Provider Directory - TakeCare

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PARTICIPATING PROVIDERS The true measure of any health care organization is the quality of the care you receive. And at the heart of this is your relationship with your participating provider. Your participating provider is essential in providing your day to day health care needs as well as providing the avenue for health care alternatives such as specialty care. That’s why, at TakeCare, you have the freedom to make the most important health care decision of all - the choice of your participating provider. This provider directory serves as ahelpful tool to select a participating provider. HOW TO SELECT A PARTICIPATING PROVIDER Choose aParticipating Provider (Medical Group or Individual Physician) from this directory. You and your enrolled dependents may choose a different Participating Provider. You may switch Participating Providers as often as needed by simply calling the TakeCare Customer Service Department, Monday-Friday, 8 a.m. to 5 p.m. at (671) 647-3526 on Guam and (670) 235-7687 in the CNMI and (680) 488-4715 in Palau. Your new selection will be effective immediately. Services received through providers not listed in this Provider Directory may be covered at a lesser coverage level. Please refer to your Schedule of Benefits for specific Out-of- Network Benefits. HELPFUL INFORMATION Who is aParticipating Provider? A participating provider is any individual practice association, individual physician, pharmacy, hospital or group of licensed providers who have entered into awritten agreement with TakeCare to provide medical or dental services to you and your enrolled dependents. How are Participating Providers Compensated (paid)? TakeCare pays its Participating Providers using various payment methods, including per diem and fee-for-service arrangements. Per diem means paying afixed dollar amount per day for all services rendered. Fee-forservice means paying the provider’s usual, customary and regular fee at adiscount for having a written agreement for TakeCare members. What is a Primary Care Provider and a Specialty Care Provider and how many of each do you have in your network of providers? A Primary Care Provider is responsible for providing or authorizing your medical care services. A Primary Care Provider may be physicians of Internal Medicine, Pediatrics, Family Practice or General Practice. A Specialty Care Provider is a duly licensed physician, osteopath, psychologist or other practitioner that your Primary Care Provider may refer you to. TakeCare has the largest on-island contracted provider network with over 100 Primary Care and Specialty Care Providers. Provider Directory 1 When am Iable to access a Specialty Care Provider? When you or your Primary Care Provider feel you need more specialized treatment, you may request for a referral to seek a specialist for an office consultation. However, before any treatment begins, you may need to have prior authorization from TakeCare’s Medical Management Department. Once the request is reviewed and approved, treatment can commence. WHO TO CALL FOR HELP Introduction If you have any questions, please feel free to call the TakeCare Customer Service Department, Monday -Friday, 8am -5pm at: Guam (671) 647-3526, CNMI (670) 235-7687 or Palau (680) 488-4715. All network provider agreements automatically renew each year on the anniversary date unless otherwise indicated. It is important to know that when you enroll in this plan, services are provided through the plan’s delivery system, but the continued participation of any one doctor, hospital or other provider cannot be guaranteed. TIC-PD111309
FHP Health Center FHP Health Center (Guam) #548 South Marine Corps Drive, Tamuning, Guam 96913 (671) 646-5825 MEDICAL Urgent Care Fly, Eric, PA-C Frickel, Wendy, M.D. Stanley, W. Ed, PA-C Family Practice Arana, Maria Chela, M.D. Kaufman, Karyn, PA-C Lombard, Chiyo, F.N.P. Rozycki, Thomas, M.D. Stratton, Walter, PA-C Internal Medicine Dulay, Marylou, M.D. Martineau, Charles, M.D. Obstetrics/Gynecology Cole, Farrell, M.D. Leliukas, Alice, C.N.M. Pediatrics Alano, Maria Andrea, M.D. Leon Guerrero, Robert, M.D. Sarmiento, Dennis, M.D. Stadler, James, M.D. DENTAL General Dentistry Bero, David P., D.D.S. Johnson, Elwood, D.D.S. Kowal, Robert, D.D.S. Sullivan, John, D.D.S. Endodontic Dentistry Baugh, Dean, D.D.S. All network provider agreements automatically renew each year on the anniversary date unless otherwise indicated. It is important to know that when you enroll in this plan, services are provided through the plan’s delivery system, but the continued participation of any one doctor, hospital or other provider cannot be guaranteed. Provider Directory 2 HEALTH CENTER SERVICES · Health Education · Home Health · Hospice · Laboratory · Mammography · Optical · Pharmacy · Radiology · Surgi-Center FHP VISION CENTER McDonald, Jay, O.D. San Nicolas, Marlene, O.D. TIC-PD111309
Page 1: Provider Directory A guide to help
Page 6 and 7: PRIMARY CARE Providers FAMILY PRACT
Page 8 and 9: Primary Care Providers by CLINIC FH
Page 10 and 11: SPECIALISTS, cont. ORAL AND MAXILLO
Page 12 and 13: DENTAL Services GENERAL DENTISTRY F
Page 14: OFF-ISLAND Asia Network ASIA NETWOR

Provider Directory - TakeCare

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