Insurance Providers

Contracted Insurance

Authorization/Referral

Aetna

PPO, POS, Open Access EPO, Open Access HMO

HMO

Requires Auth

Amerigroup

Written Referral

Beechstreet

 

Blue Cross Blue Shield

Blue Choice PPO Blue Option HMO Blue Texas Par Plan

Blue Advantage

 

Blue Cross Blue Shield Medicaid

Medicaid Plus Star

Star Plus Star Kids CHIP

Written Referral

Cigna

PPO, POS, Open Access EPO, Open Access HMO

HMO

Requires Auth

City MAP

Requires Auth

Covenant Management

 

First Care

 

First Choice (Whole Foods) Employers Health Network

 

Geha

 

Golden Rule

 

Group and Pension Administrator (GPA)

 

Great West

 
   

Health Smart

 

Humana

PPO, POS, Open Access EPO, Open Access HMO

HMO

Requires Auth

Medicaid

CSHCN

Written Referral Office Visit

Medicare

 

Meritain Health

 

Multi Plan

 

PHCS

 

Sendero

Star/Chip

Written Referral

Dell Children’s (formerly Seton)

Star/Chip/Healthcare/ Smart Health

Written Referral

Superior

MDD/Chip/Foster Care/Star Kids

Written Referral

TML Intergovernmental

 

Tricare

Standard/Reserve/Champ Va

Written Referral PRIME/REMOTE Require Authorization must be

under the Facility’s name “Children’s Urology”

United Healthcare PPO/ POS EPO/HMO

UHC Harvard Pilgrim Healthcare

UHC All Savers

Require Auth

UMR

 

**Non-Contracted Insurance**

 

Community First

 

First Health

 

Foundation Health

 

Right Care

 

Scott and White

 

Unicare

 

Ambetter from Superior

 

Sendero Ideal Care

 

Blue Premier