Transcription
Provider InformationalGuide Booklet(Updated 7-25-16)1
TABLE OF CONTENTSVendor List.Aetna .Blue Cross Blue Shield . . .CIGNA-HealthSpring . . .County Care . . .FHN / CCAI . . .Harmony . . .Health Alliance . . .Humana . . .Illini Care . . .Meridian . . .Molina Healthcare . . .NextLevel Health . . .Provider Relations ContactsAetnaBlue Cross Blue ShieldCIGNA-HealthSpringCounty CareFHN / CCAIHarmonyHealth AllianceHumanaIllini CareMeridianMolina HealthcareNextLevel Health3-16345-678-910111213-14151617. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18-35 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1819-2021-2223242526272829-3233-3435CAQH Education Guide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36-38ICD-10 Links. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39Prior Authorization Links. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40Provider Manual Links. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412
Vendor List - Aetna Better Health of IllinoisBehavioral HealthContact information for point of contact (internal or external)NameSue StrangeKaren WhitePhone Number312-821-0514312-821-0680Email AddressStangeS@aetna.comWhiteK1@aetna.comTerriana Clark630-737-6462ClarkT9@aetna.comDentalContact information for point of contact (internal or external)NameBetty IrvingDavid ThielemierPhone Number312-821-6503314-221-2394Email t.comLong Term CareContact information for point of contact (internal or external)NameNicole SunderMagali DurePhone Number312-821-0487312-821-0633Email calsContact information for point of contact (internal or external) FHP & ICPNameAlisha Sellers, Pharm DBruce Himelstein, MDPhone Number602-616-1277312-928-3094Email AddressSellersA@aetna.comHimelsteinB@aetna.comFor MMAI DUALS PharmacyNameKathy LojkovicPhone Number224-281-2690Email addressLojkovick@aetna.comTransportationContact information for point of contact (internal or external)NameBetty IrvingHenry GrahamPhone Number312-821-6503314-662-0880Email ontact information for point of contact (internal or external)NameBetty IrvingHeather RagusaPhone Number312-821-6503888-493-4070 x2455Email m3
Vendor List - BlueCross BlueShield of IllinoisBehavioral HealthIf there is a concern should the provider contact the health plan or the vendor?BlueCross BlueShield of Illinois (no vendor)Derek Punzalan312.653.6916derek punzalan@bcbsil.comDentalIf there is a concern should the provider contact the health plan or the vendor?DentaquestSuzanne t.comLong Term CareIf there is a concern should the provider contact the health plan or the vendor?BlueCross BlueShield of Illinois (no vendor)Sherry f there is a concern should the provider contact the health plan or the vendor?Prime TherapeuticsJohn harmacies should call:TransportationIf there is a concern should the provider contact the health plan or the vendor?MTMHenry Graham636.695.5652www.mtm-inc.netVisionIf there is a concern should the provider contact the health plan or the vendor?Davis VisionGarry Denk224.545.0618gdenk@davisvision.com4
Vendor List - Cigna-HealthSpringBehavioral HealthThe provider should contact the health plan.Behavioral Health Hotline:866-780-8546Contracting Questions:Maggie pring.comClinical Questions:Suzie lThe provider should contact DentaQuest.DentaQuest:Carol Leonard – Account igna-HealthSpring Primary:Angela Cigna-HealthSpring Secondary:Maren Hill615-695-1287Maren.hill@healthspring.comLong Term CareThe provider should contact the health plan.General LTC Questions: IL NursingHome Requests@healthspring.comContracting Questions:Kirsten linical LTC Questions:Maureen DrummMaureen.drumm@healthspring.com312-547-21865
Non-Clinical Questions:Maggie -548-2011PharmaceuticalsThe provider should contact the health plan.Joel tationThe provider should contact the health plan.Cigna-HealthSpring:Leonard comVisionThe provider should contact the vendor.Superior Vision:Adrian Bennett, MBAVice President, Quality and Account Management443-451-1026800-243-1401 x Primary: Angela Secondary: Maren Hill615-695-1287Maren.hill@healthspring.com6
Vendor List - CountyCare Health PlanBehavioral HealthIf there is a concern should the provider contact the health plan or the vendor?Name Alicia SearcyPhone Number 866.329.4701 x 47829Email Address asearcy@cenpatico.comDentalIf there is a concern should the provider contact the health plan or the vendor?Name Carol LeonardPhone Number 262-834-3543Email Address carol.leonard@dentaquest.comLong Term CareIf there is a concern should the provider contact the health plan or the vendor?Name #1 – Kristin MurphyPhone Number - 630-655-7876Email Address - KRMURPHY@illinicare.comName #2 – Andrea McGlynnPhone Number – 312-864-0915Email Address – amcglynn@cookcountyhhs.orgPharmaceuticalsIf there is a concern should the provider contact the health plan or the vendor?Name- Elmer Abbo, MDPhone Number 312-864-1156Email Address eabbo@cookcountyhhs.orgTransportationIf there is a concern should the provider contact the health plan or the vendor?Name Tasha ReesePhone Number Tel: (630) 873-1356Email Address tasha.reece@firstgroup.comVisionIf there is a concern should the provider contact the health plan or the vendor?Name Tracy MillsPhone Number (252) 544-9264Email Address tmills@Opticare.net7
Vendor List- Family Health Network & Community Care AllianceAncillary Services (Home Health, DME, Med Supplies, etc.)Contracting inquiries: FHNProviderRequest@myfhn.comMarleen Severino, Manager, Ancillary Services- MSeverino@myfhn.com - 312-561-2542Behavioral HealthIf there is a concern should the provider contact the health plan or the vendor? Health PlanContracting inquiries: Scott Krugel, Network Management Specialist – SKrugel@myfhn.com – 312-605-9828Authorizations: Health Integrated at 888-211-6851Claims Disputes, Appeals, and InquiryMCPID@myfhn.comContractingContracting inquiries: FHNProviderRequest@myfhn.comMarcia Moore, Senior Manager, Contracting - MMoore@myfhn.com - 312-605-9851CredentialingAnnette Allen, Manager, Credentialing - AAllen@myfhn.com - 312-605-9877DentalIf there is a concern should the provider contact the health plan or the vendor? Health PlanDentaQuest Customer Service: 888-286-2447, Provider Relations: 888-281-2076Marleen Severino- Manager, Ancillary Services- MSeverino@myfhn.com - 312-561-2542Long Term CareIf there is a concern should the provider contact the health plan or the vendor? Health PlanAmy Edders, Director, LTSS – AEdders@ccaillinois.com – 312-605-9822Marleen Severino, Manager, Ancillary Services - MSeverino@myfhn.com - 312-561-2542PharmaceuticalsIf there is a concern should the provider contact the health plan or the vendor? Health PlanCVS Caremark Customer Care: 855-248-3446, TDD: 800-231-4403Luenetta Jackson, Director, Pharmacy Services - LJackson@ccaillinois.com - 312-605-9826Quality and Case ManagementSally Szumlas, Vice President, Quality Improvement– SSzumlas@myfhn.com – 312-995-1899Dr. Connie L. Zak, Vice President, Healthcare Management- CZak@ccaillinois.com - 312-880-1696TransportationIf there is a concern should the provider contact the health plan or the vendor? Health PlanFirst Transit: 877-725-0569Chris Zaruszak, Vice President, Operations - CZaruszak@myfhn.com - 312-995-12898
Vendor List- Family Health Network & Community Care Alliance(Continued)Utilization Management (UM) FHN Referrals and AuthorizationsAuthorization guidelines for covered services and procedures: www.fhnchicago.com/providersLourdes Reyes, Vice President, UM and Care Transition– LReyes@myfhn.com – 312-995-1881VisionIf there is a concern should the provider contact the health plan or the vendor? Health PlanEyeQuest- 888-696-9551 - eyequestproviderservices@dentaquest.comMarleen Severino, Manager, Ancillary Services- MSeverino@myfhn.com - 312-561-25429
Vendor List - HarmonyBehavioral HealthIf there is a concern should the provider contact the health plan or the vendor? – Health PlanName – Dr. Traci PowellPhone Number - 312-516-4906Email Address – traci.powell@wellcare.comDentalIf there is a concern should the provider contact the health plan or the vendor? - VendorName – Liberty Dental PlanPhone Number – 1-888-352-0215Long Term CareIf there is a concern should the provider contact the health plan or the vendor? – Health PlanName – Barb AlexanderPhone Number 312-516-5835Email Address – Barbara.Alexander@WellCare.comPharmaceuticalsIf there is a concern should the provider contact the health plan or the vendor? – Health PlanPalak DesaiPharmacy Director, Harmony / WellCarePalak.Desai@wellcare.comTransportationIf there is a concern should the provider contact the health plan or the vendor? – Vendor (Non Emergent);Health Plan (Emergent)Local Provider Rep - 312-658-3100Name – Greg Irby - Medical Transportation ManagementPhone Number – 1-877-248-1338Email Address - girby@mtm-inc.netVisionIf there is a concern should the provider contact the health plan or the vendor? - VendorName – Premier Eye CarePhone Number – 1-855-865-972310
Vendor List - Health AllianceRefer to:Maxine Wallnermaxine.wallner@healthalliance.orgSinead Rice Madigansinead.madigan@healthalliance.org11
Vendor List - HumanaBehavioral HealthIf there is a concern should the provider contact the health plan or the vendor? Health PlanAshley lIf there is a concern should the provider contact the health plan or the vendor? Health PlanKammy Schneider(262)408-4697kschneider@humana.comLong Term CareIf there is a concern should the provider contact the health plan or the vendor? Health PlanLisa M. lsIf there is a concern should the provider contact the health plan or the vendor? Health PlanMark onIf there is a concern should the provider contact the health plan or the vendor? Health PlanLee Havey(502)476-5927lhavey@humana.comVisionIf there is a concern should the provider contact the health plan or the vendor? Health PlanKelli Moody813.829.9145kmoody4@Humana.com12
Vendor List - IlliniCare HealthIlliniCare Health Contact:Tiffany LewisPhone Number: 312-260-5747Email: Tilewis@illinicare.comBehavioral HealthInternalName: Emily Cassidy, Senior Manager, Case ManagementPhone Number: 630-655-7855Email Address: ecassidy@illinicare.comDentalExternalName: Cenpatico – Wendy VernerPhone Number: 512-406-7200 ext. 67401Email Address: wverner@centene.comInternalName: Eric Forster, Clinical ManagerPhone Number: 630-655-7833E-mail Address: eforster@illinicarehealth.comExternalName: Dental Health & Wellness – Tara PricePhone Number: 252-452-9771Email Address: tprice@dentalhw.comLong Term CareInternalName: Connie Sherman, Senior Manager, Case ManagementPhone Number: 630-655-7858Email Address: : Steven Sproat, Director of PharmacyPhone Number: 630-655-7952Email Address: ssproat@illinicare.comExternalName: US Script – Phil DoveikisPhone Number: 314-445-0738Email Address: pdoveikis@usscript.com13
TransportationInternalName: Emily Cassidy, Senior Manager, Case ManagementPhone Number: 630-655-7855Email Address: ecassidy@illinicare.comVisionExternalName: MTM – Allison TusseyPhone Number: 636-695-5569Email Address: atussey@mtm-inc.netInternalName: Dan Byars, Clinical ManagerPhone Number: 312-260-5347Email Address: dbyars@illinicare.comExternalName: Opti-Care – Tracey SimpsonPhone Number: 252-544-9263Email Address: tracey.simpson@opticare.net14
Vendor List - Meridian Health PlanBehavioral HealthIf there is a concern should the provider contact the health plan or the vendor?Sara Mathews312-508-7994Sara.mathews@mhplan.comDentalIf there is a concern should the provider contact the health plan or the vendor?Sean Kendall(313) 324-3793Sean.kendall@mhplan.comLong Term CareIf there is a concern should the provider contact the health plan or the vendor?Michael euticalsIf there is a concern should the provider contact the health plan or the vendor?Andrew MillerVice President of Operations – ionIf there is a concern should the provider contact the health plan or the vendor?Sean Kendall(313) 324-3793Sean.kendall@mhplan.comVisionIf there is a concern should the provider contact the health plan or the vendor?Sean Kendall(313) 324-3793Sean.kendall@mhplan.com15
Vendor List - Molina HealthcareBehavioral HealthIf there is a concern should the provider contact the health plan or the vendor?Kathleen omDentalIf there is a concern should the provider contact the health plan or the vendor?Amber Wilkins888-562-5442 Ext 163964Amber.Wilkins@MolinaHealthcare.comLong Term CareIf there is a concern should the provider contact the health plan or the vendor?Jared harmaceuticalsIf there is a concern should the provider contact the health plan or the vendor?Vinay Bhargava855-866-5462 prompt for language – prompt for rtationIf there is a concern should the provider contact the health plan or the vendor?Amber Wilkins888-562-5442 Ext 163964Amber.Wilkins@MolinaHealthcare.comVisionIf there is a concern should the provider contact the health plan or the vendor?Amber Wilkins888-562-5442 Ext 163964Amber.Wilkins@MolinaHealthcare.com16
Vendor List - NextLevel HealthBehavioral HealthIf there is a concern should the provider contact the health plan or the vendor? Health PlanName Provider ServicesPhone Number 844-807-9734Email Address provider.services@nlhpartners.comDentalIf there is a concern should the provider contact the health plan or the vendor? Health PlanName Provider ServicesPhone Number 844-807-9734Email Address provider.services@nlhpartners.comLong Term CareIf there is a concern should the provider contact the health plan or the vendor? Health PlanName Provider ServicesPhone Number 844-807-9734Email Address provider.services@nlhpartners.comPharmaceuticalsIf there is a concern should the provider contact the health plan or the vendor? VendorName Meridian Rx – James CowhyPhone Number 313-324-3700x1669Email Address james.cowhy@meridianrx.comTransportationIf there is a concern should the provider contact the health plan or the vendor? Health PlanName Provider ServicesPhone Number 844-807-9734Email Address provider.services@nlhpartners.comVisionIf there is a concern should the provider contact the health plan or the vendor? VendorName OpticarePhone Number 844-302-921117
Provider Relations Contacts - Aetna Better Health of ILGeneral Provider Relations: 1-866-212-2851HospitalsLawrence nsJocelyn Carroll630-737-6519CarrollJ2@aetna.comLawrence er providersWilliam Henderson312-821-0629HendersonW2@aetna.comLawrence Underwood630-737-6464UnderwoodL2@aetna.comLTC- Skilled Nursing FacilitiesMagali Dure312-821-0633DureM@aetna.comLawrence Underwood630-737-6464UnderwoodL2@aetna.comLTC- Supported Living FacilitiesWilliam Henderson312-821-0629HendersonW2@aetna.comLawrence Underwood630-737-6464UnderwoodL2@aetna.comMental HealthTerriana Clark630-737-6462ClarkT9@aetna.comLawrence e Use DisorderTerriana Clark630-737-6462ClarkT9@aetna.comLawrence agali Dure312-821-0633DureM@aetna.comLawrence Underwood630-737-6464UnderwoodL2@aetna.comHome HealthJuanita Harris312-821-0513HarrisJ5e19f@aetna.comLawrence ta Harris312-821-0513HarrisJ5e19f@aetna.comLawrence riana Clark630-737-6462ClarkT9@aetna.comLawrence tationBetty Irving312-821-6503IrvingB@aetna.comHenry Graham314-662-0880Hgraham@mtm-inc.netDentistsBetty Irving312-821-6503IrvingB@aetna.comSuzanne t.comPublic Health Dept’sJocelyn Carroll, MPA630-737-6519CarrollJ2@Aetna.comLawrence Kathy LojkovicPharmacy Director224-281-2690lojkovicK@aetna.comBrian DavisMedicare Director314-506-2046davisB4@aetna.com18
Provider Relations Contacts - BlueCross BlueShield of lsJohn M. Evans,(312) 653-8279evansj1@bcbsil.comPhysiciansJoanne O’brien312-653-2413joanne obrien@bcbsil.comTishika TownsendOffice: (312) 653-4915tishika townsend@bcbsil.comLTC-Waiver providersDerek Punzalan312.653.6916derek punzalan@bcbsil.comLTC- Skilled Nursing FacilitiesSherry Heise,312-653-7652heises@bcbsil.comLTC- Supported Living FacilitiesSherry Heise,312-653-7652heises@bcbsil.comMental HealthDerek Punzalan312.653.6916derek punzalan@bcbsil.comSubstance Use DisorderDerek Punzalan312.653.6916derek punzalan@bcbsil.comHospice/Home HealthSherry Heise,312-653-7652heises@bcbsil.comDMESherry Heise,312-653-7652heises@bcbsil.com19
FQHCsTishika Townsend312-653-4915tishika townsend@bcbsil.comRatna Soni312-653-2317Ratna Soni@bcbsil.comTransportationHenry Graham636.695.5652www.mtm-inc.netDentistsSuzanne t.com20
Provider Relations Contacts - Cigna-HealthSpringStructure of Provider Rep AssignmentsShelina Kassam175 W Jackson Blvd ste 1750 Chicago, IL 60604shelina.kassam@healthspring.com(312) 548-2061Sheetal Rami9701 W Higgings Rd ste. 360 Rosemont, IL 60018sheetal.rami@healthspring.com(312) 548-2028Leaonard VanSlyke175 W Jackson Blvd ste 1750 Chicago, IL 60604leonard.vanslyke@healthspring.com(312) 548-2035Anna Volberg175 W Jackson Blvd ste 1750 Chicago, IL 60604anna.volberg@healthspring.comN/AStructure of Provider Rep Assignments (Behavioral Health)Magdalena Domaradzki175 W Jackson Blvd ste 1750 Chicago, IL 60604magdalena.domaradzki@healthspring.com(312) 548-2011Structure of Provider Rep Assignments (Professional)All Previous ContactsDirector, Provider ContractingKirsten Keeley175 W Jackson Blvd ste 1750 Chicago, IL 60604kirsten.keeley@healthspring.comN/ADirector, Provider RelationsN/ADirector of OperationsN/ADirector of ClaimsKim Stuart2900 N Loop West ste. 1300 Houston, TX 77092kimberly.stuart@healthspring.com(443) 573-1620Director of Utilization/Medical ManagementDan Chambers2208 N Hwy 121 Ste. 210 Bedford, TX 76021mark.chambers@healthspring.com817-554-576021
Director of CredentiallingLori Pegler530 Great Circle Rd. Nashville, TN 37228ri.pegler@healthspring.com(615) 234-2171Vice President of OperationsRobyn Leland2208 N Hwy 121 Ste. 210 Bedford, TX 76021robyn.leland@healthspring.com(817) 554-5553Vice President of Network ManagementMelissa Dannenberg175 W. Jackson ste 1750 Chicago, IL 60604melissa.dannenberg@healthspring.com(312) 548-2009External Vendor Liaison (i.e. pysch, dental, transportation)Vonda Kinney1225 N Loop West ste 127 Houston, TX 77008vonda.kinney@healthspring.com(770) 261-775122
Provider Relations Contacts - CountyCare Health PlanALL Provider Relations issues should be directed to:1st optionCountyCare312-864-82002nd optionTina BarksdaleDirector of Business Development/Provider eanne Klein312-864-0947jklein2@cookcountyhhs.org23
Provider Relations Contacts - Family Health Network & Community Care Alliance of IllinoisFamily Health Network Provider Services: 1-888-FHN-4YOU (346-4968)www.fhnchicago.comCommunity Care Alliance of Illinois Provider Services: 1-866-871- 2305https://www.ccaillinois.com24
Provider Relations Contacts - Harmony Health Plan of IllinoisA WellCare CompanyProvider Services: (800) 504-2766Provider Relations issues should be directed to:Local Provider Rep – (312) 658-3100Escalated Issues: Ron Damasauskas(312) 658-3136ronald.damasauskas@wellcare.com25
Provider Relations Contacts - Health Alliance1-800-851-3379, extension 4668PSC@healthalliance.org(217) 365-7492Provider Relations issues should be directed to the following:Maxine WallnerMaxine.wallner@healthalliance.orgDenise GrussingDenise.grussing@healthalliance.org26
Provider Relations Contacts -HumanaHospitalsHumana Provider Relations: 800-626-2741Casandra Montgomery: 312.441.5989; cmontgomery@humana.comPhysiciansHumana Provider Relations: 800-626-2741Casandra Montgomery: 312.441.5989; cmontgomery@humana.comLTC-Waiver providersIndependent Living Systems Provider Relations: 855-661-2029IllinoisProviders@ilshealth.comKathryn Schmit: 305-262-1292 x5010; kschmit@ilshealth.comLTC- Skilled Nursing FacilitiesIndependent Living Systems Provider Relations: 855-661-2029IllinoisProviders@ilshealth.comKathryn Schmit: 305-262-1292 x5010; kschmit@ilshealth.comLTC- Supported Living FacilitiesIndependent Living Systems Provider Relations: 855-661-2029IllinoisProviders@ilshealth.comKathryn Schmit: 305-262-1292 x5010; kschmit@ilshealth.comMental HealthBeacon Health Strategies Provider Relations: 855-481-7044prelations@beaconhs.comJohn Sellers: 630-382-5250; john.sellers@beaconhs.comSubstance Use DisorderBeacon Health Strategies Provider Relations: 855-481-7044prelations@beaconhs.comJohn Sellers: 630-382-5250; john.sellers@beaconhs.comHospice/Home HealthHumana Provider Relations: 800-626-2741Casandra Montgomery: 312.441.5989; cmontgomery@humana.comDMEFQHCsHumana Provider Relations: 800-626-2741Casandra Montgomery: 312.441.5989; cmontgomery@humana.comHumana Provider Relations: 800-626-2741Casandra Montgomery: 312.441.5989; cmontgomery@humana.comTransportationLogisticare ICP: 855-253-6865Logisticare MMP: 855-253-6867DentistsDentaQuest: 855-343-7400Casandra Montgomery: 312.441.5989; cmontgomery@humana.com27
Provider Relations Contacts - IlliniCare HealthHospitalsMariam Jafri – 312-995-0123 – mjarfi@illinicare.comJerome Salter – 708-793-0677 – jesalter@illinicare.comPhysiciansShatina Jackson – 312-497-7996 – shatjackson@illinicare.comChristine Fox – 708-625-7612 – chrifox@illinicare.comLTC-Waiver providersChris Waskiewicz – 312-519-9280 – cwaskiewicz@illinicare.comTahniyat Patel – 312-590-5703 – tpatel@illinicare.comLTC- Skilled Nursing FacilitiesChris Waskiewicz – 312-519-9280 – cwaskiewicz@illinicare.comTahniyat Patel – 312-590-5703 – tpatel@illinicare.comLTC- Supported Living FacilitiesChris Waskiewicz – 312-519-9280 – cwaskiewicz@illinicare.comTahniyat Patel – 312-590-5703 – tpatel@illinicare.comMental HealthClaudia Phillips – 630-655-7968 – clphillips@cenpatico.comAlicia Searcy - 866-329-4701 ext. 47829 – asearcu@cenpatico.comSubstance Use DisorderClaudia Phillips – 630-655-7968 – clphillips@cenpatico.comAlicia Searcy - 866-329-4701 ext. 47829 – asearcu@cenpatico.comHospice/Home HealthAngelic Williams – 312-465-0390 – angwilliams@illinicare.comChristine Fox – 708-625-7612 – chrifox@illinicare.comDMEChris Waskiewicz - 312-519-9280 – cwaskiewicz@illinicare.comTahniyat Patel – 312-590-5703 – tpatel@illinicare.comFQHCsMariam Jafri – 312-995-0123 – mjafri@illinicare.comJerome Salter – 708-793-0677 – jesalter@illinicare.comTransportationChris Waskiewicz – 312-519-9280 – cwaskiewicz@illinicare.comTahniyat Patel – 312-590-5703 – tpatel@illinicare.comDentistsCatherine Cameron – 331-305-9468 - cacameron@dentalw.com28
Provider Relations Contacts - Meridian Health PlanALL Provider Relations issues should be directed to:Sean Kendall(313) 324-3793Sean.kendall@mhplan.com29
Provider Network Development Representative Coverage MapNorthern IL NetworkDirector of Network Development312-805-8723John HeintzLTSS Network (State of IL)312-350-2849Ben SalentineBehavioral Health (State of IL)312-505-0614Stephanie HustonCrystal Klier, Manager312-415-7170Nighat Ali312-718-5557Taylor Guthrie312-550-2417Dawn Schutt309-235-7910Alexandria Walton312-505-6840Erin Wilson312-447-1923Southern IL NetworkJo DaviessStephensonWinnebago WhitesideKendallRock nPikeScottChristianEffinghamClayMarionSt. 06606064060613606576064760639606516061460610 606116062260654 60601606066066160644 60624 606126062360632Gallatin60638Pope6062660641 60618WhiteHardinOak Blue ingClarkBondEvergreen ParkOak LawnOrlandParkCumberlandMontgomeryFayetteMonroeOak ParkBerwynEdgarShelbyWashingtonMaywoodOak BrookColesGreeneClintonWheelingNorthbrookHoffman Estates Arlington Mount ProspectWilmetteHeightsEvanstonPark NilesStreamwoodSkokieRidgeHanover ParkBartlettPalatineBurbankMoultrieMadisonCook nMacoupinAntwone dDe WittMenardMorganFred McLeanTazewellFultonMcDonoughHancockCourtney rshallKnoxWarrenKimberly French*Please contact Provider Services directly at ative TBD*WillLa SalleMichelle Roan, Manager60608 6061660607 6060260603606056060460653606156060960621 606176062860633
Cook County Hospital AssignmentsPhoneProvider NetworkDevelopmentRepresentative4440 W 95th StOak Lawn, IL 60453708-684-8000Taylor GuthrieIllinois Masonic Medical Center836 W Wellington AveChicago, IL 60657773-975-1600Taylor GuthrieAdvocate Lutheran General Hospital1775 Dempster StPark Ridge, IL 6068847-723-2210Taylor GuthrieAdvocate South Suburban Hospital17800 Kedzie AveHazel Crest, IL 60429708-799-8000Taylor GuthrieAdvocate Medical Group Trinity2320 E 93rd StChicago, IL 60617773-967-2000Taylor GuthrieAlexian Brothers Behavioral Health1650 Moon Lake BlvdHoffman Estates, IL 60169847-882-1600Taylor GuthrieAlexian Brothers Medical Center800 Biesterfield RdElk Grove Village, IL 60007847-882-1600Taylor GuthrieAnn and Robert H. LurieChildren's Hospital of Chicago225 E Chicago AveChicago, IL 60611312-227-4000Taylor GuthriePresence Holy Family Medical Center100 N River RdDes Plaines, IL 60016847-297-1800Taylor GuthriePresence Our Lady of ResurrectionMedical Center5645 W Addison StChicago, IL 60634773-282-7000Taylor GuthriePresence Resurrection Medical Center7435 W Talcott AveChicago, IL 60631773-774-8000Taylor GuthrieSt. Francis Hospital355 Ridge AveEvanston, IL 60202847-316-4000Taylor GuthriePresence Saint Joseph Hospital-Chicago2900 N Lake Shore DrChicago, IL 60657773-665-3000Taylor GuthriePresence Saints Mary and ElizabethMedical Center2233 W Division StChicago, IL 60622312-770-2000Taylor GuthrieSt Alexius Medical Center1555 Barrington RdHoffman Estates, IL 60169847-843-2000Taylor GuthrieChicago Behavioral Hospital555 Wilson LnDes Plaines, IL 60016847-768-5430Stephanie HustonAries Health Care of Illinois8311 Roosevelt RdForest Park, IL 60130708-771-7000Stephanie HustonAdventist Paulson Rehab, La Grange5101 Willow Springs RdLa Grange, IL 60525708-245-7900Kim FrenchHoly Cross Hospital2701 W 68th StChicago, IL 60629773-884-9000Kim FrenchThe Ingalls Memorial Hospital1 Ingalls DrHarvey, IL 60426708-333-2300Kim FrenchJackson Park Hospital Foundation7531 S Stony Island AveChicago, IL 60649773-947-7500Kim FrenchClinicAddressAdvocate Christ Medical CenterFLYPS53 ILwww.mhplan.com
Cook County Hospital AssignmentsPhoneProvider NetworkDevelopmentRepresentative1501 S California AveChicago, IL 60608773-542-2000Kim FrenchSchwab Rehabilitation Hospital1401 S California AveChicago, IL 60608773-257-1783Kim FrenchShriners Hospitals for Children2211 N Oak Park AveChicago, IL 60707773-622-5400Kim FrenchSouth Shore Hospital8012 S Crandon AveChicago, IL 60617773-356-5000Kim FrenchRML Chicago3435 W Van Buren StChicago, IL 60624773-826-6300Erin Wilson/CentralMethodist Hospital of Chicago5025 N Paulina StChicago, IL 60640773-989-7357Central - TBDProvident Hospital of Cook County55 E 51st StChicago, IL 60615312-572-1200Central - TBD
Phone Number 312-821-0514 312-821-0680 630-737-6462 . Email Address . StangeS@aetna.com. WhiteK1@aetna.com ClarkT9@aetna.com . Dental . The provider should contact DentaQuest. DentaQuest: Carol Leonard - Account Executive . 262-290-1678 . Carol.leonard@dentaquest.com. Cigna-HealthSpring Primary: Angela Stevens .
