|Specialty:||The provider’s particular field of practice (choose from the drop down list or type in your selection).|
|Who Are You Looking For?:||Type in the provider’s last and/or first name (in part or in full) that you are looking for.|
|Where:||The city where the provider’s office is located (choose from the drop down list or type in your selection).|
|Zip Code:||The zip code where the provider’s office is located (choose from the drop down list or type in your selection).|
|Service Facility:||A field of practice conducted at the facility (choose from the drop down list or type in your selection).|
|What are you looking for?:||Type in the name (in part or in full) of the facility that you are looking for.|
|Where:||The city where the facility is located (choose from the drop down list or type in your selection).|
|Zip Code:||The zip code where the facility is located (choose from the drop down list or type in your selection).|
This directory is current as of January 25, 2020
This directory provides a list of Simpra Advantage’s current network providers.
This directory is for Simpra Advantage’s residents of Alabama.
Simpra Advantage complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
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This directory provides a list of Simpra Advantage’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC).
You will have to choose one of our network providers in this directory to be your Primary Care Provider (PCP). Generally, you must get your health care coverage from your PCP. Your PCP works in collaboration with your Simpra Advantage Nurse Practitioner to assure you receive seamless, patient-centered care.
The network providers listed in this directory have agreed to provide you with health care services. You may go to any of our network providers listed in this directory; however, some services may require a referral. To obtain a referral, please contact your PCP or Nurse Practitioner.
For a complete listing of services that require prior authorization, or a referral, please refer to the Member Resources section of the Simpra Advantage website at Simpra.com or call our Member Services Department at 1-844-637-4770 (TTY 711).
Our network providers are the doctors and other health care professionals, medical groups, hospitals, and other health care facilities that have an agreement with us to accept our payment and your cost-sharing amount as payment in full.
You may go to any of our network providers listed in this directory, and you may also receive services from out-of-network providers. Before receiving services from an out-of-network provider, you may want to contact Simpra Advantage to confirm if prior authorization is required, and if the services you are receiving are covered by the plan.
We have arranged for these providers to deliver covered services to members in our plan. The providers in our network bill us directly for care they give you. When you see a network provider, you pay only your share of the cost for their services. If you use an out-of-network provider, your share of the costs for your covered services may be higher.
In most cases, the out-of-network provider must be eligible to participate in Medicare. If you receive care from a provider who is not eligible to participate in Medicare, you will be responsible for the full cost of the services you receive. Check with your provider before receiving services to confirm that they are eligible to participate in Medicare.
If you receive a bill from an out-of-network provider, you should not pay the bill, unless you have received an Explanation of Benefits (EOB) that details what the plan will pay for your service, and any remaining balance you need to pay. The out-of-network provider may also bill you for any remaining balance not paid by Simpra Advantage.
If you have already paid for the covered services, Simpra Advantage will reimburse you for our share of the cost, if prior approval is obtained. If you have any questions, visit Simpra.com or call member services at 1-844-637-4770 (TTY 711).
Payment for services is contingent upon:
Out-of-network providers are under no obligation to treat Simpra Advantage enrollees, except in emergencies. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call our Member Services at 1-844-637-4770 (TTY 711). You may also refer to your Evidence of Coverage for more information, including the cost sharing that applies to out-of-network services.
The counties in our service area are listed below:
This interactive directory contains two listings of providers.
Step 1: Select the type of provider you are looking for, doctor/health care professional, or medical facility.
Step 2: Search by a specialty, name of provider, name of facility, or by the office location (city, state or zip code).
You may get directions or view the location on a map by clicking the image of the map on the right side of the provider’s information on the details page.
If you have questions about Simpra Advantage, or require assistance in selecting a PCP, please call our Member Service Department at 1-844-637-4770 (TTY 711) , TTY users should call 711, or visit Simpra.com.