiana
IUH University
Hospital,
Indianapolis
IUH Methodist
Hospital,
Indianapolis
Riley Hospital for
Children at IUH,
Indianapolis
Indiana Blood
and Marrow
Transplantation,
Beech Grove
Iowa
University of Iowa
Hospital and
Clinics, Iowa City
Kansas
University of Kansas
Hospital, Kansas
City
Kentucky
Jewish Hospital,
Louisville
University of Kentucky
Medical Center,
Lexington
Louisiana
Ochsner Clinic
Foundation, New
Orleans
Tulane University
Hospital and Clinic,
New Orleans
Maine
Maine Medical Center,
Portland
Maryland
Johns Hopkins Health
System, Baltimore
University of Maryland
Medical Center,
Baltimore
Massachusetts
Beth Israel Deaconess
Medical Center,
Boston
Brigham and Women’s
Hospital and Dana
Farber Cancer
Institute, Boston
Children’s Hospital
Boston and Dana
Farber Cancer
Institute, Boston
Lahey Clinic Medical
Center, Burlington
Massachusetts General
Hospital and Dana
Farber Cancer
Institute, Boston
Tufts - New England
Medical Center,
Boston
UMass Memorial
Medical Center,
Worcester
Michigan
Henry Ford Health
System, Detroit
Karmanos Cancer
Center, Detroit
University of Michigan
Health System, Ann
Arbor
Minnesota
Hennepin County
Medical Center,
Minneapolis
Mayo Clinic, Rochester
University of
Minnesota Medical
Center, Fairview
and University of
Minnesota Amplatz
Children’s Hospital,
Minneapolis
Missouri
Barnes Jewish Hospital,
St. Louis
Children’s Mercy
Hospital, Kansas
City
Research Medical
Center, Kansas City
St. Louis Children’s
Hospital
Saint Louis University
Hospital
Saint Luke’s Hospital
of Kansas City
Nebraska
The Nebraska Medical
Center, Omaha
New Hampshire
Mary Hitchcock
Memorial Hospital,
Lebanon
New Jersey
Hackensack University
Medical Center,
Hackensack
Newark Beth Israel
Medical Center,
Newark
Robert Wood Johnson
University Hospital,
New Brunswick
St. Barnabas Medical
Center, Livingston
Cigna LifeSOURCE Transplant Network 5
New York
Albany Medical Center,
Albany
Memorial Sloan-
Kettering Cancer
Center, New York
Mount Sinai Medical
Center, New York
New York Presbyterian
Hospital,
(Columbia), New
York
New York Presbyterian
Hospital, (Cornell),
New York
New York University
Medical Center,
New York
Roswell Park Cancer
Institute, Buffalo
St. Luke’s Roosevelt
Hospital, New York
Strong Memorial
Hospital, Rochester
Westchester Medical
Center, Valhalla
North Carolina
Carolinas Medical
Center, Charlotte
Duke University
Hospital, Durham
University of North
Carolina Hospitals,
Chapel Hill
Ohio
Arthur G. James Cancer
Hospital, Columbus
Children’s Hospital
Medical Center,
Cincinnati
Christ Hospital,
Cincinnati
Cleveland Clinic
Foundation,
Cleveland
Jewish Hospital,
Cincinnati
Nationwide Children’s
Hospital, Columbus
The Ohio State
University Wexner
Medical Center
(formerly Ohio
State University
Medical Center),
Columbus
University Hospital,
Cincinnati
University Hospitals
Case Medical
Center, Cleveland
Oklahoma
INTEGRIS Baptist
Medical Center dba
INTEGRIS Nazih
Zuhdi Transplant
Institute, Oklahoma
City
Oregon
Legacy Good Samaritan
Hospital and
Medical Center,
Portland
Oregon Health &
Science University,
Portland
Pennsylvania
Albert Einstein Medical
Center, Philadephia
Allegheny General
Hospital, Pittsburgh
Children’s Hospital of
Pittsburgh
Penn State Milton S.
Hershey Medical
Center, Hershey
Pinnacle Health
System, Harrisburg
Temple University
Health System,
Philadelphia
Thomas Jefferson
University Hospital,
Philadelphia
University of
Pennsylvania
Health System,
Philadelphia
UPMC Presbyterian
Shadyside Hospital,
Pittsburgh
West Penn Hospital,
Pittsburgh
South Carolina
Medical University
of South Carolina
Medical Center,
Charleston
Tennessee
Methodist University
Hospital
(LeBonheur
Healthcare),
Memphis
St. Jude Children’s
Research Hospital,
Memphis
Vanderbilt University
Medical Center,
Nashville
Texas
Children’s Medical
Center, Dallas
Cook Children’s
Medical Center, Ft.
Worth
Houston Methodist
Hospital
Medical City Dallas
Hospital
Memorial Hermann
Hospital, Houston
Methodist Dallas
Medical Center
St. Luke’s Episcopal
Hospital, Houston
Texas Children’s
Hospital, Houston
Texas Transplant
Institute, San
Antonio
University Health
System, San
Antonio
University of Texas MD
Anderson Cancer
Center, Houston
University of Texas
Southwestern
Medical Center,
Dallas
Utah
Intermountain Medical
Center, Salt Lake
City
LDS Hospital, Salt
Lake City
University of Utah
Hospital, Salt Lake
City
Vermont
Fletcher Allen Health
Care, Burlington
Virginia
Inova Fairfax Hospital,
Fairfax
Sentara Norfolk
General Hospital,
Norfolk
University of
Virginia Hospital,
Charlottesville
VCU Health Systems
Washington
Seattle Children’s
Hospital
University of
Washington
Medical Center,
Seattle
Wisconsin
Aurora St. Luke’s
Medical Center
Children’s Hospital
of Wisconsin,
Milwaukee
Froedtert Memorial
Lutheran Hospital,
Milwaukee
University of
Wisconsin, Madison
6 Health Care Professional Compensation
Health Care Professional Compensation
Cigna is committed to keeping you
informed about matters related to your
health care plan. For that reason, we
offer the following description of the
way that Cigna compensates health care
professionals (physicians, hospitals
and other health care practitioners and
facilities) that participate in our networks.
Cigna compensates health care
professionals in ways that are intended
to emphasize preventive care, promote
quality care and ensure the appropriate
and cost-effective use of covered
medical services and supplies. Cigna
reinforces this philosophy through
utilization management decisions made
by its medical directors and medical
management staff. Cigna employees
are encouraged to promote appropriate
utilization of covered health care services
and to discourage underutilization.
The methods by which participating
health care professionals agree to be
compensated are described generally
here. The amount and type of
compensation a health care professional
agrees to accept may vary depending
upon the type of plan. For example, a
hospital may agree to accept less for
services provided to patients enrolled in
an HMO plan than to patients enrolled
in other types of plans. In addition,
Cigna may attempt in various ways to
promote the use of participating health
care professionals based upon quality
and cost-effectiveness measures while
assuring quality and access to covered
services and supplies.
DISCOUNTED FEE FOR
SERVICE:
Payment for services is based on an
agreed-upon discounted amount from the
health care professional’s bill.
CAPITATION:
By mutual agreement, network
physicians, physician/hospital
organizations (PHOs) or other health
care professional groups are paid a
fixed amount (capitation) at regular
intervals for each individual assigned
to the physician, PHO or other health
care professional groups, whether
or not services are provided. This
payment covers physician and/or, where
applicable, hospital or other services
covered under the benefits plan. Health
care professional groups and PHOs
may in turn compensate health care
professionals using a variety of methods.
Capitation can offer health care
professionals a predictable income,
encourage physicians to keep people well
through preventive care, eliminate the
financial incentive to provide services
that will not benefit the patient and
reduce paperwork.
Cigna may also work with third parties
that provide network management
services. Under these arrangements,
Cigna pays the third party a fixed
monthly amount per individual for these
services. Health care professionals
are compensated by the third party
for services provided to Cigna plan
participants from the fixed amount.
Compensation arrangements are agreed
upon by the third parties and their
contracted health care professionals, and
may include discounted fee for service
and capitation.
Some health care professionals and third
parties that provide network management
services may participate in a risk-sharing
arrangement with Cigna; they agree on
a target amount for the cost of certain
services and share all or some of the
amount by which costs are over or under
the target. Services are monitored using
criteria that may include accessibility,
quality of care, customer satisfaction
and appropriate and cost-effective use of
medical services and supplies.
SALARY:
Physicians and other health care
professionals who are employed to work
in Cigna’s Arizona staff-model medical
facility are paid a salary. The salary is
decided in advance each year and is
guaranteed regardless of the services
provided. Physicians are eligible for a
bonus at the end of the year based on
performance, which is evaluated using
criteria that may include quality of care,
quality of service and appropriate and
cost-effective use of medical services and
supplies.
BONUSES AND INCENTIVES:
Some health care professionals may
receive additional payments based on
their performance, which is measured
using criteria that may include quality of
care, quality of service and appropriate
and cost-effective use of medical services
and supplies. Health care professionals
may also receive financial and/or
nonfinancial incentives that promote
utilization of cost-effective participating
health care professionals (such as
hospitals, labs, specialists and vendors)
and covered drugs and supplies.
PER DIEM:
A specific amount is paid to a hospital
per day for all health care received. The
per diem payment may vary by type
of service and length of stay and the
payment may in some cases be greater
than the hospital’s normal billed charges.
CASE RATE:
A specific amount is paid for all health
care received in the hospital for a given
hospital stay (such as for a normal
maternity delivery).
If you would like to find out which
compensation method applies to
services you receive from a health
care professional, just ask the doctor’s
administrative staff. Cigna Customer
Service is available to help with general
questions at the toll-free telephone
number on your Cigna ID card.
Contact this candidate