| AARP
(UNITED HEALTHCARE)
ACCOUNTABLE HEALTH PLAN
AETNA MEDICARE (MEDICARE REPLACEMENT PLAN) (CO-PAY ONLY)
AETNA NETWORK – HMO/PPO/MC/POS/TRS-AETNA REFERRAL FORM
BEECHSTREET NETWORK – PPO (CAPP CARE NETWORK)
BC/BS OF TEXAS – HEALTH SELECT, FEDERAL & PPO
BRAVO ELDER HEALTH (MHHP – MEDICARE HMO)
CARE PLUS IMPROVEMENT-(MEDICARE REPLACEMENT PLAN) (CO-PAY
ONLY)
CHAMPUS/TRICARE SOUTHWEST
CIGNA – PPO, HMO, POS HMO NEEDS REFERRAL FROM PCP
FIRST HEALTH
GALAXY NETWORK
GREAT WEST
HUMANA GOLD CHOICE-(MEDICARE REPLACEMENT PLAN) (CO-PAY ONLY)
HUMANA – PPO, HMO (HMO-ONLY FOR ISD PLAN)
INDEPENDENT MEDICAL SYSTEMS (IMS)
MEDCORP SOUTHWEST
MEDICAID
MEDICARE
RAILROAD MEDICARE
TEXAS TRUE CHOICE
TODAY’S OPTION (MEDICARE REPLACEMENT PLAN)
TRICARE SOUTHWEST/CHAMPUS
UNICARE – HMO, PPO HMO REFERRAL FORM FROM PCP
UNITED HEALTHCARE – PPO, HMO, POS, EPO & MANAGED
INDEMNITY
USA HEALTH CARE
WELLCARE (MEDICARE REPLACEMENT PLAN)
MEMORIAL
HEALTHNET PROVIDERS -
AMERIGROUP/STAR PLUS
ADMERIVANTAGE MEDICARE – HMO
BLUE CHOICE - PPO
BRAVO ELDER HEALTH MEDICARE – HMO
CI – HEALTHSMART (PPO)
CI NPA
EMPLOYERS HEALTH NETWORK
FREEDOM OF CHOICE – PPO
HEALTHSMART – EPO
INDEPENDENT MEDICAL SYSTEMS (IMS)
INTERPLAN HEALTH GROUP (IGH)
MM NPA
MSCH – PPO
MULTIPLAN – PPO
PHCS – PPO & EPO
PROVIDER SELECT - PPO
TEXAS TRUE CHOICE
THREE RIVERS
WELLCARE
PRIMARY
CARE CASE MANAGEMENT- (MEDICAID REPLACEMENT PLAN)
PRIVATE
HEALTHCARE SYSTEMS–PPO/OPEN ACCESS (CHOICE CARE)
-
ADMINISTRATIVE
SERVICES HEALTH PLAN
AFTRA HEALTH FUND
AMERICAN POSTAL WORKERS UNION – AFL/CIO – TEXAS
ONLY
AMERIHEALTH HMO
AMERIHEALTH INSURANCE CO.
CORE SOURCE – FIRST BENEFIT/FIRST CARE
DIVERSIFIED GROUP ADMINISTRATORS
EMPLOYERS HEALTH INSURANCE
FORTIS BENEFITS
GENERAL AMERICAN
GILSBAR, INC.
GOLDEN RULE INSURANCE COMPANY
HEALTHSOURCE PROVIDENT
HEARTLAND ALLIANCE OF AMERICA
HOMETOWN HEALTH
HUMANA – PPO HMO - (ONLY ISD PLANS)
JEFFERSON PILOT INSURANCE
NOVA HEALTHCARE
PM GROUP LIFE
RANDALL’S EMPLOYEE NETWORK
SOUTHERN BENEFIT ADMINISTRATION
THE GUARDIAN LIFE INSURANCE
TML INTERGOVERNMENTAL BENEFITS POOL
TRUSTMARK INSURANCE COMPANY
UPMC HEALTH PLAN
ZENITH ADMINISTRATORS
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