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In Texas
For members covered under our points of service products,Open Access POS II or Open Access HMO, PCP means physician (primary care).
To view a listing of counties in the service area(s) and whether they meet state network adequacy rules, click here.
If you see that there are no contracted Emergency Room doctors, pathologists, radiologists or anesthesiologists, this hospital is part of a Limited Hospital Care Network (LHCN). An LHCN relies on an access plan to meet state network adequacy requirements for hospitals.
Telemedicine
Telemedicine is a method of delivering health care information and services that enable your doctor or other health professional to evaluate, diagnose and treat you remotely by using the latest telecommunications technology. Telemedicine offers numerous benefits as an alternative to traditional in-person medical care. Many specialists and hospitals in the United States use some form of telemedicine. Check with your doctor or medical facility to see if they offer telemedicine services and if they are appropriate for your health care needs.
Note: check your plan of benefits to see if Telemedicine is covered.
Help for those who speak another language
If you need help in another language ask an English speaking family member or friend to contact your doctor or medical facility. Ask if multi-lingual employees are on staff. If not, you can also ask if they provide over-the-phone interpretation through a service like the AT&T Language Line. These types of services can provide interpretation for up to 170 languages. If this is a service offered by your doctor or medical facility, they'll connect you to the number associated with their practice and ask for an interpreter that speaks your native language. A member of the practice will remain on the line to answer your questions through the interpreter. This directory is also available in other languages at no cost to you.
Handicapped accessibility
Handicapped accessibility Health care providers participating in our network are required to have all areas physically accessible to all members, including but not limited to the office entrance, parking, and bathroom facilities.
Texas In Network Facility Out of Network Health Care Providers
Here
you can find the percent of dollars that are filed with Aetna by
non-contracted health care providers that provide services at our In
Network facilities. This will give Members a sense of the probability
of being seen or treated at each facility by a non-contracted health
care provider. To learn more about the number of insureds, providers
and hospitals in each service area, please call the toll-free number
on the back of your ID Card.
Graphic Regions
To learn more about the number of insureds, providers and hospitals in
each service area, please call the toll-free number on the back of
your ID Card or if you are not a member, call 1-800-872-3862.
Hospital Usage of Preferred Providers
± Hospitals with this notation have agreed to facilitate the
usage of preferred providers. As of May 1, 2018, no hospitals will
have this notation.
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