Directory / Directorio - Aetna

1 Directory / DirectorioPhysicians, Hospitals and Other Health Care ProfessionalsM dicos, hospitales y otros profesionales de la saludThis Directory lists participating health careprofessionals for the following benefits plan:Este Directorio incluye a los profesionales dela salud participantes del siguiente plan debeneficios: Aetna Illinois Community PlanSM(Plan comunitaro de Aetnapara Illinois)ChicagoCurrent Directory information availableon DocFind at n actual del directoriodisponible en DocFind 11/6/2008 9:45 AM Page 3 Many health care professionals listed in this Directory are accepting new patients. There may be others who are accepting existing patients only. Please call provider to profesionales de la salud incluidos en este Directorio est n aceptando pacientes haber otros que est n aceptando s lo a pacientes existentes.

2 Por favor llame al proveedor para 11/6/2008 9:45 AM Page 4 Table of ContentsTier 1 - Community NetworkImportant Disclosure Information ..IIIS panish Version ..XXVP articipating Hospitals ..4 Institutes of Excellence Transplant Facilities ..8 Institutes of Excellence Pediatric Congenital Heart Surgery Facilities ..22 Nationally Contracted Walk-In Clinics ..24 Primary Care Physicians ..40 Obstetricians and Gynecologists / Women's Health Specialists ..90 Specialists ..104 Behavioral Health Providers ..200 Other Participating Providers ..240 Index of Providers Speaking Additional Languages ..248 Index of Providers ..260 Tier 2 - Managed Choice NetworkImportant Disclosure Information ..IIIS panish Version ..XXVP articipating Hospitals ..284 Institutes of Excellence Transplant Facilities.

3 288 Institutes of Excellence Pediatric Congenital Heart Surgery Facilities ..302 Nationally Contracted Walk-In Clinics ..304 Primary Care Physicians ..320 Obstetricians and Gynecologists / Women's Health Specialists ..410 Specialists ..434 Behavioral Health Providers ..654 Other Participating Providers ..664 Index of Providers Speaking Additional Languages ..674 Index of Providers ..688 Health benefits and health insurance plans are underwritten or administered by Aetna Life Insurance up-to-date listings, visit our DocFind online provider Directory Contact Member Services either online or at the toll-free numberon your ID card with questions about selecting or changing a provider or 11/6/2008 9:46 AM Page 11/6/2008 9:46 AM Page IIPlan of BenefitsYour plan of benefits will be determined by your plansponsor, while the plan itself is underwritten oradministered by Aetna Life Insurance Company, 151 Farmington Avenue, Hartford, CT 06156, services include most types of treatment providedby primary care physicians, specialists and , the health plan does exclude and/or includelimits on coverage for some services, including but notlimited to, cosmetic surgery and experimental addition, in order to be covered, all services, includingthe location (type of facility), duration and costs of services,must be medically necessary as defined below and asdetermined by Aetna *.

4 The information that followsprovides general information regarding Aetna health a complete description of the benefits available to you,including procedures, exclusions and limitations, refer toyour specific plan documents, which may include theGroup Agreement, Group Insurance Certificate, GroupPolicy and any applicable riders and amendments to Copays and DeductiblesYour plan of benefits may contain some or all of thefollowing features: Copayments or Coinsurance - These are fees that youmust pay for some covered medical expenses. Calendar Year Deductible - The amount of coveredmedical expenses you pay each calendar year beforebenefits are paid. There is a calendar year deductiblethat applies to each person. Inpatient Hospital Deductible - The amount of coveredinpatient hospital expenses you pay for each hospitalconfinement before benefits are paid.

5 Emergency Room Deductible - A separate hospitalemergency room deductible applies to each visit by aperson to a hospital emergency room unless the personis admitted to the hospital as an inpatient within 24hours after a visit to a hospital emergency applicability and amount of each copay and deductiblelisted above will be determined by your plan sponsor anddescribed in your plan of Primary Care Physicians ("PCPs")For some plans, you are required or encouraged to select aPCP who participates in the network. The PCP can provideprimary health care services as well as coordinate youroverall care. You should consult with your PCP when youare sick or injured to help determine the care that isneeded. Under Elect Choice EPO and Managed Choice ,your PCP should issue referrals to participating specialistsand facilities for certain some services, the PCP is required to obtain priorauthorization from Aetna .

6 Under Elect Choice, except forthose benefits described in the plan documents as directaccess benefits or in an emergency, you will need to obtaina referral authorization ("referral") from your PCP beforeseeking covered nonemergency specialty or hospital Disclosure InformationIIIFor Managed Choice , Elect Choice , Open Choice and Aetna Open Access mandates do not apply to self-funded plans governed by ERISA. If you are unsure if your plan is self-funded and/or governed by ERISA, please confer with your benefitsadministrator. Specific plan documents supersede general disclosures contained within, as members with the Student Accident and Sickness plan please access website for questions or call Chickering at the 800 number on your ID card. For appeals please forward your request to Chickering Claims Administrators, Inc.

7 , Box 15717, Boston, MA 02215-0014. The Student Accident and Sickness plan isadministered by The Chickering Group, an Aetna company.** The Chickering Group refers to an internal business unit of Chickering Claims Administrators, Inc. The Student Plan is underwritten by Aetna Life Insurance Company and administered by Chickering Claims Administrators, Inc.* Aetna is the brand name used for products and services provided by oneor more of the Aetna group of subsidiary (10/08) 11/6/2008 9:46 AM Page IIIU nder Managed Choice, Open Choice PPO and AetnaOpen Access Managed Choice you may go directly to aprovider or facility for covered services, you will generallybe responsible for a deductible and coinsurance in thesecircumstances. Even so, you may be able to reduce yourout-of-pocket expenses considerably by using theparticipating providers listed in the Provider , under Aetna Open Access Managed Choiceand Aetna Open Access Elect Choice you may go directlyto a participating specialist without a referral from yourPCP, and pay the applicable copay.

8 Please refer to yourplan documents for PolicyIf your plan requires referrals to obtain maximum benefits,the following points are important to remember: The referral is how your PCP arranges for you to becovered for necessary, appropriate specialty care andfollow-up treatment. You should discuss the referral with your PCP tounderstand what specialist services are beingrecommended and why. If the specialist recommends any additional treatmentsor tests that are covered services, you may need to getanother referral from your PCP prior to receiving theservices. If you do not get another referral for theseservices, you may be responsible for payment. Except in emergencies, all hospital admissions andoutpatient surgery require a prior referral from your PCPand prior approval by Aetna .

9 If it is not an emergency and you go to a doctor orfacility without a referral, you must pay the bill. Referrals are valid for one year as long as you remain aneligible member of the plan; the first visit must bewithin 90 days of referral issue date. Under Elect Choice, coverage for services fromnonparticipating providers requires prior approval byAetna in addition to a special nonparticipating referralfrom your PCP. When properly authorized, theseservices are fully covered, less the applicable copay. The referral provides that, except for applicable copay,you will not have to pay the charges for coveredservices, as long as you are a member at the time theservices are provided. If your plan does not specifically cover nonpreferredbenefits and you go directly to a specialist or hospitalfor nonemergency or nonurgent care without a referral,you must pay the bill yourself unless the service isspecifically identified as a direct access benefit in yourplan Access Ob/Gyn ProgramThis program allows female members to visit anyparticipating obstetrician or gynecologist for a routine wellwoman exam, including a Pap smear, and for obstetric orgynecologic problems.

10 Obstetricians and gynecologists mayalso refer a woman directly to other participating providersfor covered obstetric or gynecologic services. All healthplan preauthorization and coordination requirementscontinue to apply. If your Ob/Gyn is part of anIndependent Practice Association (IPA), a Physician MedicalGroup (PMG), an Integrated Delivery System (IDS) or asimilar organization, your care must be coordinatedthrough the IPA, the PMG or similar organization and theorganization may have different referral Care Provider NetworkAll hospitals may not be considered participating for allservices. Your physician can contact Aetna to identify aparticipating facility for your specific needs. Certain PCPsare affiliated with integrated delivery systems, independentpractice associations ("IPAs") or other provider groups, ifyou select these PCPs you will generally be referred tospecialists and hospitals within that system, association orgroup ( organization ).