Managed Care is the integration of the delivery and payment of healthcare services to individuals.
Roper St. Francis includes more than 20 facilities and services in four counties. Our facilities include two acute care hospitals, an inpatient rehab hospital, four emergency rooms, outpatient surgery centers, and outpatient lab and imaging, just to name a few. We are also proud of our large offering of physician services which encompasses both primary care and many specialties such as orthopaedics, OB/GYN, neurosurgery, and many more.
Our primary goal is to provide our community with access to all Roper St. Francis facilities, physicians and services through our network participation with more than 40 insurance plans. These insurance plans include, but are not limited to: Health Maintenance Organizations (HMO), Exclusive Provider Organizations (EPO), Preferred Provider Organizations (PPO), Point of Service Plans (POS), Indemnity, Worker’s Compensation, Medicare Advantage, Medicaid Managed Care, and Hospice plans.
We know insurance can be very confusing, so here are a few hints to make your visit easier:
- bring your insurance card and form of payment with you to each visit.
- ask one of our representatives at the time of service to verify whether we participate with your insurance.
- if required by your plan, obtain any necessary pre-authorizations or pre-certifications in advance of your services.
Insurance Carrier:
Aetna/ProNet
Beech Street/Capp Care
Blue Choice Health Plan
Blue Cross Blue Shield Federal Plan
Blue Cross Blue Shield of South Carolina
Blue Cross Blue Shield Preferred Blue
Carolina Care Plan
CCN (through First Health)
ChoiceCare (Humana)
CIGNA Healthcare
Coventry
CWI Benefits - Roper St. Francis Healthcare Employees Only
First Health
Kanawha
Mailhandlers Benefit Plan (through First Health)
MedCost
MultiPlan
National Provider Networks (NPN)
One Health Plan (Great West)
Premier
Private Healthcare Systems (PHCS) (through Multiplan)
SouthCare PPO (Ethix, Southeast)
State Health Plan
Thomas Cooper & Assoc
Tricare - Prime
Tricare - Standard
United Health Care
United Payors/United Providers (America's Hlth Plan)
USA Managed Care Organization - except for Medicare Supplement
Wellpath
Medicaid Plans:
Traditional Medicaid
SelectHealth (First Choice)
Medicare Plans:
Traditional Medicare
Blue Cross Blue Shield Medicare Blue
Humana Choicecare Medicare PPO
United Healthcare Medicare
Hospice:
Hospice of Charleston
Hospice Health Services
Southern Care Hospice
Lutheran Hospice
Odyssey HealthCare, Inc.
Heartland Hospice
Palmetto Health Hospice
Winyah Community Hospice Care
Behavioral Health:
Planned Behavioral Health Care, Inc.
Preferred Mental Health Management
Workers' Compensation:
Corvel/CoreCare
Focus
To ensure that Roper St. Francis is in-network with your plan you should verify our status as an in-network provider as of the day of your visits and/or admission. To learn the specifics of your coverage, contact your insurance provider directly. Your insurance representative is the best person to inform you of the level of coverage you will have as a patient at Roper St. Francis.
Thank you for choosing Roper St. Francis Healthcare for your healthcare needs, and for visiting our website. For further information, please call us at 402.CARE and ask for the Managed Care Department.
Please note:
* Plan participation is subject to change without notice.
* Medical Savings Program cards are not accepted. Examples: Capella, Care Entrée, Life Guard or Wellcare.
* All Roper St. Francis Healthcare Facilities participate with the above insurance carriers unless otherwise indicated.