Oaktree Hospital

Insurance Name	Hospital Service	Referral Form Required	Pre-Certification Phone Reference	Initiating Provider
Oaktree Health Plan	Inpatient Acute Care – Elective Non-Elective Extended Acute	Yes No No	Yes Yes Yes	Admitting Physician
Billing Address:	Skilled Nursing Facility	No	Yes	Admitting Physician
	Outpatient
PO Box 1520	Emergency Room Visits	No	No
Philadelphia, PA. 19105	Same Day Surgery	Yes	Yes	PCP/Specialist
	Diagnostic Radiology	Yes	No	PCP
Eligibility 800-959-6258	CT Scan	Yes	No	PCP
	Stress Test	Yes	No	PCP
Pre-Certification 800-949-4661	Nuclear Stress Test	Yes	No	PCP
	Echo	Yes	No	PCP
Provider Services 800-959-6258	Ultrasound	Yes	No	PCP
	Chemotherapy	Yes	Yes	PCP
	Laboratory
	Capitated with SmithKline	Yes –SmithKline Lab Form	No
	STAT testing at Hospital	Yes – Write stat on form	No
	Pre-Admission Testing	Yes – See note #1		PCP/Specialist
Referral is good for 60 days	Cardiology Department	Yes	Yes	PCP
3 visits per referral	Physical Therapy	Yes	Yes	PCP Must Call
	Speech Therapy	Yes	No	PCP
Contact Person:	Occupational Therapy	Yes	No	PCP
Franklyn Martinez	Pulmonary/Respiratory	Yes	Yes	PCP
215-814-4744	Gastroenterology	Yes	Yes	PCP
	Infusion	Yes	Yes	PCP

Inpatient