Health Plan Matrix :: Nationwide Children's Hospital

Payor Matrix

Always check with your health plan for the most up-to-date coverage.

Nationwide Children's Hospital

Payor Inpatient
& Outpatient
Hospital Services
ChildLab
(outpatient lab)
Radiology
(outpatient diagnostic)
Clinical Therapy
Outpatient
*Physical
*Occupational
*Speech, etc.
 Close to Home
(Urgent Care)
Guidance Centers
Yes Yes Yes Yes Yes Yes
Aetna
(all products)
Yes Yes Yes Yes Yes Yes
Anthem
(all products)
Yes Yes Yes Yes Yes Yes
Bureau for Children with Medical Handicaps (BCMH) Yes Yes Yes Yes Yes Yes
Buckeye Community Health Plan (Medicaid Managed Care) Yes Yes Yes Yes Yes Yes
CareSource Yes Yes Yes Yes Yes Yes
CIGNA
(includes Great West and GWH - CIGNA)
Yes Yes Yes Yes Yes No
First Health Yes Yes Yes Yes Yes Yes
Yes Yes Yes Yes Yes Yes
HealthSmart Yes Yes Yes Yes Yes Yes
HealthSpan Yes Yes Yes Yes Yes Yes
Humana Yes Yes Yes Yes Yes Yes
Medicaid (Fee for Service) - Ohio Yes Yes Yes Yes Yes Yes
Medical Mutual
of Ohio
Yes Yes Yes Yes Yes Yes
Medicare Yes Yes Yes Yes Yes Yes
Molina Yes Yes Yes Yes Yes Yes
NPPN Yes Yes Yes Yes Yes Yes
Ohio Health Choice Yes Yes Yes Yes Yes Yes
OhioHealth Group HealthReach Yes Yes Yes Yes Yes Yes
OSU Managed Health Care Systems Yes Yes Yes Yes Yes Yes
Ohio Medicaid (Traditional) Yes Yes Yes Yes Yes Yes
Paramount Advantage - Medicaid Managed Care Yes Yes Yes Yes Yes Yes
Private Health Care Systems(PHCS) Yes Yes Yes Yes Yes Yes
The Health Plan (Commercial Only) Yes Yes Yes Yes Yes Yes
Tricare Military Health Services (HealthNet) Yes Yes Yes Yes Yes Yes
UniCare (Commerical Only)
Yes Yes Yes Yes Yes Yes
United Behavioral Health No N/A N/A N/A N/A Yes
United HealthCare Yes Yes Yes Yes Yes Yes
United HealthCare Community Plan (Unison Health Plan) Yes Yes Yes Yes Yes Yes
KEY:
Yes = Nationwide Children's Hospital does participate with this plan for this service.
No = Nationwide Children's Hospital does NOT participate with this plan for this service.
N/A = Not Applicable. The plan does not offer this service.

 

 

Payor

*  Contracted with Health Exchange Plan
(Affordable Care Act)
Nationwide Children's Hospital
NCH Westerville Surgery Center
Children's Anesthesia Associates
Children's Surgical Associates Corporation
Pediatric Academic Associates
Children's Radiologic Institute Pediatric Pathology Associates of Columbus
Accountable Health Plan of Ohio (AHPO) Yes Yes Yes Yes Yes Yes Yes
Aetna Yes Yes Yes Yes Yes Yes Yes
*  Anthem BC, BS and Anthem Health Exchange Plans Yes Yes Yes Yes Yes Yes Yes
Buckeye Community Health Plan (Medicaid Managed Care) Yes Yes Yes Yes Yes Yes Yes
Bureau for Children w Medical Handicaps (BCMH) Yes Yes Yes Yes Yes Yes Yes
CareSource (Medicaid Managed Care) Yes Yes Yes Yes Yes Yes Yes
Cigna/Great West/GWH Yes Yes Yes Yes Yes Yes No

Coventry Cares (WV Medicaid) & Coventry Health Care of WV (Commercial).

Formerly Carelink, effective 12-1-2013

Yes Yes Yes Yes Yes Yes Yes
Emerald Health Network now HealthSmart Yes Yes No No No No No
First Health Yes Yes No No No No No
Frontpath Health Coalition (Toledo & 80 reg hosp) Yes Yes Yes Yes Yes Yes Yes
Great West (GWH) part of Cigna Yes Yes Yes Yes Yes Yes No

Health Smart

Formerly Emerald Health

Yes Yes No No No No No
HealthScope/Central Benefits Yes Yes No No No No No
HealthSpan Yes Yes No No No No No
*  Humana Yes Yes No No Yes No No
*  Medical Mutual Ohio (MMO)/SuperMed and MMO Exchange Plans" Yes Yes Yes Yes Yes Yes Yes
Molina (Medicaid Managed Care) Yes Yes Yes Yes Yes Yes Yes
Ohio Health Choice Yes Yes Yes Yes Yes Yes Yes
OhioHealth Group/Health Reach Yes Yes Yes Yes Yes Yes No
OSU Health Plan, OSU Student Health Plan, University & Regional University Prime /Care, Mary Rutan Hosp (EBMC) and Ohio Wesleyan University Yes Yes Yes Yes Yes Yes Yes
Paramount Advantage (Medicaid Managed Care) Yes Yes Yes Yes Yes Yes Yes
PHCS-Private Healthcare Systems Yes Yes No No No No No
The Health Plan (commercial only) Yes Yes No No No No No
Tricare/Champus Yes Yes Yes Yes Yes Yes Yes
UHC Community Plan (Medicaid Managed Care) Yes Yes Yes Yes Yes Yes Yes
UHC/Golden Rule/ Oxford/River Valley/UMR Yes Yes Yes Yes Yes Yes Yes
Unicare (commercial only) Yes Yes No No No No No
KEY:
Yes = Nationwide Children's Hospital does participate with this plan for this service.
No = Nationwide Children's Hospital does NOT participate with this plan for this service.

Nationwide Children's Hospital Homecare

Payor Home Infusion Therapy Home Health
DME Home Hospice
No No No No
Aetna (all products) Limted access through CSI Limted access through CSI Limted access through CSI Limted access through CSI
Anthem (all products) Limited access through CSI or University Option Care Limited access through CSI or University Option Care Limited access through CSI or University Option Care Limited access through CSI or University Option Care
Bureau for Children with Medical Handicaps (BCMH) Yes Yes Yes No
Buckeye Community Health Plan (Medicaid Managed Care) Yes Yes Yes Yes
CareSource Yes Yes Yes Yes
CIGNA
(includes Great West and GWH - CIGNA)
Referrals must go through Gentival CareCentrix Referrals must go through Gentival CareCentrix Referrals must go through Gentival CareCentrix Referrals must go through Gentival CareCentrix
First Health No No No No
Yes Yes Yes No
HealthSmart No No No No
HealthSpan No No No
No
Humana No No No No
Yes Yes Yes Yes
Medical Mutual
of Ohio
Yes Yes Yes Yes
Medicare No No Yes Yes
Molina Yes Yes Yes Yes
NPPN No No No No
Ohio Health Choice Yes Yes Yes Yes
OhioHealth Group HealthReach Yes Yes Yes Yes
OSU Managed Health Care Systems Yes Yes Yes Yes
Ohio Medicaid (Traditional) Yes Yes Yes Yes
Paramount Advantage - Medicaid Managed Care Yes Yes Yes Yes
Private Health Care Systems(PHCS) No No No No
The Health Plan (Commercial Only) No No No No
Tricare Military Health Services (HealthNet) Yes Yes Yes Yes
UniCare (Commerical Only) Limited access through CSI or University Option Care Limited access through CSI or University Option Care Limited access through CSI or University Option Care Limited access through CSI or University Option Care
United Behavioral Health Yes Yes Yes Yes
United HealthCare N/A N/A N/A N/A
United HealthCare Community Plan (Unison Health Plan) Yes Yes Yes Yes
KEY:
Yes = Nationwide Children's Hospital does participate with this plan for this service.
No = Nationwide Children's Hospital does NOT participate with this plan for this service.
N/A = Not Applicable. The plan does not offer this service.
Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000