Provider and Pharmacy Network

Provider and Pharmacy Network

The Provider and Pharmacy Directory is a list of the providers and pharmacies in the RiverSpring Star (HMO SNP) network. While you are a Member of our plan, you must use network providers, with some exceptions, to get covered services.

For more information about the directory, you can call Member Services at 1-800-580-7000 and we would be happy to assist you in identifying a provider who meets your needs and preferences, including any special accommodations that you may not see in the directory.

Provider and Pharmacy Directory

How to Get Care from Out-of-Network Providers

Out-of-network providers are providers that are not in the RiverSpring Star (HMO SNP) network. If you need care that our plan covers and our network providers cannot give it to you, you can get permission from RiverSpring STAR (HMO SNP) to get the care from an out-of-network provider. Contact Member Services at 1-800-580-7000, 7 Days a Week from 8am – 8pm Eastern Time.

Getting Care During a State of Disaster or Emergency

If the Governor of your state, the U.S. Secretary of Health and Human Services, or the President of the United States declares a state of disaster or emergency in your geographic area, you are still entitled to care from RiverSpring Health.

During a declared disaster, we will allow you to get your care from out-of-network providers, including pharmacies, at your standard cost-sharing amount.

What to Do if You Receive a Bill from a Provider or Pharmacy

Providers should only bill RiverSpring for the cost of your covered services and items. If you receive a bill from a provider, you should send it to us to pay.

If you have any questions, please call Member Services at 1-800-580-7000 (TTY 711) 7 Days a Week from 8am – 8pm Eastern Time.

Please note: If you need to go to an out-of-network provider, please work with RiverSpring Star to get approval to see an out-of-network provider and to find one that meets applicable Medicare. If you go to an out-of-network provider without first getting Plan approval, you may have to pay the full cost of the services you get.


Last updated on July 9, 2019