Product Type: EPO, Limited Network Plan Name: Colorado HealthOP

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,
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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
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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
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Pediatrician
Obstetrics & Gynecology
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65
0
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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
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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
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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
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Service Area
Insert service area counties / map / description about your service area
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