Plan Name: Colorado HealthOP EPO, Limited Network Product Type: EPO, Limited Network Accessing Care Outside the Service Area/ State: If you access out-of-network services, your coverage does not apply and you will be responsible for the entire cost, except in cases of emergency. Emergency health services will be covered as an in-network benefit regardless of the provider’s network status or service area. Key Provider Network Features: The EPO offers a more limited network than a PPO, which allows us to offer lower premiums. We are currently in the following counties and are committed to providing a full network of providers in Adams, Alamosa, Arapahoe, Boulder, Broomfield, Clear Creek, Conejos, Costilla, Denver, Douglas, El Paso, Elbert, Gilpin, Grand, Jefferson, Lake, La Plata, Larimer, Logan, Morgan, Park, Saguache, Summit, Teller, and Weld counties. Members in mountain areas have access to EPO providers throughout the state. Hospital Medical Facilities: General Hospitals: Rehab Hospitals: Avista Adventist Hospital Avista Adventist Hospital Rehab Castle Rock Adventist Hospital Littleton Adventist Hospital Rehab East Morgan County Hospital OrthoColorado Hospital at St Anthony St Anthony Hospital Parker Adventist Hospital Rehab Littleton Adventist Hospital Porter Adventist Hospital Rehab Longmont United Hospital St Anthony Hospital Rehab McKee Medical Center Mercy Regional Medical Center Specialty Hospitals: North Colorado Medical Center Kidney Stone Center of the Rocky Mountains Parker Adventist Hospital OrthoColorado Hospital Porter Adventist Hospital St Anthony Hospital North St Anthony Summit Medical Center San Luis Valley Regional Medical Center Penrose-St Francis Medical Center St Mary-Corwin Medical Center St. Thomas More St. Vincent Hospital Sterling Regional Med Center, Conejos County Hospital, Middle Park Medical Center Granby, Middle Park Medical Cener Kremmling Emergency Care & Urgent Care Facilities: Quantum Plus, Penrose Urgent Care Center at Cripple Creek, St Anthony Breckenridge Community Clinic Emergency Center, St Anthony Copper Mountain Clinic, St Anthony Keystone Medical Clinic, Urgent Care at Durango, Mountain Resort, Urgent Care of Golden Avista Adventist Hospital, Castle Rock Adventist Hospital, East Morgan County Hospital , Flight for Life St Anthony Central Hospital, Adventist Hospital, Longmont United Hospital , McKee Medical Center, Mercy Regional Medical Center , North Colorado Medical Center, Parker Adventist Hospital , Penrose Hospital, Porter Adventist Hospital, St Anthony Hospital, St Anthony Summit Medical Center, San Luis Valley Regional Medical Center, St Francis Medical Center, St Mary-Corwin Medical Center, St. Thomas More, St. Vincent Hospital, Sterling Regional Med Center, Prepared by: Colorado HealthOP Page 1 of 5 Connect for Health Colorado Specialty Care Facilities: Ambulatory Surgical Centers: Crown Point Surgery Center, Endoscopy Center at Porter, Flatirons Surgery Center, Golden Ridge Surgery Center, Harvard Park Surgery Center , Mountain Vista Orthopedic Surgery Center, PeakOne Surgery Center, Summit view Surgery Center, Avista Surgery Center Residential Treatment Facilities: Porter Place Retirement Residence, The Gardens at St Elizabeth, The Villas at Sunny Acres Mental Health Clinics: Porter Adventist Behavioral Health, The Center for Behavioral Health Ancillary Providers: Hospice: Hospice of Mercy, Porter Hospice (Home Hospice), Porter Hospice (Johnson Center), St Anthony Hospice Labs: Aspen Medical Clinic (BTMG), Banner Health Clinic Fort Morgan, Colorado Laboratory Services Aurora PSC, Colorado Laboratory Services Avista PSC, Colorado Laboratory Services Castle Rock PSC, Colorado Laboratory Services Highlands Ranch PSC, Colorado Laboratory Services Littleton PSC, Colorado Laboratory Services Parker Alpine Building PSC, Colorado Laboratory Services Parker Sierra Building PSC, Colorado Laboratory Services Porter PSC, Colorado Laboratory Services St Anthony PSC, Colorado Laboratory Services Summit PSC, Skyline Center for Health, Fossil Creek (BTMG), Horizon Laboratory, Southwest Loveland, Home Health Agencies: Banner Home Care Colorado, Banner Home Medsolutions, Centura Home Care, Centura Home Care Bristlecone Health Services, Skilled Nursing: Alpine Living Center, Applewood Living Center, Berthoud Living Center, Boulder Manor, Care Meridian - Littleton, Centennial Healthcare Center, Fort Collins Health Care Center, Four Corners Health Care Center, Jewell care Center of Denver, Kenton Manor, Kindred Nursing and Rehab - Aurora, Kindred Nursing and Rehab - Cherry Hills, Kindred Nursing and Rehab - Brighton, Life Care Center of Aurora, Life Care Center of Westminster, Monaco Parkway Health and Rehab, Pearl Street Health and Rehabilitation Center, Sierra Vista Health Care Center, Spring Creek Healthcare Center, Sterling Living Center, Summit Rehab, The Peaks Care Center, Windsor Healthcare Center, Radiology Centers: Health Images at Boulder, Health Images at Cherry Hills, Health Images at City Place, Health Images at South Denver, Health Images at South Park, Health Images at South Potomac Occupational Therapy Clinics: CCOM Breckenridge, CCOM Cripple Creek, CCOM Durango, CCOM Frisco, CCOM Keystone, CCOM South Denver, Summit CSSC Durable Medical Equipment: Banner Home Medical Equipment, Apria Healthcare, Bennett Medical Services, C onnect Hearing, Destiny Medical Supply, HOMELINK, KCI USA, Lincare, Numotion, Opnet Hanger Colorado, Otto Bock Orthopedic Services, RS Medical Parker, Sleep Therapeutics, The Scooter Store-Denver, Zynex Medical Orthotics/Prosthetics: Certified Rehab Services, HOMELINK, Select Physical Therapy, PrimeCare O&P Network - Bulow Biotech Prosthetics Chiropractic: Colorado Chiropractic & Wellness PC, Colorado Injury Treatment Center, Colorado Pain and Rehabilitation, Comprehensive Chiropractic Integrated Health, The Center for Spine Pain Pharmacy Providers: https://netcard.welldynerx.com/portals/0/pharmacies/colorado.pdf Prepared by: Colorado HealthOP Page 2 of 5 Connect for Health Colorado PRIMARY CARE PHYSICIANS Selecting a Primary Care Physician: Selecting a PCP is not required for participation in this plan. Having a visit with a PCP is a requirement to meet our Health Actions, which provide enhanced benefits once completed. Key Features: We work directly with primary care physician groups who focus on high quality care in medical home type structures. Primary Care Physicians by Type and Quantity Family Medicine 519 General Practice 0 Internal Medicine 116 Prepared by: Colorado HealthOP Pediatrician Obstetrics & Gynecology Page 3 of 5 65 0 Connect for Health Colorado SPECIALTY CARE PHYSICIANS Accessing care from a Specialty Care Physician: Referrals are not required, although recommendations for specialty providers from your PCP is always recommended. You may utilize our customer service or care management services to assist in selecting in network specialty providers. Many treatments do require prior authorization. A list of these treatments can be found in our Certificate of Coverage. Key Features: The EPO network includes all facilities managed by the Centura and Banner corporations, as well as several independent facilities thorughout the service area. Specialty Care Physicians by Type and Quantity Allergy and Immunology 60 Anesthesiology 138 Audiology 7 Cardiothoracic Surgery 1 Cardiology 205 Certified Nurse Midwife 3 Nurse Anesthetist (CRNA) 28 Chiropractic 215 Clinical Nurse Specialist 12 Colon and Rectal Surgery 6 Counselor 1 Critical Care Medicine 4 Dermatology 15 Diagnostic Radiology 7 Emergency Medicine 104 Endocrinology 355 Gastroenterology 32 General Surgery 92 Geriatric Medicine 5 Hematology and Oncology 88 Hospice and Palliative Medicine 4 Hospitalist 40 Infectious Disease 6 Interventional Cardiology 4 Licensed Clinical Social Worker 2 Midwife 5 Nephrology 32 Neurological Surgery 46 Neurology 27 Neuroradiology 10 Nuclear Medicine 6 Nurse Practitioner 41 Nurse Practitioner - Family Med 135 Prepared by: Colorado HealthOP Obstetrics and Gynecology Occupational Therapy Ophthalmology Optometry Oral/Maxillofacial Surgery Orthopaedic Surgery Orthopaedic Surgery of the Hand Otolaryngology (ENT) Pain Medicine Pathology Pediatric Emergency Medicine Pediatric Neonatal Perinatal Pediatric Radiology Physical Medicine & Rehab Physician Assistant Physician Assistant - Emer Dept Physician Assistant Family Plastic Surgery Podiatry Preventive Medicine Psychiatry Psychology Pulmonary Disease Radiation Oncology Radiology Rheumatology Sleep Medicine Surgery Thoracic Cardiovascular Surgery Transplant Surgery Urgent Care Urology Vascular Surgery Page 4 of 5 143 4 14 3 5 173 9 45 3 22 10 3 2 9 51 4 237 6 18 1 38 94 29 31 149 4 2 84 14 1 3 31 4 Connect for Health Colorado Service Area Insert service area counties / map / description about your service area Prepared by: Colorado HealthOP Page 5 of 5 Connect for Health Colorado
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