OPEN ACCESS PLUS - Miami-Dade County Public Schools

1 open ACCESS PLUSOPEN ACCESS PLUS IN-NETWORKCIGNA Care Network Important plan information for:Broward, Charlotte, Collier, Dade, Hardee, Hendry, Highlands, Lee, Martin,Monroe, Okeechobee, Palm Beach, Sarasota and St Lucie CountiesContentsFall 2009 Introduction3 CIGNA LIFESOURCE Transplant Network 5 Provider Compensation7 Service Area8 How to Read the Physician Listing9 Primary Care Physicians10 Obstetricians/Gynecologists75 Specialists89 Hospitals220 Mental Health / Substance Abuse222 Pharmacies251 Vision Care Providers255 Other create chooseyour guidecan WE ARE CIGNA strives to keep the workforce of its customer companies - and CIGNA sown workforce - healthy and productive. We are committed to giving you accessto technology, information and support in reaching health care decisions. We are where you are. CIGNA HealthCare has a national presence, but we alsohave a local focus in most areas.

2 This means local medical directors and healthservices representatives work to provide you with ACCESS to quality YOU CAN EXPECT Convenient ACCESS to quality health care. Before joining the CIGNAH ealthCare network of contracted physicians, doctors must meet CIGNAH ealthCare standards through a process called credentialing. We regularlyreview physicians credentials to help ensure they continue to meet thesestandards. Responsive customer service. Whether on our Web site, , byphone when you talk to a representative or through our automated telephonesystem, you have easy ACCESS to consistent, accurate, and timely informationabout your plan when it s convenient for THIS DIRECTORYThe following pages list the doctors and other health care providers in this area whoparticipate in the CIGNA HealthCare network. An updated listing of participatingproviders is always available at You can use our online directoryto: search for participating physicians, hospitals and providers.

3 Download your own personalized provider directory to have on hand when youneed it. find hospital scores for specific conditions/procedures through CIGNA Centersof Excellence. The online provider directory is updated often, so visit it often. For moreinformation, please visit or call CIGNA HealthCare CustomerService at the toll-free number on your CIGNA HealthCare ID serve asa source foradvice to search for participating providers, findinformation on preventive care and other health topics, andlearn more about your plan s benefits and WITH YOUR DOCTORWe encourage you to choose a primary care physician (PCP) to be your personalphysician. Your personal physician can serve as a home base for basic care your sourcefor advice and direction. Your personal physician also coordinates your care - from preventive checkupsand routine medical care to specialized care and SUMMARY OF BENEFITSYour Summary of Benefits gives you important information on the medical benefitsand other types of services your plan covers.

4 You should read your Summary ofBenefits to determine whether you have prescription drug coverage, coverage formental health and substance abuse, and/or vision care coverage as a part of yourCIGNA HealthCare listing of a provider in this directory does not guarantee that the services rendered bythat provider are covered under your specific medical plan. Check the materials whichdescribe your particular plan benefits, or call CIGNA Member Services, for informationabout the services covered under your plan benefits. If you have questions or needassistance, please contact Member Services at the toll-free telephone number listed in yourenrollment materials or on your CIGNA identification LIFESOURCE Transplant NetworkRespectedhospitals andmedicalcentersthroughoutthe LIFESOURCET ransplant Network As a CIGNA HealthCare member, you have ACCESS to the CIGNALIFESOURCE Transplant Network , a network of participating organ andtissue transplant centers.

5 Developed by a team of CIGNA HealthCare clinicalprofessionals, the transplant network includes respected hospitals and medicalcenters throughout the transplant facility is evaluated for favorable rates of patient outcomes,support services and patient friendly environments before it is included in theCIGNA LIFESOURCE Transplant LIFESOURCE participants are managed by our comprehensivetransplant case management unit. This unit consists of registered nurses withclinical experience in transplant, hematology/oncology, home health care,dialysis, critical care and/or community care. They are specially trained tomanage complex transplant comprehensive transplant case management unit offers the followingbenefits: Clinical partnership with providers Consistency in service and benefit administration Dedicated resources for complex areas of medicine Advocacy Administrative efficiencyIn some instances a travel reimbursement is offered as a feature of the be aware that most of these expenses are considered taxable a CIGNA HealthCare member, you can have ACCESS to these services whenthey are coordinated through your physician and your transplant case may not receive the in-network level of benefits for all types oftransplants at all facilities.

6 In addition, our network of facilities changesfrequently. For the most current listings with the programs covered at thein-network benefit level, please visit or callCIGNA LIFESOURCE Member Services at all CIGNA LIFESOURCE Transplant Network facilities are available tomembers in all plans. Please call Member Services at for moreinformation. If you are already in transplant case management, please call yourcase manager LIFESOURCE Transplant NetworkAlabamaUniversity of Alabamaat BirminghamMedical CenterArizonaBanner GoodSamaritan andGood SamaritanCity of HopeMayo Clinic ScottsdaleUniversity of ArizonaHealth SciencesCenterCaliforniaCalifornia PacificMedical CenterCedars-Sinai MedicalCenterChildren s HospitalLos AngelesChildren s HospitalOaklandChildren s Hospital ofOrange CountyCity of Hope NationalMedical CenterLoma Linda UniversityMedical CenterLucile Salter PackardChildren's HospitalSharp MemorialHospitalStanford UniversityMedical CenterUC Davis MedicalCenterUCLA Medical CenterUCSD Medical CenterUCSF Medical CenterUSC UniversityHospitalColoradoChildren s Hospital ofDenverPorter AdventistHospitalPresbyterian St.

7 Luke'sMedical CenterUniversity of ColoradoHospitalConnecticutYale-New HavenHospitalDelawareAlfred I. duPontHospital forChildren (Nemours)District ofColumbiaGeorgetown UniversityHospitalWashington HospitalCenterFloridaAll Children s HospitalFlorida HospitalH. Lee Moffitt CancerCenterMayo ClinicJacksonvilleShands HospitalTampa GeneralHospitalUniversity of MiamiJackson MemorialHospitalGeorgiaEmory UniversityHospitalNorthside Hospital/TheBlood and MarrowTransplant Groupof GeorgiaPiedmont HospitalIllinoisChildren s MemorialHospitalNorthwesternMemorial HospitalRush UniversityMedical CenterUniversity of ChicagoMedical Center andWyler Children'sHospitalIndianaClarian Health -Indiana UniversityHospitalClarian Health -Methodist HospitalClarian Health - RileyChildren's HospitalIndiana Blood andMarrow GroupKentuckyJewish HospitalLouisianaOchsner ClinicFoundationTulane UniversityHospital and ClinicMaineMaine Medical CenterMarylandJohns Hopkins HealthSystemUniversity of MarylandMedical CenterMassachusettsBrigham and Women sHospital and Dana-Farber CancerInstituteChildren s HospitalBostonChildren s HospitalBoston and Dana-Farber

8 CancerInstituteLahey Clinic MedicalCenterMassachusetts GeneralHospital and Dana-Farber CancerInstituteTufts - New EnglandMedical CenterUniversity ofMassachusettsMedical CenterMichiganHenry Ford HealthSystemKarmanos CancerCenterMinnesotaMayo Clinic RochesterMissouriBarnes Jewish HospitalChildren s MercyHospitalSt. Louis Children'sHospitalSaint Louis UniversityHospitalNebraskaThe Nebraska MedicalCenterNew JerseyHackensack UniversityMedical CenterNewark Beth IsraelMedical CenterRobert Wood JohnsonUniversity HospitalSt. Barnabas MedicalCenterNew YorkMemorial Sloan-Kettering CancerCenterMt. Sinai MedicalCenterNew York PresbyterianHospitalNew York UniversityMedical CenterNorth CarolinaCarolinas MedicalCenterUniversity of NorthCarolina HospitalsOhioArthur G. JamesCancer HospitalChildren's HospitalMedical CenterChrist HospitalCleveland ClinicFoundationNationwide Children sHospitalOhio State UniversityMedical CenterUniversity HospitalUniversity Hospitals ofClevelandOregonLegacy GoodSamaritan Hospitaland Medical CenterOregon Health &Science UniversityPennsylvaniaChildren s Hospital ofPittsburghTemple UniversityHealth SystemThomas JeffersonUniversity HospitalUniversity ofPennsylvaniaHealth SystemUPMC PresbyterianShadyside HospitalSouth CarolinaMedical University ofSouth CarolinaMedical CenterTennesseeMethodist UniversityHospitalSt.

9 Jude Children sResearch HospitalVanderbilt UniversityMedical CenterTexasChildren s MedicalCenter of DallasCook Children'sMedical CenterMedical City DallasHospitalMemorial HermannHospitalMethodist DallasMedical CenterTexas Children'sHospitalTexas TransplantInstituteThe Methodist HospitalUniversity of TexasMD AndersonCancer CenterUniversity of TexasSouthwestern HospitalUtahUniversity of UtahHospitalVirginiaMedical College ofVirginia HospitalsSentara NorfolkGeneral HospitalUniversity of VirginiaHospitalWisconsinChildren's Hospital ofWisconsinSt. Luke s MedicalCenter7 Provider CompensationProvider CompensationCIGNA HealthCare is committed tokeeping you informed about mattersrelated to your health care plan. For thatreason, we offer the followingdescription of the way that CIGNAH ealthCare compensates health careproviders (physicians, hospitals andother health care practitioners andfacilities) that participate in HealthCare compensates healthcare providers in ways that are intendedto emphasize preventive care, promotequality care and ensure the appropriateand cost-effective use of coveredmedical services and supplies.

10 CIGNAH ealthCare reinforces this philosophythrough utilization managementdecisions made by its medical directorsand medical management staff. CIGNAH ealthCare employees are encouraged topromote appropriate utilization ofcovered health care services and todiscourage methods by which participatinghealth care providers agree to becompensated are described generallyhere. The amount and type ofcompensation a health care provideragrees to accept may vary dependingupon the type of plan. For example, ahospital may agree to accept less forservices provided to patients enrolled inan HMO plan than to patients enrolled inother types of plans. In addition, CIGNAH ealthCare may attempt in various waysto promote the use of participatingproviders based upon quality and cost-effectiveness measures while assuringquality and ACCESS to covered servicesand FEE FORSERVICE:Payment for services is based on anagreed-upon discounted amount from thehealth care provider s :By mutual agreement, networkphysicians, physician/hospitalorganizations (PHOs) or other providergroups are paid a fixed amount(capitation) at regular intervals for eachmember assigned to the physician, PHOor other provider group, whether or notservices are provided.