Southwest General Hospital

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Insurance Plans Accepted

Managed Care Contracts

In an effort to better serve our patients and physicians, Southwest General has pursued contracts with many Managed Care Organizations (MCOs). We strive to develop contracts with companies who not only provide good medical coverage to their subscribers, but also who provide fair reimbursement and equitable contract terms. In addition to accepting traditional Medicare and Medicaid, Southwest has arranged special “managed care” contracts with the following entities:

Southwest General accepts all Medicare Private Fee For Service (PFFS) plans.


Aetna US Healthcare
• Aetna HealthFund
• HMO
• Elect Choice (EPO)
• Aetna Open Access HMO
• Aetna Open Access Elect Choice (EPO)
• Quality Point-of-Service (QPOS)
• Managed Choice (POS)
• USAccess
• Aetna Choice POS
• Aetna Choice POS II
• Aetna Open Access Managed Choice (POS)
• Open Choice (PPO)
• Traditional Choice Indemnity

Anthem Blue Cross and Blue Shield of Ohio
• Blue Access (PPO)
• Blue HMO
• Blue Preferred (HMO, POS, EPO)
• Blue Traditional
• Blue Card (PPO)
• Anthem Senior Advantage (PPO, HMO)
• Anthem Medicare Preferred
• Blue Medicare Access
• Ford MHSA
• HealthLink
• Anthem Pathways X Tiered—Marketplace
• Anthem Pathways Tiered—Off Exchange

Beech Street
• PPO

Behavioral Health Systems
• Behavioral Health Only

Buckeye Community Plan
• Medicaid
• Buckeye HMO –Exchange
• MyCare Ohio

CareSource Management
Group

• Medicare
• Medicaid
• MyCare Ohio

ChoiceCare (Humana)
• PPO
• Humana Gold Choice Medicare

Cigna Behavioral Health
• Behavioral Health Only

Cigna Healthcare of Ohio
• HMO
• PPO
• Gatekeeper PPO
• International

Emerald Health Network/InterPlan Health/HealthSmart
• PPO

First Health
Network/CCN/Coventry

• PPO

Flora Health Network-PPOM
• PPO

Gateway Health
• Medicare

Health Ohio Network
• PPO

 

 

HealthSpan (formerly Kaiser)
• HealthSpan Commercial
• HealthSpan Exchange
• HealthSpan Medicare Plus

PlusHealthstar/PPO Next
• PPO

Horizon Health
• Behavioral Health Only

Humana
See ChoiceCare
• Humana Gold Choice Medicare

Marymount Behavioral Health Services
• Behavioral Health Only

Medical Mutual of Ohio
• Traditional
• SuperMed Select
• SuperMed Classic
• HMO Health Ohio
• SuperMed HMO
• Medical Mutual Exchange

Molina Medicaid
• Medicaid
• Marketplace Exchange

National Provider Network
• PPO

Northcoast HealthCare
Management

• Home Health/Home Infusion

Ohio Bureau of Workers'
Compensation (BWC)

• All BWC MCO's

Ohio Health Choice Plan/Ohio
Health Choice Plus

• PPO
• EPO

PHS/Direct Care America
• PPO

Private Healthcare
Systems (PHCS)/MultiPlan

• PPO
• POS

Summa Care
• HMO
• PPO
• POS
• Medicare Advantage
• Apex PPO, EPO and POS
• SummaCare Exchange

United Behavioral Health
• Behavioral Health Only

United Healthcare
• HMO, PPO, POS
• Medicare HMO
• Secure Horizons (Medicare)
• Evercare Medicare
• United Healthcare Community (Medicaid)
• All Savers
• Compass –Exchange
• MyCare Ohio

ValueOptions
• Behavioral Health Only


Periodic updates of this list may occur. If you have any questions or require additional information, or if you would like to make suggestions for our contracting efforts, please contact Jan Cameron at 440-816-8098.

This list is meant to be a basic guide and not provide detailed information. 

EPO Exclusive Provider Organization
POS Point of Service Plan
HMO Health Maintenance Organization
PPO Preferred Provider Organization

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