Billing & Insurance » Participating Health Plans

When you receive care at Catholic Health, you will be billed separately for hospital services and physician services.

This page lists the health plans that we participate in and the doctors who provide care at Catholic Health.

No insurance? If you do not have health insurance, you may be eligible for assistance in paying your hospital bills. Learn about financial assistance.

Close-up of health care form with options to select type of coverage

Does Catholic Health Participate in Your Health Plan?

Catholic Health participates in many health plan networks. You can find a list of the plans in which we participate in below.

Some health plans use smaller networks for certain products, so it is important to check whether we participate in your specific plan. Our list will tell you if we do not participate in all of a health plan’s products.

Hospital Charges: Hospitals are required by law to share their standard charges for the items and services they provide. Learn how to request pricing.

Does Your Doctor Participate in Your Health Plan?

The services that you receive by a doctor in the hospital are not included in the hospital charges. Doctors bill for their services separately.

Doctors who provide services at the hospital may be independent physicians or they may be employed by the hospital. They may or may not participate in the same health plans as the hospital.

To make sure that your care is covered by your health plan, please contact the following persons:

  1. The doctor who is arranging your hospital services: Ask which plans that he or she participates in.
  2. Other doctors who provide care: Ask the doctor who is arranging your hospital services if any other doctors will be needed for your care. Ask for contact information for these doctors, including the doctor’s name, practice name, mailing address, and telephone number.
  3. Physician groups that Catholic Health contracts with: These physician groups include anesthesiologists, radiologists, and pathologists. You will want to make sure that their services are covered under your plan.

Some health plans use smaller networks for certain products they offer, so it is important to check with your health plan to see whether Mount St. Mary’s Hospital participates in the specific plan you are covered by.

Participating Health Insurance Plans

Aetna/Magnacare
Amerigroup
Beechstreet
BlueCross BlueShield of Western New York
BlueCross BlueShield of Western New York Essential Plans
Cancer Services Program of Erie Co.
Cancer Services Program of Niagara Co.
ChampVA
Cigna
Fidelis
First Health (Coventry)
GHI (Emblem Health)
Hospice
Independent Health
Indian Health Services – Inpatient Only
Kalos Health
Magnacare Exchange Plan
Martin’s Point Tricare
Medicaid
Medicare
Meritain (North American Preferred)
Molina Health
Multiplan/PHCS
MVP (including Clearview)
No Fault
TLC Staff Builders PT Services Only
Today’s Options (American Progressive)
Tricare Champus
Tri-State Benefits (PACE)
Tuscarora Nation Health Center-OP Services Only
United Healthcare
United Mine Workers of America
Univera Healthcare
Wellcare
Workmen’s Comp

Examples of specific products Mount St. Mary’s Hospital is not participating with:

Aetna PPO and Medicare Plans
United Healthcare – Medicaid Plan (Except Alcohol and Substance Abuse Rehab)
Blue Choice Monroe Plan
Blue Cross Align Select
Empire Plan Routine Lab Series Processed Through United Healthcare
TLC Staff Builders – Other
Center Plans for Healthy Living
Independent Health Passport Advantage PPO (effective 1/1/18)

The health plans below are accepted by Catholic Health and our employed physicians.

If you do not see your insurance plan, please contact us at (716) 601-3600 and our customer service team will be happy to check your insurance coverage. You may also contact your insurance provider or physician directly for additional information.

Effective 1/1/18:

Aetna

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded All Products None
Health Care Exchange/Essential N/A N/A
Medicare All Products None
Medicaid None All Products

Amerigroup

Category of Insurance Included Products Excluded Products
Commercial N/A N/A
Self-Funded N/A N/A
Health Care Exchange/Essential N/A N/A
Medicare N/A N/A
Medicaid All Products None

Beech Street

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded All Products None
Health Care Exchange/Essential N/A N/A
Medicare N/A N/A
Medicaid N/A N/A

BlueCross BlueShield of Western New York

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded All Products (member cost shares may vary by product) None
Health Care Exchange/Essential All Products None
Medicare All Products None
Medicaid N/A N/A
ALIGN Health Plans Align Tiered Products (member cost share may vary by Tier/Service “Align Select” Products
FOCUS Health Plans All Products None

Cancer Services Program of Erie County

Category of Insurance Accepted?
Erie County Yes

Catholic Health LIFE Program

Category of Insurance Included Products Excluded Products
Commercial N/A N/A
Self-Funded N/A N/A
Health Care Exchange/Essential N/A N/A
Medicare All Products None
Medicaid All Products None

Cigna

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded All Products None
Health Care Exchange/Essential N/A N/A
Medicare All Products None
Medicaid N/A N/A

Fidelis

Category of Insurance Included Products Excluded Products
Commercial None None
Self-Funded None None
Health Care Exchange/Essential All Products None
Medicare All Products None
Medicaid All Products None

Fallon Health Weinberg

Category of Insurance Included Products Excluded Products
Commercial N/A N/A
Self-Funded N/A N/A
Health Care Exchange/Essential N/A N/A
Medicare None All Products
Medicaid None N/A

GHI

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded N/A None
Health Care Exchange/Essential N/A N/A
Medicare All Products None
Medicaid See Excluded Product All Products

Hospice

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded All Products None
Health Care Exchange/Essential All Products None
Medicare All Products None
Medicaid All Products None

Independent Health Association (IHA)

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded All Products None
Health Care Exchange/Essential All Products None
Medicare See Excluded Products IHA Passport Advantage PPO
Medicaid All Products None

Kalos Health

Category of Insurance Included Products Excluded Products
Medicare All None
Long Term Care All None

Magnacare

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded N/A N/A
Health Care Exchange/Essential All Products None
Medicare N/A N/A
Medicaid N/A N/A

Mailhandlers

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded N/A N/A
Health Care Exchange/Essential N/A N/A
Medicare N/A N/A
Medicaid N/A N/A

Martin’s Point

Category of Insurance Included Products Excluded Products
Commercial N/A N/A
Self-Funded N/A N/A
Health Care Exchange/Essential N/A N/A
Medicare All Products None
Medicaid N/A N/A

Medicare & Medicaid

Category of Insurance Accepted?
Traditional Medicare Yes
Traditional Medicaid Yes

Molina Health

Category of Insurance Included Products Excluded Products
Commercial N/A N/A
Self-Funded N/A N/A
Health Care Exchange/Essential All Products None
Medicare N/A N/A
Medicaid All Products None

Multiplan

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded N/A N/A
Health Care Exchange/Essential N/A N/A
Medicare N/A N/A
Medicaid N/A N/A

MVP

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded N/A N/A
Health Care Exchange/Essential None All Products
Medicare All Products None
Medicaid None All Products

North American/Meritain

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded N/A N/A
Health Care Exchange/Essential N/A N/A
Medicare N/A N/A
Medicaid N/A N/A

United Healthcare

Category of Insurance Included Products Excluded Products
Commercial See Excluded Products Compass and Oxford Plans
Self-Funded All Products None
Health Care Exchange/Essential Essential Plans N/A
Medicare/Dual All Products None
Medicaid All Products None

Univera

Category of Insurance Included Products Excluded Products
Commercial All Products None
Self-Funded All Products None
Health Care Exchange/Essential All Products None
Medicare All Products None
Medicaid All Products None

VA Choice

Category of Insurance Accepted?
VA Choice Yes

WellCare

Category of Insurance Included Products Excluded Products
Commercial N/A N/A
Self-Funded N/A N/A
Health Care Exchange/Essential All Products None
Medicare All Products None
Medicaid All Products None

For Mount St. Mary’s Hospital, download our list of contracted physician groups.

Anethesiologists

Site of Service Physician Group Website Contact Information
Kenmore Mercy Hospital Anesthesia Consultant Associates None (716) 874-1098
St. Joseph Campus Parkside Anesthesia None (716) 836-7510
Sisters of Charity Hospital Parkside Anesthesia None (716) 836-7510
Mercy Hospital of Buffalo Abbott Anesthesia None (716) 826-6628

Emergency Room

Site of Service Physician Group Website Contact Information
Kenmore Mercy Hospital Team Health www.teamhealth.com 1-800-848-3721
St. Joseph Campus Team Health www.teamhealth.com 1-800-848-3721
Sisters of Charity Hospital Team Health www.teamhealth.com 1-800-848-3721
Mercy Hospital of Buffalo Team Health www.teamhealth.com 1-800-848-3721

Hospitalist Services

Site of Service Physician Group Website Contact Information
Kenmore Mercy Hospital Buffalo Niagara Hospitalist Group None Craig Fetterman, MD; David Serra MD; (716) 447-6931
Dr. Zulkharnain, Dr. Adham None Dr. Zulkharnain (716) 472-4567
Dr. Adham (716) 263-8240
St. Joseph Campus Buffalo Medical Group None (716) 630-1100
Sisters of Charity Hospital Buffalo Medical Group None (716) 630-1100
Mercy Hospital of Buffalo Buffalo Medical Group None (716) 630-1100
Sound Physicians None 1-866-765-0513

Neonatologists

Site of Service Physician Group Website Contact Information
Kenmore Mercy Hospital N/A
St. Joseph Campus N/A
Sisters of Charity Hospital Buffalo Neonatology Associates None Kamal Singhal, MD (716) 310-8926
Mercy Hospital of Buffalo Mercy Laborists None Dept. of OB/GYN at Mercy, L. Gugino, Chair (716) 828-2568
Buffalo Neonatology Associates None Kamal Singhal, MD (716) 310-8926

Pathologists

Site of Service Physician Group Website Contact Information
Kenmore Mercy Hospital Eastern Great Lakes Pathology, PC None (716) 692-2160
St. Joseph Campus Eastern Great Lakes Pathology, PC None (716) 692-2160
Sisters of Charity Hospital Eastern Great Lakes Pathology, PC None (716) 692-2160
Mercy Hospital of Buffalo Eastern Great Lakes Pathology, PC None (716) 692-2160

Radiologists

Site of Service Physician Group Website Contact Information
Kenmore Mercy Hospital Southtowns Radiology Associates www.southtownsradiology.com (716) 649-9000
Sadashiv Shenoy, MD LLC None (716) 447-6177
St. Joseph Campus Southtowns Radiology Associates www.southtownsradiology.com (716) 649-9000
Sadashiv Shenoy, MD LLC None (716) 447-6177
Sisters of Charity Hospital Southtowns Radiology Associates www.southtownsradiology.com (716) 649-9000
Mercy Hospital of Buffalo Southtowns Radiology Associates www.southtownsradiology.com (716) 649-9000

 

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