Aetna PPO Network for HCA-Affiliated Employees Enrolled in the Smart Care PPO Plan
PLEASE READ FIRST BEFORE SELECTING AN AETNA NETWORK PROVIDER
In order to receive the highest level of benefits,
employees of HCA affiliates enrolled in Smart Care must
utilize HCA-affiliated facilities and Aetna PPO Network
physicians. NOTE: Not all physicians contained in this
directory are associated with or have admitting privileges to
HCA-affiliated facilities. Employees and their dependents
should confirm with the Aetna PPO network physician prior to
their appointment if they are taking new patients and if they
have admitting privileges to an HCA affiliate when inpatient
and outpatient services are anticipated.
If your physician refers you for services outside of their
office setting for physical therapy, lab or x-rays, e.g., it's
important you use an HCA-affiliated facility if available to
receive the highest level of benefit.
THE SMART CARE PPO PLAN RECOGNIZES ONLY HCA-AFFILIATED
FACILITIES FOR THE HIGHEST PAYABLE BENEFIT LEVELS.
This directory also includes a comprehensive listing of
Aetna PPO network facilities; however, not all facilities
listed are HCA affiliates. To determine if medically necessary
services are available at an HCA affiliate, participants must
call Aetna Member Services. If Aetna determines that medically
necessary services are unavailable at an HCA affiliate,
participants must utilize an Aetna PPO network facility to
avoid penalties. If those services are received from an Aetna
facility, participants will receive a discounted rate. If care
is not received at an HCA affiliate or Aetna PPO network
facility when it was available, penalties will apply. Please
refer to LifeTimes Benefits Choices Summary Plan Description
for a detailed plan of benefits. All medical claims and/or
benefit-related questions should be submitted to:
Aetna
P.O. Box 14079
Lexington, KY 40512
(800) 222-9215
Member Services Representatives are available
from 7 a.m. to 5 p.m. Central, Monday-Friday
To begin a provider search, click on the Enter DocFind
button below, and follow the screen prompts. If you have any
questions about which plan you are eligible to enroll in,
please contact your local HR/Benefits representative.
Behavioral Health Providers
Behavioral health providers are not included in the Aetna
PPO network for Smart Care plan participants. The behavioral
health plan is administered by ValueOptions. All services for
mental health and/or chemical dependency treatment or services
must be pre-certified in advance. Eligible providers are
defined as licensed psychiatrists, licensed clinical
psychologists, licensed or certified master's level clinical
social workers, licensed or certified masters level
psychiatric nurse specialists, or licensed professional
counselors in the ValueOptions network. For more information
about behavioral health benefits, contact ValueOptions at
800.434.5100.
Directory Disclaimer
This Directory does not constitute a recommendation of any
hospital, physician or other health care provider. The
providers listed are independent contractors and Aetna is not
responsible for health care provided or the omission of health
care by these providers. While this listing of providers is
complete as of it's printing, it is subject to change.
This Directory does not guarantee that all services or all
providers will be covered under your health care plan. You
must consult your employee benefits handbook, "A Guide To Your
Benefits: Benefit Choices," as well as the medical claims
administrator listed above to determine what type of providers
and services are covered. Failure to refer to these resources
may result in lesser reimbursement for certain medical
expenses.
Verification of Aetna PPO Physicians and
Facility Network Providers
In addition to this directory, employees and their
dependents can verify if a particular physician is in the
Aetna PPO network by calling HCA's dedicated Member Services
Representatives at 800.222.9215.
October 2004
The data on this web site is for informational purposes only. For
additional information about your Aetna health plan, including
benefits coverage, please refer to the employee booklet available
from your employer.
Important information for DocFind users who live in California, Massachusetts, Texas or Washington.
Terms of Use: By using DocFind, you acknowledge and agree that DocFind and all of the data contained in DocFind belongs exclusively to Aetna Inc. and is protected by copyright and other law. DocFind is provided solely for the personal, non-commercial use of current and prospective Aetna members and providers. Use of any robot, spider or other intelligent agent to copy content from DocFind, extract any portion of it or otherwise cause DocFind to be burdened with unwarranted high access or transaction activity is strictly prohibited. Aetna reserves all rights to take appropriate civil, criminal or injunctive action to enforce these terms of use.
DocFind is updated three times a week. Updated information appears every Monday, Wednesday and Friday morning. Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. Notice of the change shall be provided in accordance with applicable state law.