Accepted Insurance Plans

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.

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Aetna US Healthcare

• HMO
• Elect Choice (EPO)
• Aetna Select
• Aetna Select Open Access
• Aetna Open Access Elect Choice (EPO)
• Quality Point-of-Service (QPOS)
• Managed Choice (POS)
• Aetna Choice POS
• Aetna Choice POS II
• Aetna Open Access Managed Choice
• Open Choice (PPO)
• Traditional Choice Indemnity
• Aetna Insurance Exchange
• Aetna Medicare Advantage HMO & PPO

Anthem Blue Cross and Blue Shield of Ohio

• Blue Access PPO
• Blue Access OH I & II (prefix VXA,XVD)
• 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 Pathway X Tiered PPO—Marketplace
• Anthem Pathway Tiered PPO— 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

*NOTE—we are an out-of-network provider for Caresource Marketplace. These patients are welcome to receive care at Southwest, but they may be responsible for higher out-of-pocket expenses.

Cigna Behavioral Health

• Behavioral Health Only

Cigna Healthcare of Ohio

• HMO
• PPO
• Gatekeeper PPO
• International

Emerald Health/InterPlan Health/HealthSmart

• PPO

First Health Network/CCN/Coventry

• PPO

Flora Health Network-PPOM

• PPO

Gateway Health

• Medicare

Health Design Plus

• UH Choice RTA

Health Ohio Network

• PPO

Healthstar/PPO Next

• PPO

Horizon Health

• Behavioral Health Only

Humana

• Commercial PPO, HMO, POS, EPO
• Commercial HMOx
• Medicare PPO, HMO
• Medicare Network PFFS

Marymount Behavioral Health Services

• Behavioral Health Only

Medical Mutual of Ohio

• Traditional
• SuperMed Select
• SuperMed Classic
• Supermed HMO
• HMO Health Ohio
• Medical Mutual Exchange
• Medicare Advantage

Molina

• 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

*NOTE—Southwest General is Out Of Network for SummaCare Exchange–patients will have a higher out of pocket.

United Behavioral Health

• Behavioral Health Only

United Healthcare

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

Beacon Health (Value Options)

• Behavioral Health Only

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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 Michelle Cinquepalmi at 440-816-6779.

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