TÍTULO DE LA POLÍTICA: Política de ayuda financiera de Centura Health

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1 TÍTULO DE LA POLÍTICA: Política de ayuda financiera de Centura Health DEPARTAMENTO: Gestión de ingresos FECHA DE CREACIÓN: 11/01/2006 CATEGORÍA: Facturación FECHA DE ENTRADA EN VIGOR: 1º de julio de 2016 APÉNDICE B PROVEEDORES CUBIERTOS* (Revisado el 06/29/2017) *Lista de proveedores a actualizar trimestralmente. La política de ayuda financiera (FAP, por sus siglas en inglés) de Centura cubre los honorarios de los siguientes profesionales. 84TH AVENUE NEIGHBORHOOD HEALTH CENTER ASPEN RIDGE ENT AT ST ANTHONY BILLINGS NEPHROLOGY CLINIC CARDIAC THORACIC SURGERY ASSOC ST ANTHONY CARDIAC THORACIC SURGERY ASSOC SUMMIT CASTLE ROCK ADVENTIST HOSPITAL PALLIATIVE CARE CENTER FOR ENDOCRINOLOGY AND DIABETES CENTRE FOR BEHAVIORAL HEALTH CENTURA CENTER FOR REHABILITATION PUEBLO CENTURA CENTER PUEBLO WEST CENTURA HEALTH ORTHOTICS AND PROSTHETICS CENTURA HEALTH PHYSICIAN GROUP CENTER FOR BREAST CARE HIGHLANDS CENTURA HEALTH URGENT CARE BROADMOOR CENTURA HEALTH URGENT CARE CANON CITY CENTURA HEALTH URGENT CARE TRI LAKES CENTURA NEUROSCIENCE CONCUSSION FRISCO CENTURA ORTHOPEDICS CHPG AUDUBON CENTURA ORTHOPEDICS CHPG BRIARGATE CENTURA ORTHOPEDICS CHPG BROADMOOR CENTURA ORTHOPEDICS CHPG LONE TREE CENTURA ORTHOPEDICS CHPG MEADOWS CENTURA ORTHOPEDICS MERIDIAN CENTURA ORTHOPEDICS PSA AUDUBON CENTURA ORTHOPEDICS PSA BRIARGATE CENTURA ORTHOPEDICS PSA BROADMOOR CENTURA ORTHOPEDICS PSA HUGO CENTURA ORTHOPEDICS PSA LAMAR CENTURA ORTHOPEDICS PSA LONE TREE Categoría Statewide Financial Assistance Policy Página 1 de 9

2 CENTURA ORTHOPEDICS PSA MEADOWS CENTURA ORTHOPEDICS PSA POWERS CENTURA PEDIATRICS ST THOMAS MORE CENTURA PHYSICAL THERAPY AT GOLDEN CENTURA PHYSICAL THERAPY NORTH CENTURA PHYSICAL THERAPY UNION CHPG PHYS MED & REHAB PORTER IP CHPG ADVENTIST HOSPITALISTS AVISTA CHPG AVISTA FAMILY MEDICINE CHPG BARIATRIC MEDICINE PARKER CHPG BREAST CARE LONGMONT CHPG BREAST CARE PORTER ADVENTIST HOSPITAL CHPG BREAST IMAGING LONGMONT CHPG BREAST IMAGING ST ANTHONY CHPG CARDIAC & THORACIC SURGERY DURANGO K CHPG CARDIAC & THORACIC SURGERY PENROSE CHPG CARDIAC & THORACIC SURGERY PUEBLO CHPG CARDIOLOGY AZTEC CHPG CARDIOLOGY CORTEZ CHPG CARDIOLOGY LONGMONT CHPG CARDIOLOGY MERCY CHPG CARDIOLOGY PAGOSA CHPG CENTER FOR BREAST CARE CHURCH RANCH CHPG CHURCH RANCH GENERAL SURGERY CHPG CHURCH RANCH PRIMARY CARE CHPG COLORADO HEAD NECK SPEC CHPG COLORADO JOINT REPLACEMENT CHPG COLORECTAL PARKER CHPG CRIPPLE CREEK & VICTOR MOUNTAIN HEALTH CENTER CHPG CRIPPLE CREEK PRIMARY CARE NORTH CHPG CRITICAL MEDICINE FOUR CORNERS CHPG CTR FOR BREAST CARE AVISTA ADVENTIST HOSPITAL CHPG CTR FOR BREAST CARE ST ANTHONY HOSPITAL CHPG CTR FOR BREAST CARE SUMMIT CHPG EKG INTERPRETATIONS ST THOMAS MORE CHPG ENDOCRINOLOGY LITTLETON CHPG ENDOCRINOLOGY LONGMONT CHPG ENDOCRINOLOGY PARKER CHPG ENDOCRINOLOGY ST ANTHONY CHPG ENDOCRINOLOGY SUMMIT CHPG ENDOCRINOLOGY THREE SPRINGS Categoría Statewide Financial Assistance Policy Página 2 de 9

3 CHPG ENT CASTLE ROCK CHPG ENT ORCHARD CHPG ENT PARKER CHPG ENT ST THOMAS MORE CHPG ENT SUMMIT CHPG FOUR CORNERS PULMONARY AND CC AT AZTEC CHPG GASTRO LONGMONT CHPG GASTROENTEROLOGY AVISTA CHPG GASTROENTEROLOGY CASTLE ROCK CHPG GASTROENTEROLOGY CHURCH RANCH CHPG GASTROENTEROLOGY MERCY CHPG GASTROENTEROLOGY ORCHARD CHPG GASTROENTEROLOGY PORTER CHPG GASTROENTEROLOGY ST MARY CORWIN CHPG GENERAL SURGERY LONGMONT CHPG GENERAL SURGERY MERCY CHPG GENERAL SURGERY ORCHARD CHPG GENERAL SURGERY ST ANTHONY CHPG GENERAL SURGERY ST ANTHONY KS CHPG GENERAL SURGERY ST. THOMAS MORE CHPG GOLDEN PRIMARY CARE CHPG GRACE FAMILY CHPG GYN ONC PENROSE CHPG HEART AND VASCULAR HEALTH AVISTA CHPG HEART AND VASCULAR HEALTH CHURCH RANCH CHPG HEART AND VASCULAR HEALTH GRANBY CHPG HEART AND VASCULAR HEALTH KREMMING CHPG HEART AND VASCULAR HEALTH SUMMIT CHPG HEART AND VASCULAR HEALTH SUMMIT LEAD CHPG HIGH COUNTRY PRIMARY CARE BRECKENRIDGE CHPG HIGH COUNTRY PRIMARY CARE FRISCO CHPG HIGH COUNTRY PRIMARY CARE SILVERTHORNE CHPG HIGH COUNTRY WOMEN S HEALTH GRANBY CHPG HIGH COUNTRY WOMENS HEALTH FRISCO CHPG HOME PALLIATIVE CARE MERCY CHPG HOME PALLIATIVE CARE ST ANTHONY CHPG HOSPITALISTS CASTLE ROCK CHPG HOSPITALISTS LITTLETON CHPG HOSPITALISTS MERCY CHPG HOSPITALISTS ORTHO COLO CHPG HOSPITALISTS PARKER Categoría Statewide Financial Assistance Policy Página 3 de 9

4 CHPG HOSPITALISTS PORTER CHPG HOSPITALISTS ST ANTHONY CHPG HOSPITALISTS ST ANTHONY NORTH CHPG HOSPITALISTS ST MARY CORWIN CHPG HOSPITALISTS ST THOMAS MORE CHPG INTERNAL MEDICINE AVISTA CHPG INTERNAL MEDICINE MERCY CHPG INTERNAL MEDICINE ORCHARD CHPG INTERNAL MEDICINE PARKER CHPG INTERNAL MEDICINE ST THOMAS MORE CHPG MEDICAL CONSULTANTS PORTER ADVVENTIST HOSPITAL CHPG MEDICAL ONCOLOGY AVISTA CHPG MEDICAL ONCOLOGY LITTLETON CHPG MEDICAL ONCOLOGY PARKER CHPG MEDICAL ONCOLOGY PORTER CHPG MEDICAL ONCOLOGY SUMMIT CHPG MERCY ORTHOPEDIC ASSOCIATES CHPG MERCY ORTHOPEDIC ASSOCIATES AZTEC CHPG MERCY ORTHOPEDIC ASSOCIATES FT LEWIS CHPG NEPHROLOGY CORTEZ CHPG NEPHROLOGY MERCY CHPG NEUROSCIENCE AND SPINE CHURCH RANCH CHPG NEUROSCIENCE AND SPINE LAH CHPG NEUROSCIENCE AND SPINE SAH CHPG NEUROSCIENCE AND SPINE SAH CHPG NEUROSCIENCE AND SPINE SAN ORCHARD CHPG NEUROSCIENCE AND SPINE ORCHARD CHPG NEUROSCIENCES AND SPINE CHURCH RANCH CHPG NEUROSURG AT LITTLETON HOSPITAL CHPG ORTHO AND SPORTS MED LT CHPG ORTHO AND SPORTS MEDICINE AT PORTER CHPG ORTHOPEDICS & SPORTS MEDICINE CASTLE ROCK MEADOWS CHPG ORTHOPEDICS & SPORTS MEDICINE HIGHLANDS CHPG ORTHOPEDICS ST MARY CORWIN CHPG ORTHOPEDICS ST THOMAS MORE CHPG PAIN SPECIALISTS AVISTA CHPG PAIN SPECIALISTS CHURCH RANCH CHPG PAIN SPECIALISTS ORCHARD CHPG PAIN SPECIALISTS PARKER CHPG PEDIATRICS FIRESTONE CHPG PEDIATRICS LONGMONT Categoría Statewide Financial Assistance Policy Página 4 de 9

5 CHPG PEDIATRICS NORTH CARE CHPG PENROSE NEUROSCIENCES CHPG PHYS MED & REHAB PORTER CHPG PRIMARY CARE BAYFIELD CHPG PRIMARY CARE BELMAR CHPG PRIMARY CARE BERTHOUD CHPG PRIMARY CARE BROADMOOR CHPG PRIMARY CARE CASTLE PINES CHPG PRIMARY CARE CHATFIELD CHPG PRIMARY CARE CHERRY CREEK CHPG PRIMARY CARE CLEMENT PARK CHPG PRIMARY CARE CORNERSTAR CHPG PRIMARY CARE DTC CHPG PRIMARY CARE EDGEWATER CHPG PRIMARY CARE FIRESTONE CHPG PRIMARY CARE HIGHLANDS CHPG PRIMARY CARE HIGHLANDS RANCH CHPG PRIMARY CARE HORSE GULCH CHPG PRIMARY CARE IDAHO SPRINGS CHPG PRIMARY CARE LONGMONT CHPG PRIMARY CARE LYONS CHPG PRIMARY CARE MEADOWS CHPG PRIMARY CARE MERCY CHPG PRIMARY CARE MERIDIAN CHPG PRIMARY CARE NIWOT CHPG PRIMARY CARE NORTHGLENN CHPG PRIMARY CARE PENROSE CHPG PRIMARY CARE PORTER CHPG PRIMARY CARE POWERS CHPG PRIMARY CARE PUEBLO CHPG PRIMARY CARE PUEBLO WEST CHPG PRIMARY CARE SOUTHLANDS CHPG PRIMARY CARE SOUTHWEST LONGMONT CHPG PRIMARY CARE ST THOMAS MORE CHPG PRIMARY CARE THORNTON CHPG PRIMARY CARE TIMBERVIEW CHPG PULMONARY & CC FOUR CORNERS CHPG PULMONARY & CC FOUR CORNERS CORTEZ CHPG SOUTH DENVER NEUROSURGERY CHPG SOUTHWEST NEUROSCIENCE CHPG SOUTHWEST RHEUMATOLOGY Categoría Statewide Financial Assistance Policy Página 5 de 9

6 CHPG SPECIALTY WOMENS CORNERSTAR CHPG SPORT & FAMILY MEDICINE PUEBLO CHPG SPORTS AND FAMILY MEDICINE ARVADA CHPG SPORTS AND FAMILY MEDICINE CHURCH RANCH CHPG ST ANTHONY CENTER EVERGREEN CHPG ST ANTHONY INTERNAL MEDICINE CHPG TRAVEL & INFECTIOUS DISEASE LONGMONT CHPG TRI LAKES NEIGHBORHOOD HEALTH CTR CHPG UROLOGY MERCY CHPG VASCULAR SURGERY PENROSE CHPG VASCULAR SURGERY PUEBLO CHPG VASCULAR SURGERY PUEBLO/CANON CITY CHPG WOMEN'S HEALTH ARVADA CHPG WOMEN'S HEALTH CASTLE ROCK CHPG WOMEN'S HEALTH CHATFIELD CHPG WOMEN'S HEALTH CHERRY CREEK CHPG WOMEN'S HEALTH CHURCH RANCH CHPG WOMENS HEALTH CORNERSTAR CHPG WOMEN'S HEALTH ERIE CHPG WOMENS HEALTH FIRESTONE CHPG WOMEN'S HEALTH HIGHLANDS CHPG WOMEN'S HEALTH LITTLETON CHPG WOMEN'S HEALTH LONE TREE CHPG WOMEN'S HEALTH LONE TREE CHPG WOMEN'S HEALTH LONGMONT CHPG WOMEN'S HEALTH LOUISVILLE CHPG WOMEN'S HEALTH MERIDIAN CHPG WOMEN'S HEALTH ORCHARD CHPG WOMENS HEALTH PARKER CHPG WOMEN'S HEALTH PINNACLE CHPG WOMEN'S HEALTH SOUTHLANDS CHPG WOMEN'S HEALTH ST THOMAS MORE CHPG WOMEN'S HEALTH THORNTON CHPG WOMEN'S SPECIALTY AVISTA CHPG WOMEN'S SPECIALTY HEALTH CHURCH RANCH CHPG WOMEN'S SPECIALTY HEALTH LOUISVILLE CHPG WOMEN'S SPECIALTY HEALTH MERIDIAN CHPG WOMEN'S SPECIALTY HEALTH PORTER COLO SPRINGS SET COLORADO SPORT AND SPINE ASPEN CREEK COLORADO SPORT AND SPINE AT LANGSTAFF BROWN Categoría Statewide Financial Assistance Policy Página 6 de 9

7 COLORADO SPORT AND SPINE AUDUBON HANDS COLORADO SPORT AND SPINE AUDUBON PSYCH COLORADO SPORT AND SPINE BRIARGATE PSYCH COLORADO SPORT AND SPINE CENTURA CENTER PSYCHOLOGY COLORADO SPORT AND SPINE CHURCH RANCH COLORADO SPORT AND SPINE CIRCLE COLORADO SPORT AND SPINE DRY CREEK COLORADO SPORT AND SPINE FRISCO COLORADO SPORT AND SPINE MONUMENT COLORADO SPORT AND SPINE SISTERS GROVE PAVILION COLORADO SPORT AND SPINE TRI LAKES COLORADO SPRINGS CARDIOLOGY COLORADO SPRINGS CARDIOLOGY BUENA VISTA COLORADO SPRINGS CARDIOLOGY CANON CITY COLORADO SPRINGS CARDIOLOGY DURANGO COLORADO SPRINGS CARDIOLOGY MONUMENT COLORADO SPRINGS CARDIOLOGY SALIDA COLORADO SPRINGS CARDIOLOGY SFMC COLORADO SPRINGS CARDIOLOGY WOODLAND PARK CS PT BROADMOOR CTSA CARDIAC TS DUR PIC SURGERY DURANGO DENVER SET DURANGO NEPHROLOGY ASSOCIATES EVERGREEN URGENT CARE GRAND MESA NEPHROLOGY IDFC ID & INTERNAL MED FOUR CORNERS LITTLETON PALLIATIVE CARE LONGMONT UNITED HOSPITAL MERCY INTEGRATED THERAPY DOWNTOWN MERCY INTEGRATED THERAPY HORSE GULCH MERCY INTEGRATED THERAPY THREE SPRINGS MERCY PALLIATIVE CARE MERCY REGIONAL MEDICAL CENTER MERCY REGIONAL MEDICAL CENTER DURANGO CANCER CENTER MERCY SOUTHWEST ONCOLOGY MERCY URGENT CARE AT DURANGO MOUNTAIN RESORT MONTANA NEPHROLOGY ASSOCIATES ORTHO COLO PALLIATIVE CARE PAH PALLIATIVE CARE PARKER PALLIATIVE CARE PEN PALLIATIVE CARE Categoría Statewide Financial Assistance Policy Página 7 de 9

8 PENROSE COMMUNITY URGENT CARE PENROSE INTENSIVE CARDIAC REHAB PENROSE MOUNTAIN URGENT CARE PIKES PEAK NEPHROLOGY PORTER ADVENTIST HOSPITAL PORTER ADVENTIST HOSPITAL PORTER ADVENTIST HOSPITAL ADULT PARTIAL PORTER ADVENTIST HOSPITAL CARDIAC DIAGNOSTICS PORTER ADVENTIST HOSPITAL ECT PORTER ADVENTIST HOSPITAL PRE ADMISSION TESTING PSF BEHAVIORAL HEALTH PSF BEHAVIORAL HEALTH BROADMOOR PSF BEHAVIORAL HEALTH PENROSE PSF BEHAVIORAL HEALTH REHAB PSF BEHAVIORAL HEALTH SISTERS PSF BEHAVIORAL HEALTH TRI LAKES REGIONAL MEDICAL CLINIC ASPEN CENTER S COLO FAM MED HIGH RISK OB S COLORADO FAMILY MEDICINE S SUBURBAN INTERNAL MEDICINE SAC NURSE FAMILY PARTNERSHIP SAH PALLIATIVE CARE SCH CONVENIENT CARE CLINIC SCH HEART CENTER SCH PALLIATIVE CARE SCHC PODIATRY SCHR RADIOLOGY PHYSICIANS SENIOR HEALTH WEST AT ST. ANTHONY HOSPITAL SFM PALLIATIVE CARE SIENA MEDICAL CLINIC ORTHOPAEDIC SURGERY SIENA MEDICAL CLINIC PEDIATRICS SMC PHYSICIAN PARTNERS PAIN AND REHAB SMC PHYSICIAN PARTNERS PAIN AND REHAB NORTH SOUTHERN COLORADO BREAST CARE SPECIALISTS SOUTHERN COLORADO NEPHROLOGY ST ANTHONY FAMILY MEDICINE CENTER ORCHARD ST ANTHONY HOSPITAL SENIOR HEALTH NORTH ST CATHERINE EMERGENCY PHYSICIANS Categoría Statewide Financial Assistance Policy Página 8 de 9

9 ST MARY CORWIN PALLIATIVE CARE ST. ANTHONY HOSPITAL BEHAVIORAL HEALTH ST. ANTHONY NORTH FAMILY MEDICINE 84TH ST. ANTHONY NORTH HEALTH CAMPUS NICU ST. ANTHONY NORTH HEALTH CAMPUS PALLIATIVE CARE ST. CATHERINE'S HOSPITAL SIENA MEDICAL CLINIC ST. FRANCIS MEDICAL CENTER ST. MARY'S NEPHROLOGY STM PALLIATIVE CARE SUMMIT PALLIATIVE CARE TRANSPLANT CENTER AT PORTER ADVENTIST HOSPITAL ULYSSES FAMILY PHYSICIANS ULYSSES SURGICAL WOUND CARE CENTER AT ST CATHERINE HOSPITAL Categoría Statewide Financial Assistance Policy Página 9 de 9