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Aetna Network Update - June 4, 2012

Eye Consultants of Pennsylvania located in Berks, Carbon and Schuylkill County will terminate from our Southeastern and Central PA Aetna network effective July 15, 2012
 
Highlights
• In a letter dated May 2, 2012, Eye Consultants of PA’s proposed a significant double digit increase for commercial and Medicare plans.
• The Network team has attempted to negotiate with rate offers in line with medical inflation and Eye Consultants of PA rejected all offers.
• Member notification letters have been released with a provider termination date of 06/15/2012. Member letters will not be rescinded to reflect 07/15/2012.
• Negotiations are currently on-going.
 
Physician Group Locations
1 Granite Point Drive
Suite 100
Wyomissing, PA 19610
 
100 Schuylkill Medical Plaza
Suite 100
Pottsville, PA 17901
 
1503 Sunset Drive
Suite 5
Pottstown, PA 19464
 
219 East Wesner Road
Blandon, PA  19510
                       
There are 27 participating physicians who are affiliated with Eye Consultants of Pennsylvania. This includes 19 ophthalmology and 8 optometry specialists. Of the providers, all 27 are Aexcel designated. 
 
Alternate Physician Groups available
Below is a listing of alternate participating practices/providers in the immediate area where employees and their dependents can continue to access care.
 
Berks Eye Physicians and Surgeons- Location in Wyomissing

Carim Eye Retina Center- Location in Wyomissing

Campanella and Pearah Eye Care Associates- Location in Sinking Springs

Progressive Vision Institute- Locations in Pottsville, Reading, Shamokin

Reading Hospital OPS- Location in West Reading

Solomon C. Luo, MD, PC- Reading and Pottsville

Neil Chasen, MD- West Reading

Delaware Valley Vision Associates- King of Prussia, Hatboro, Pottstown

Amiram Shapiro- Pottstown, PA

Wills Eye- King of Prussia, Collegeville
 
Eye Consultants of Pennsylvania may terminate their contract for the following product(s):
  •  HMO 
  •  Aetna Open Access® HMO 
  •  Quality Point-of-Service® (QPOS®
  •  Aetna Choice® POS 
  •  Aetna Medicaresm Plan (HMO)
  •  Aetna Medicaresm Plan (PPO) 
  •  Managed Choice® POS 
  •  Aetna Choice® POS II 
  •  Aetna Open Access®
  •  Managed Choice® POS 
  •  Elect Choice® EPO 
  •  Aetna Open Access®Elect Choice® EPO 
  •  Aetna Selectsm
  •  Open Access Aetna Selectsm
  •  Open Choice® PPO
Member letters
We sent letters to the following employees and their dependents: 
  • Employees and their dependents who have been treated by a specialist provider at least twice in the past 12 months.
We will help with transition of care
Aetna’s standard transition of care policy will apply to members actively in a course of treatment. If any of your employees will require frequent or continuing consultation with a specialist physician for ongoing covered care, the employee should contact his or her current PCP who can help arrange transfer of that care to a similar specialist in the Aetna network.  If the member does not have a relationship with a PCP, the member should check DocFind® and other available resources to help find another specialist in the Aetna Network.  For a limited time and when appropriate, Aetna will cover certain ongoing medical care for a serious illness for a specified period at the preferred level of benefits, rendered by a specialist who no longer participates in the network.
 
DocFind/directory information
We will remove Eye Consultants of Pennsylvania from our DocFind® online directory at the next scheduled update, after the contract is terminated.  Current printed provider directories include Eye Consultants of Pennsylvania. This Physician Group will be removed from the next directory edition. DocFind is updated nightly, and is the most current source of participating physician and hospital information.
 
Posted: 6/7/2012 8:47 AM