MERCY MEDICAL CENTER MANAGED CARE CONTRACTS

IMPORTANT NOTE:

Managed Care Companies require pre-certification by the physician for all Hospital elective inpatient admissions and outpatient procedures inclusive of PAT.  All emergency treatments and admissions require notification within 24 hours post services.  Failure to notify a managed care company will result in a denial of payment.

CONTRACT NAME        

Aetna USHC (HMO/POS/PPO/Medicare)

America’s Health Plan (PPO) (Merged with UPUP)

American Medical & Life Insurance Co. (PPO)

Anthem Health Plan (PPO)

Bayley Seton (Uniformed Services Family Health Plan)

- MedSolutions (Radiology vendor for Bayley Seton)

- OrthoNet (P/T vendor for Bayley Seton)

Benefice Health LLC

Better Health Advantage (PPO)

Beech Street (PPO)

Cigna Healthcare of NY (HMO, Medicare, PPO)

CMS Care of NY

Community Care Network (CCN-PPO)

Diocesan Health Plan (PPO)

Empire Blue Cross and Blue Shield

- Blue Choice (HMO)

- Empire B/C & B/S (Indemnity, POS, PPO)

- Empire B/C Senior Plan

Fidelis (HMO Medicaid) (Fidelis now owns Better Health Plan)

- Child Health Plus

- TenderCare

First Choice Network (PPO)

GENESIS (HMO / Medicaid only)

GHI  (Flex Select, HMO, PPO)

Health Net (a/k/a Physician Health Services) (PPO, HMO)

HIP (HMO, POS, & Medicare)

Horizon Healthcare  (PPO, HMO)

Island Group Administration, Inc. (PPO)

Local 1199 / 1199 National Benefit Fund (PPO)

Magna Direct Plus

MagnaHealth (HMO)

MagnaPreferred (PPO)

Managed Care Inc. (PPO)

MDNY HealthCare (Medicaid HMO / POS / PPO & Value)

MediChoice (PPO)

MediGroup (PPO)

Merit Behavioral Care (HMO/Mental Health)

MultiPlan (PPO)

National Health Plan (PPO)

National Preferred Providers Network (PPO)

Oxford Health Plans (HMO, POS)

Oxford Liberty (HMO & Freedom HMO

Private HealthCare System (PPO)

ProAmerica (PPO)

Shepard Pratt (HMO/Mental Health)

United Healthcare (Medicaid HMO, Indemnity, PPO & POS)

United Payers/United Providers (PPO)

Value Behavioral Health/Value Options  (HMO/Mental Health)

Vytra Health Plans (HMO, PPO)

MANAGED CARE COMPANIES CURRENTLY NOT CONTRACTED:

Consumer Health Network (CHN) ~~~  Terminated as of 5/02/02

Oxford Health Plans (Managed Medicare)  ~~~  Terminated

Note: Oxford Health Plans not contracted in Nassau & SuffolkCounties.  
Contracted for members living in NYC and the 5 Boroughs.