Blue Cross Medicare Advantage (HMO/HMO …

1 Y0096_BEN_TMP_MAPRDIRCVR14a Approved Cross Medicare Advantage (HMO/HMO-POS)SM2014 Provider DirectoryJanuary 1, 2014 - December 31, 2014 Last updated 04/14 HCSC is a Medicare Advantage organization with a Medicare contract. Enrollment in HCSC s plans depends on contract renewal. This information is available for free in other languages. Please call our Customer Service number at 1-877-774-8592 (TTY/TDD users should call 711). We are open between 8 and 8 , local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and informaci n est disponible en otros idiomas de forma gratuita. Comun quese a nuestro n mero de Servicio al cliente al 1-877-774-8592 (los usuarios de TTY/TDD deben llamar al 711). Nuestro horario es de 8 a 8 , hora local, los 7 d as de la semana.

2 Si usted llama del 15 de febrero al 30 de septiembre, durante los fines de semana y feriados, se usar n tecnolog as alternas (por ejemplo, correo de voz). Y0096_BEN_IL_HMOPRDR14 Accepted directory provides a list of blue Cross Medicare Advantage sSM network directory is for the entire blue Cross Medicare Advantage provider network offered to people that are Medicare eligibles and residing in Cook, DuPage, Kane and Will directory is current as of April 2014. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about blue Cross Medicare Advantage s network providers in your area, you can visit or call our Customer Service Department at 1-877-774-8592. We are open between 8 and 8 , local time, 7 days a week.

3 If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on the weekends and holidays. TTY/TDD users should call: Cross Medicare Advantage (HMO/HMO-POS)SM PlanProvider DirectorySection 1 IntroductionThis directory provides a list of blue Cross Medicare Advantage s (HMO/HMO-POS) network providers. To get detailed information about your health care coverage, please see your Evidence of you join the blue Cross Medicare Advantage Basic (HMO) Plan, you will have to choose one of our network providers who are listed in this directory to be your Primary Care Physician/Provider (PCP). The term PCP will be used throughout this directory . Generally, you must get your health care coverage from your PCP. It is not required but recommended that you select a PCP if you join the blue Cross Medicare Advantage Basic Plus (HMO-POS) Plan or blue Cross Medicare Advantage Premier Plus (HMO-POS) PCP is a doctor who is a family practitioner, internist or geriatric physician.

4 The PCP is trained to provide general medical care. The PCP you select provides or manages your health care. The PCP also helps you make informed decisions about your care. When necessary the PCP makes referrals to specialists, generally within your medical group network . The network providers listed in this directory have agreed to provide you with your health care coverage. You may go to any of our network providers listed in this directory ; however, some services may require a referral. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non- network providers. If you require medical care beyond the scope of your PCP, the PCP will coordinate with providers most appropriate to render the medical treatment. It is important to note that the PCP belongs to a network .

5 The PCP has certain network specialists and hospitals that they use for coordinated specialty, diagnostic and hospital medical care. The specialist and hospitals that the PCP may refer you to will be within the PCP network may be financially responsible to pay for some or possibly all services if you choose to go to a doctor outside of your affiliated medical group without authorization from your PCP. Your PCP will coordinate the authorization process. If you are traveling and are out of the blue Cross Medicare Advantage Basic (HMO) Plan, blue Cross Medicare Advantage Basic Plus (HMO-POS) Plan or blue Cross Medicare Advantage Premier Plus (HMO-POS) Plan service area and need urgent care or emergency care, you should go to the nearest provider to seek care. You do not need prior authorization to seek medical help in an urgent or emergency situation.

6 The physician treating your emergency needs will discuss your condition with your Primary Care Physician. When your condition is stable the physicians will coordinate the transfer of your care back to your Primary Care Physician you enroll in blue Cross Medicare Advantage Basic Plus (HMO-POS) Plan or blue Cross Medicare Advantage Premier Plus (HMO-POS) Plan, you are not required to pay an out-of- network provider more than what the provider is allowed by Medicare . Ask the out-of- network provider to bill us first. If you pay for services that are covered and in benefit for your plan, we will reimburse you for our share of the cost. If you get a bill from the provider, you can send the bill to us for consideration of benefits at the above address. If the services are considered covered and in benefit for your plan, we will reimburse the out-of- network provider and you will be informed of your financial an out-of- network provider asks you to pay for covered services you receive, please call Customer Service at 1-877-774-8592 or send the bill(s) with a note explaining the situation to: blue Cross Medicare Box 805107 Chicago, IL 60680 You must use plan providers except in emergency or urgent care situations.

7 If you obtain routine care from out-of- network providers neither Medicare nor blue Cross Medicare Advantage will be responsible for the may receive covered urgent or emergency medical care whenever you need it. You are covered for emergency care worldwide. Our plan covers ambulance services in situations where getting to the emergency room in any other way could endanger your health after your co-pay. If your emergency care is provided by out-of- network providers, we will try to arrange for network providers to take over your care as soon as your medical condition and the circumstances is the service area for blue Cross Medicare Advantage ?The counties for the State of Illinois in our service area are listed below. Cook DuPage Kane WillHow do you find blue Cross Medicare Advantage providers in your area? The directory includes hospitals, physicians and other providers participating in the blue Cross Medicare Advantage Basic (HMO) Plan, blue Cross Medicare Advantage Basic Plus (HMO-POS) Plan or blue Cross Medicare Advantage Premier Plus (HMO-POS) Plan.

8 Please refer to the Table of Contents for section names. Each section is organized alphabetically by each city, the city and/or physician names are listed in alphabetical order along with the address and phone number. For the most updated blue Cross Medicare Advantage provider information, please visit our Provider Finder at While every provider listed in this directory is affiliated with or employed by a contracting medical group, not every provider listed will be accepting new patients. Although blue Cross Medicare Advantage has identified those providers who were not accepting patients at the time this directory was created, the status of any physicians practice may have changed. For the most current information regarding the status of any physician s practice, please contact either the physician or the medical group you have selected at the phone number listed in this ensure that you are comfortable with your choice of doctors, you may change your medical group or PCP for any reason.

9 To change to another PCP, simply call the blue Cross Medicare Advantage Plan at 1-877-774-8592. You can begin to see your new PCP the first of the following month of your request. A change of PCP cannot be retroactive. If you have questions about blue Cross Medicare Advantage or require assistance in selecting a PCP, please call our Customer Service Department at 1-877-774-8592, 8 - 8 , local time, 7 days a week. If you are calling from February 15 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays. TTY/TDD users should call 711. Or, visit COUNTYINTERNAL MEDICINEuKagzi, Mohammad W MDVPCP# 0030440420175 Cadillac CTSte 2 Belvidere, IL 61008(847) 984-2917 Medical Group: AdvocateCondell Physician PrtnrsLanguage: Hindi, UrduBOONE COUNTYBELVIDEREP rimary Care PhysiciansBELVIDERE1uBoard Certified in Listed Care Physician COUNTYFAMILY PRACTICEuBalagani, Radha K MDVPCP# 0098344002825 E Golf Rd2nd FlArlington Heights, IL 60005(847) 640-9180 Medical Group: AdvocateLutheran Gen Phys PrtnrsLanguage: Hindi, Persian, TeluguCastaldi, Adele DOVPCP# 0098343549825 E Golf Rd2nd FlArlington Heights, IL 60005(847) 640-9180 Medical Group: AdvocateLutheran Gen Phys PrtnrsLanguage: ItalianCrystal, Nurit MDVPCP# 00982490101700 W Central RdSuite 140 Arlington Heights, IL 60005(847) 259-6200 Medical Group: NorthwestCommunity Hlth PartnersLanguage.

10 HebrewuEkeberg, James G MDVPCP# 00982492031700 W Central RdSte 140 Arlington Heights, IL 60005(847) 259-6200 Medical Group: NorthwestCommunity Hlth PartnersuHartl, Erica E MDVPCP# 0098344625825 East Golf Rd2 Nd FlrArlington Heights, IL 60005(847) 640-9180 Medical Group: AdvocateLutheran Gen Phys PrtnrsuHennegan, Ena E DOVPCP# 00982490211700 W Central RdSte 140 Arlington Heights, IL 60005(847) 259-6200 Medical Group: NorthwestCommunity Hlth PartnersJurkonie, Michelle DOVPCP# 00984492371538 N Arlington Heights RdArlington Heights, IL 60004(847) 253-6464 Medical Group: NorthwestCommunity Hlth PartnersuLightfoot, John D MDVPCP# 00982492201700 W Central RdSte 140 Arlington Heights, IL 60005(847) 259-6200 Medical Group: NorthwestCommunity Hlth PartnersuLindsay, Gregory J MDVPCP# 00982488721051 W Rand RdArlington Heights, IL 60004(847) 342-8220 Medical Group: NorthwestCommunity Hlth PartnersuMarch, Anthony DOVPCP# 0098344489825 E Golf Rd2nd FlArlington Heights, IL 60005(847) 640-9180 Medical Group: AdvocateLutheran Gen Phys PrtnrsuNovota, Peter A MDVPCP# 0098343972675 W Central RdSte 101 Arlington Heights, IL 60005(847) 342-1554 Medical Group: AdvocateLutheran Gen Phys PrtnrsLanguage: SpanishuStefaniuk, Mark A MDVPCP# 00982490271051 W Rand RdArlington Heights, IL 60004(847) 618-5450 Medical Group: NorthwestCommunity Hlth PartnersLanguage: Spanish, UkrainianINTERNAL MEDICINEuAhn, Chong H MDVPCP# 00982491211430 N Arlington Hts RdSte 104 Arlington Heights, IL 60004(847) 253-5985 Medical Group.