Physiatry, Rehabilitative Medicine Archives - Page 5 of 7

This directory provides a list of Texas Independence Health Plan HMO I-SNP and Texas Independence Community Plan IE-SNP’s current network providers for the following counties in Texas: Aransas, Atascosa, Austin, Bandera, Bastrop, Bee, Bexar, Blanco, Brooks, Burleson, Burnet, Caldwell, Calhoun, Cameron, Cass, Chambers, Colorado, Comal, Cooke, Denton, DeWitt, Dimmit, Duval, Fayette, Fort Bend, Franklin, Frio, Galveston, Gillespie, Goliad, Gonzales, Gregg, Grimes, Guadalupe, Hamilton, Hardin, Harris, Harrison, Hays, Hidalgo, Hill, Jack, Jackson, Jefferson, Jim Hogg, Jim Wells, Karnes, Kendall, Kenedy, Kleberg, Lampasas, La Salle, Lavaca, Lee, Liberty, Live Oak, Llano, McMullen, Marion, Mason, Matagorda, Medina, Mills, Montgomery, Morris, Nueces, Palo Pinto, Panola, Real, Refugio, Rusk, San Jacinto, San Saba, Smith, Somervell, Starr, Tarrant, Travis, Upshur, Washington, Webb, Wharton, Willacy, Williamson, Wilson, Wise, Wood, Zapata, and Zavala.

To access Texas Independence Health Plan’s online provider directory, you can visit www.txindependencehealthplan.com/provider-directory/. For any questions about the information contained in this directory, please call our Member Service Department at 1-833-471-8447. Hours are 8:00 A.M. to 8:00 P.M., seven days a week from October 1 through March 31; 8:00 A.M. to 8:00 P.M. Monday to Friday from April 1 through September 30. TTY users should call 1-833-414-8447. Texas Independence Health Plan may ask whether your request for a hard copy is a one-time request or if you are requesting to receive the provider directory in hard copy permanently.

If you request it, your request for hard copies of the provider directory remains until you leave Texas Independence Health Plan or request that hard copies be discontinued.

This directory provides a list of Texas Independence Health Plan HMO I-SNP and Texas Independence Community Plan IE-SNP’s network providers.

You can use the directory to find providers and facilities that are currently in our network. You can search by specialty and county. Due to the type of plan that Texas Independence Health Plan HMO I-SNP and Texas Independence Community Plan IE-SNP ar, a referral is not required for any appointments.

You will have to choose one of our network providers listed in this directory to be your Primary Care Provider (PCP). Generally, you must get your health care services from your PCP. Texas Independence Health Plan is an Institutional Special Needs Plan (I-SNP) and Texas Independence Community Plan is an Institutional Equivalent Special Needs Plan (IE-SNP) are both a Health Maintenance Organization (HMO). Since we are an HMO, it is necessary for you to select a PCP to utilize while on the plan. We do not guarantee that each provider is still accepting new members.

The network providers listed in this directory have agreed to provide you with your healthcare, vision and dental services. You may go to any of our network providers listed in this directory.

Under certain circumstances members may obtain services from out-of-network providers. Newly eligible members who are undergoing an existing course of treatment under the care of an out-of-network provider at the time of eligibility may continue to obtain services from that provider until the member’s care is safely transferred to an in-network provider. Out-of-network providers with members under a current treatment plan must notify the health plan and request authorization of services as appropriate according to the Plan benefits. Once the health plan is notified that the member is under the care of an out-of-network provider, the provider must submit a request for authorization. All supporting clinical information must be provided to substantiate the continuation of the requested service(s). During this time existing care will not be interrupted until clinical information is reviewed for medical necessity and appropriateness. In the case where there may not be a network specialist available to the member, an out-of-network provider may be accessed at the discretion of the PCP.

Whenever you get a bill from an Out of Network provider, you should not pay the bill and you should submit it to the plan for processing and determination of enrollee liability, if any.

You must use network providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers, neither Medicare nor Texas Independence Health Plan HMO I-SNP and Texas Independence Community Plan will be responsible for the costs.

Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area you must use plan providers for urgent care. When out of the service area, urgent care may be obtained from the first available provider. In addition, when out of the service area, you can obtain dialysis treatment from any qualified dialysis provider.

How do you find Texas Independence Health HMO I-SNP/Texas Independence Community Plan IE-SNP providers that serve your area?

Providers are listed in this directory by type of provider. Within each provider type, providers are listed alphabetically by county.

If you have questions about Texas Independence Health Plan HMO I-SNP or require assistance in selecting a PCP, please call our Member Service Department at 1-833-471-8447. Hours are 8:00 A.M. to 8:00 P.M., seven days a week from October 1 through March 31; 8:00 A.M. to 8:00 P.M. Monday to Friday from April 1 through September 30. TTY users should call 1-833-414-8447. You can also visit www.txindependencehealthplan.com.

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