Vincent F. Biank, M.D.

Vincent F. Biank, M.D.

Vincent F. Biank, M.D.

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Conditions & Procedures

Conditions

Inflammatory Bowel Disease (IBD)

Procedures

Pediatric Gastroenterology (GI)

General Information

Gender

Male

Affiliation

NorthShore Medical Group

Expertise

Pediatric GI Disorders, Reflux, Abdominal Pain

Academic Rank

Clinician Educator

Languages

English

Board Certified

Pediatric Gastroenterology, Pediatric Transplant Hepatology, Pediatrics

Clinical Service

Pediatric Gastroenterology

Education, Training & Fellowships

Medical School

University of Illinois - Rockford School of Medicine, 2001

Internship

Children's Hospital of Wisconsin, 2002

Residency

Children's Hospital of Wisconsin, 2004

Fellowship

Medical College of Wisconsin, 2007

Locations

A

NorthShore Medical Group

1000 Central St.
Suite 800
Evanston, IL 60201
847.570.1795 847.503.4590 fax Get Directions This location is wheelchair accessible.
B

NorthShore Medical Group

9650 Gross Point Rd.
Suite 3900
Skokie, IL 60076
847.570.1795 847.503.4590 fax Get Directions This location is wheelchair accessible.
C

NorthShore Medical Group

2150 Pfingsten Rd.
Suite 3000
Glenview, IL 60026
847.570.1795 847.503.4590 fax Get Directions This location is wheelchair accessible.
D

NorthShore Medical Group

830 W. End Ct.
Suite 500
Vernon Hills, IL 60061
847.570.1795 847.503.4590 fax Get Directions This location is wheelchair accessible.

Insurance

Commercial Plans - Employer Sponsored
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Aetna Choice POS II
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Aetna Health Network Only
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Aetna HMO
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Aetna Managed Choice
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Aetna Network Options
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Aetna Open Access Aetna Select
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Aetna Open Access Managed Choice
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Aetna Open Choice PPO
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Aetna Savings Plus
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Aetna Select
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Aetna Sub- Cofinity
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Aetna Sub- First Health
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Aetna Traditional Choice-Indemnity Plan
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Aetna Whole Health Chicago (All Metal Tiers)
Not Available In 2017
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Beechstreet PPO Network
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Blue Cross Blue Shield Blue Advantage HMO
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Blue Cross Blue Shield Blue Choice Options
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Blue Cross Blue Shield Blue Choice Preferred PPO Plans (All Metal Tiers)
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Blue Cross Blue Shield Blue Choice Select PPO
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Blue Cross Blue Shield Blue Choice Select Value Choice
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Blue Cross Blue Shield Blue Distinction Total Care Benefit Differentail
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Blue Cross Blue Shield Blue Options (All Metal Tiers)
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Blue Cross Blue Shield Blue PPO (All Metal Tiers)
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Blue Cross Blue Shield Blue Precision HMO Plans (All Metal Tiers)
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Blue Cross Blue Shield BlueCare Direct (All Metal Tiers)
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Blue Cross Blue Shield BlueEdge HSA and BlueEdge HCA
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Blue Cross Blue Shield BluePrint
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Blue Cross Blue Shield HMOI
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Blue Cross Blue Shield PPO
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Blue Cross Blue Shield PPO Value Choice
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Cigna Exclusive Provider Organization EPO
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Cigna Great West Healthcare (GWH) Cigna Network
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Cigna HMO
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Cigna HMO Open Access
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Cigna HMO Open Access POS
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Cigna HMO POS
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Cigna Medical PPO
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Cigna Medical Indemnity
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Cigna Medical LocalPlus
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Cigna Medical LocalPlus In-Network
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Cigna Medical Network
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Cigna Medical Network POS
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Cigna Medical Open Access Plus (OAP)
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Cigna Medical Open Access Plus (OAP) In-Network
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Cigna Medical Open Access POS
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Cofinity PPO (an Aetna Company)
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Coventry Consumer Choices (C3)
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Coventry HMO
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Coventry POS
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Coventry PPO
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Galaxy Health Network
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Health Alliance HMO, PPO, POS, POS-C
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Health Link HMO
If Unicare Affiliate logo present on card
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Health Link PPO
If Unicare Affiliate logo present on card
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Health Link-Open Access I, II, III
If Unicare Affiliate logo present on card
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Healthcare's Finest Network- FHN 10 & 20
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Healthcare's Finest Network- FHN Platinum
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Healthcare's Finest Network- HFN Community Health Connect
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Healthcare's Finest Network- HFN Community Health Connect Elite
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Healthcare's Finest Network- HFN Community Health Connect Premiere
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Healthcare's Finest Network- HFN-ID
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Humana Advocate Centered EPO
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Humana Advocate Centered HMO
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Humana Choice POS
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Humana Classic Plan (Traditional Indemnity Plan)
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Humana Coinsurance: NPOS
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Humana Coinsurance: PPO
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Humana Coinsurance:HMO
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Humana Condell Custom PPO
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Humana Copay: HMO
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Humana Copay: NPOS
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Humana Copay: PPO
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Humana COT National POS-Open Access
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Humana Edward- Elmhurst Value HMO
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Humana Edward-Elmhurst Advantage HSA/Choice PPO
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Humana High-deductible plans (HDHP) HMO
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Humana High-deductible plans (HDHP) National point of service (NPOS)
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Humana High-deductible plans (HDHP) PPO
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Humana Illinois Coordinated Care
Available In 2017
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Humana Level Funded Premium
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Humana NorthShore Complete Care
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Humana Self Funding: Administrative Services Only (ASO)
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Humana Self-Funding: Level Funded Premium (LFP)
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Humana Self-Funding: Minimum Premium (MP)
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Humana Self-Funding: Stop Loss Insurance
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Humana Simplicity (HMO, POS, PPO)
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Humana Total Health (100 or more employees)
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Multiplan/ PHCS- Health EOS Network
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Multiplan/ PHCS- MultiPlan Complementary
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Multiplan/ PHCS- MultiPlan Limited Benefit Plan
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Multiplan/ PHCS- MultiPlan Practitioner Only
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Multiplan/ PHCS- MultiPlan Shared Savings
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Multiplan/ PHCS- PHCS Healthy Directions
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Multiplan/ PHCS- PHCS Practitioner Only
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Multiplan/ PHCS- PHCS Savility
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Multiplan/ PHCS- ValuePoint by MultiPlan
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NorthShore Employee Network
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Preferred Network Access
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Preferred Plan- HealthSmart Get Better
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Preferred Plan PPO
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Stratose- National Preferred Provider Network
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Three Rivers Provider PPO Network (TRPN)
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UniCare HMO
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UniCare HMO Performance Select
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Unicare PPO
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UniCare Travel Access
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United Healthcare Catalyst
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United Healthcare Choice
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United Healthcare Choice Plus
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United Healthcare Core
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United Healthcare Heritage
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United Healthcare Multi-Choice
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United Healthcare Navigate and Navigate Plus
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United Healthcare Options Non-Differential PPO
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United Healthcare Options PPO
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United Healthcare Tiered Benefits
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Exchange Plans
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Aetna Whole Health Chicago (All Metal Tiers)
Not Available In 2017
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Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
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Ambetter Balance Care 10+ Vision+ Adult Dental
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Ambetter Balanced Care 1
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Ambetter Balanced Care 1+ Vision+ Adult Dental
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Ambetter Balanced Care 10
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Ambetter Balanced Care 2
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Ambetter Balanced Care 2+ Vision+ Adult Dental
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Ambetter Essential Care 1
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Ambetter Secure Care 1 w/ 3 Free PCP Visits
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Blue Cross Blue Shield Basic 103 Multi-State Plan
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Blue Cross Blue Shield Blue Choice Preferred PPO (Plan #'s 101-107; All Metal Tiers)
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Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
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Blue Cross Blue Shield Blue Precision HMO (Plan #'s 101-103; All Metal Tiers)
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Blue Cross Blue Shield Blue Premier 101 Multi-State Plan
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Blue Cross Blue Shield BlueCare Direct with Advocate (Plan #'s 101-103; All Metal Tiers)
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Blue Cross Blue Shield Solution 102 Multi-State Plan
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Coventry $15 Copay; Silver & Gold
Not Available In 2017
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Coventry Bronze $ 20 Copay
Not Available In 2017
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Coventry Bronze $10 Copay Carelink St. John's
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Coventry Bronze $15 Copay Carelink St. John's
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Coventry Bronze Deductible Only HSA Eligible
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Harken Health - an Affiliate of United Healthcare
Verify physician participation and out of pocket expenses with Harken
PRIMARY CARE
SPECIALTY CARE
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Health Alliance HMO (All Metal Tiers)
PRIMARY CARE
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HOSPITALS
 
 
 
Health Alliance POS (All Metal Tiers)
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Health Alliance PPO (All Metal Tiers)
PRIMARY CARE
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Humana Chicago HMOx (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
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Land of Lincoln Health Traditional PPO
Plan Ending 9/30/16
PRIMARY CARE
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United Healthcare Compass (All Metal Tiers)
Not Available In 2017
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Medicaid
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Aetna Better Health FHP
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Aetna Better Health ICP
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Blue Cross Blue Shield Community FHP
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Blue Cross Blue Shield Community ICP
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Cigna HealthSpring ICP
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Community Care Alliance- ICP
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Family Health Network- FHP
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Harmony/WellCare FHP Plan
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Humana ICP
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Illinicare Family Health Plan (FHP/ACA)
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Illinicare ICP
Primary Care- Current Patients Only
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Illinois Department of Public Aid (IDPA)
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Meridian FHP/ACA Expansion
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Meridian ICP
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Molina ICP
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Next Level ACA/FHP
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Medicare Advantage Plans
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Aetna Medicare (SM) Plan (HMO)
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Aetna Medicare (SM) Plan (PPO)
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Aetna Medicare Advantage Group Plans
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Aetna Medicare Connect Plus (PPO)/PPO Connect Plus
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Aetna Medicare Standard Plan (PPO)/PPO Standard Plan
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Aetna Medicare Value Plan (HMO)/HMO Value
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Aetna Medicare Value Plan (PPO)/PPO Value Plan
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Aetna Traditional Choice Plan
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Blue Cross Blue Shield Medicare Advantage Basic HMO
PRIMARY CARE
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Blue Cross Blue Shield Medicare Advantage Basic Plus HMO-POS
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Blue Cross Blue Shield Medicare Advantage Choice Plus PPO
PRIMARY CARE
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Blue Cross Blue Shield Medicare Advantage Choice Premier PPO
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Cigna-HealthSpring Advantage HMO
PRIMARY CARE
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Cigna-HealthSpring Premier HMO-POS
PRIMARY CARE
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Cigna-HealthSpring Primary HMO
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Cigna-HealthSpring TotalCare HMO-SNP
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Community Care Alliance Complete HMO-D-SNP
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Community Care Alliance HMO
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Harmony/WellCare Access (HMO-SNP)
PRIMARY CARE
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Harmony/WellCare Choice (HMO-POS)
PRIMARY CARE
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Harmony/WellCare Health Plan
PRIMARY CARE
SPECIALTY CARE
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Harmony/WellCare RX (HMO)
PRIMARY CARE
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Harmony/WellCare Value (HMO-POS)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare-Medicare HMO Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare-Medicare Special Needs Plans
PRIMARY CARE
SPECIALTY CARE
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Humana Choice PPO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana Community HMO Diabetes and Heart (SNP Program)
PRIMARY CARE
SPECIALTY CARE
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Humana Gold Plus HMO
PRIMARY CARE
SPECIALTY CARE
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Humana Gold Plus PFFS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Molina Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare - AARP Medicare Complete
PRIMARY CARE
SPECIALTY CARE
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United Healthcare AARP Medicare Complete Access
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare- AARP Medicare Complete Plus (HMO-POS)
PRIMARY CARE
SPECIALTY CARE
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United Healthcare Medicare Advantage Focus
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare- Medicare Solutions/Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Medicare Medicaid Alignment Initiative (MMAI) Plans
PRIMARY CARE
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HOSPITALS
Aetna Better Health MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Community MLTSS/LTSS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Community MMAI
PRIMARY CARE
SPECIALTY CARE
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Cigna-HealthSpring MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Illinicare MLTSS/LTSS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Illinicare MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Molina MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Commercial - Individual Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Bronze Deductible Only HSA Eligible Savings Plus OAMC PD
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Savings Plus OAMC PD (All Metal Tiers)
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago (All Metal Tiers)
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Ambetter Balanced Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 1+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Essential Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Secure Care 1 w/ 3 Free PCP Visits
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred PPO (Plan #'s 101-107; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Cross Blue Premier 101 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Cross Blue Shield Basic 103 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Precision HMO (Plan #'s 101-103; All Metal Tiers)
Verify PCP Participation
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Blue Precision Platinum HMO 104
Verify PCP Participation
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield BlueCare Direct with Advocate (Plan #'s 101-103; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Solution 102 Multi-State Plan
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Publications

  • Nonalcoholic Fatty Liver Disease in Pediatrics.

    Pediatric annals 2016 Feb

    Authors: Duncan M, Zong W, Biank VF, Hageman JR
    Abstract
    A 16-year-old Hispanic girl with an elevated body mass index in an otherwise normal state of health presented for her well-child examination. She had signs of metabolic syndrome and insulin resistance including increased waist circumference and acanthosis nigricans. Laboratory results revealed elevated transaminases with otherwise normal hepatic function. Based on the physical examination and laboratory results, she was diagnosed with nonalcoholic fatty liver disease (NAFLD). After further evaluation, she eventually underwent a liver biopsy. The biopsy revealed nonalcoholic steatohepatitis (NASH) with stage 2 fibrosis. This article reviews the definition of NAFLD and NASH, an increasingly prevalent cause of pediatric chronic liver disease associated with obesity and metabolic syndrome. The article also outlines the epidemiology, risk factors, and natural history of NAFLD, which may help identify and prevent high-risk pediatric patients from progressing to irreversible liver disease. Understanding the diagnostic and treatment options offers the best chance at preventing and reversing the early stages of this disease.
    PMID: 26878184 [PubMed - as supplied by publisher]
  • Clinical Review of Failure to Thrive in Pediatric Patients.

    Pediatric annals 2016 Feb

    Authors: Larson-Nath C, Biank VF
    Abstract
    Failure to thrive (FTT) is a common problem that occurs when caloric intake is insufficient to maintain growth. For the majority of children it can be reversed with behavioral modifications and increased caloric provisions. In a minority of cases, FTT is the symptom of underlying organic disease. Routine evaluation with laboratory tests, imagining studies, and endoscopy results in an etiology of FTT in <1.4% of cases, and when investigations are positive the organic etiology is most often suspected based on history and/or physical examination. Therefore, these evaluations should be limited to those children with clear symptoms of organic disease and those who fail to grow with behavioral and nutritional interventions.
    PMID: 26878182 [PubMed - as supplied by publisher]
  • Pediatric Gastroenterology.

    Pediatric annals 2016 Feb

    Authors: Liu TC, Gurram B, Baldridge M, Head R, Lam V, Luo C, Cao Y, Simpson P, Hayward M, Holtz M, Noe J, Lerner D, Cabrera J, Biank V, Stephens M, Huttenhower C, McGovern D, Xavier R, Stappenbeck T, Salzman N
    Abstract
    To identify and develop novel targeted therapies for complex diseases such as Crohn's disease (CD), functional subtypes rooted in pathogenesis must be defined. One candidate method to subtype CD is to define the small intestinal Paneth cell phenotypes based on the intracellular distribution of antimicrobial proteins. We have previously shown that in CD patients, Paneth cell phenotype correlates with the patients' genotype, distinct gene expression signature, presence of granuloma (pathologic hallmark), and time to recurrence after surgery. However, the mechanism by which abnormal Paneth cells contribute to pathogenesis and sub-classify disease in the context of host-microbial interaction is unclear. We analyzed Paneth cell phenotype and its correlation with mucosal microbiome and transcriptome in a cohort of pediatric CD and non-inflammatory bowel disease (IBD) patients.
    We first retrospectively analyzed Paneth cell phenotypes using archived resection specimens from adult (n = 531) and pediatric (n = 73) CD patients. We next analyzed a prospectively recruited pediatric cohort, including CD (n = 44) and non-IBD (n = 62) patients aged 4 to 18. These patients were recruited at the time of routine endoscopy. Ileal mucosal biopsy samples were collected and analyzed for Paneth cell phenotype (lysozyme/defensin 5 immunofluorescence), mucosal microbiome (16S rRNA sequencing), and transcriptome (RNA-sequencing). Paneth cell phenotype was determined by the percentage of normal Paneth cells in each sample. Type I Paneth cell phenotype was defined as <80% normal Paneth cells, whereas Type II Paneth cell phenotype was defined as ≥80% normal Paneth cells.
    The prevalence of type I Paneth cell phenotype in pediatric CD patients was higher than in adult CD cohorts (47% versus 18%; P < 0.0001). In pediatric CD patients, the type I Paneth cell phenotype was associated with significant changes in the ileal mucosal microbiome, characterized by reduced abundance of barrier-associated microbes (Faecalibacterium, Blautia, Ruminococcaceae, Porphyromonas, Lachnospira, Peptostreptococcus, Anaerostipes, and Odoribacteraceae) and enrichment of potentially pro-inflammatory microbes (Corynebacterium and Erysipelotrichaceae). In addition, pediatric CD patients with type I Paneth cell phenotype also displayed an altered epithelial gene expression profile, with significant reduction in oxidative phosphorylation gene cluster. Furthermore, the down regulation of oxidative phosphorylation gene cluster in CD was in turn associated with reduced abundance of Faecalibacterium, suggesting a complex network between Paneth cell function, epithelial energy/metabolism, and microbiome homeostasis. The connections between Paneth cell phenotypes, microbiome, and transcriptome profiles were not observed in non-IBD patients.
    These data support a functional role for Paneth cells in subtyping CD that is based on a specific pattern of metabolic dysregulation and mucosal dysbiosis.
    PMID: 26878181 [PubMed - as supplied by publisher]
  • Respiratory syncytial virus and pediatric liver transplant: one center's experience.

    Progress in transplantation (Aliso Viejo, Calif.) 2013 Sep

    Authors: Lerret S, Mavis A, Biank V, Telega G
    Abstract
    Respiratory syncytial virus (RSV) is a ubiquitous virus responsible for acute infections of the respiratory tract in patients of all ages. RSV presents significant health risks to immunocompromised patients. Two patients, 1 before a liver transplant and 1 after a liver transplant, died of a severe RSV infection. Because of the high risk of death, we recommend expanding the criteria for palivizumab prophylaxis to 2 types of patients: (1) patients with chronic liver disease or who have received a liver transplant and are 24 months old or less and (2) transplant recipients with underlying pulmonary conditions who are less than 36 months old. Further research is indicated in pediatric solid-organ transplant centers to evaluate the effective management of RSV infection to prevent morbidity.
    PMID: 23996945 [PubMed - as supplied by publisher]
  • Identifying youth nonadherence in clinical settings: data-based recommendations for children and adolescents with inflammatory bowel disease.

    Inflammatory bowel diseases 2012 Jul

    Authors: Greenley RN, Kunz JH, Biank V, Martinez A, Miranda A, Noe J, Telega G, Tipnis NA, Werlin S, Stephens MC
    Abstract
    To examine the validity of patient self-report of thiopurine adherence in pediatric inflammatory bowel disease (IBD) against an objective electronic monitoring adherence measure, and to investigate the role of youth and maternal involvement in remembering to take daily medications as predictors of medication adherence.
    Fifty-one youths with IBD, ages 11-18 years, participated. Youths completed questionnaire assessments of their own and their maternal caregiver's involvement in remembering to take daily medications at baseline, completed monthly interviews assessing thiopurine adherence over the past week for a period of 6 months, and utilized a Medication Events Monitoring System (MEMS) electronic monitor for their thiopurine medication for 6 months. Participants were grouped into adherent (at least 80% of doses taken based on objective MEMS caps) or nonadherent for analyses.
    Youths who were nonadherent based on electronic monitoring overestimated their adherence by 23%, whereas adherent youths overestimated their adherence by only 2%, and as such patient self-report offered little utility in identifying youths who were nonadherent. Youths who reported high levels of involvement in remembering to take their medications were nearly eight times less likely to be nonadherent.
    The current findings provide evidence that clinicians who work with children and adolescents with IBD may benefit from modifying their approach to nonadherence screening. Asking about youth involvement in remembering daily medications may be more informative than asking them to recall their medication-taking behavior over the last week in identifying those at highest risk for nonadherence.
    PMID: 22689633 [PubMed - as supplied by publisher]
  • Predictors of nonalcoholic steatohepatitis in obese children.

    Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates

    Authors: Lerret SM, Garcia-Rodriguez L, Skelton J, Biank V, Kilway D, Telega G
    Abstract
    As the prevalence of childhood obesity increases, the incidence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis (NASH) also escalates. This study's purpose was to identify the clinical criteria to aid in determining when a liver biopsy is indicated for this growing population because currently no guidelines exist. We performed a retrospective chart review on all patients who were seen in the Nutrition Exercise and Weight Loss Kids™ Program at the Children's Hospital of Wisconsin from July 2003 through December 2004. We analyzed only individuals who underwent liver biopsy with the following criteria: (1) no evidence of other liver disease and (2) aspartate transaminase or alanine aminotransferase greater than 200 IU/L or any elevation of or for more than 6 months. Of the 284 patients reviewed, only eight patients (3%) met the criteria for analysis. Biopsy results demonstrated that 100% had histological evidence of NASH with steatosis, and seven of the eight (87.5%) had NASH with fibrosis, cirrhosis, or both. Obese children with an aspartate transaminase or alanine aminotransferase greater than 200 IU/L or any elevation of aspartate transaminase or alanine aminotransferase for more than 6 months, have a strong likelihood of having NASH with or without fibrosis, cirrhosis, or both.
    PMID: 22129796 [PubMed - as supplied by publisher]
  • HIDA, percutaneous transhepatic cholecysto-cholangiography and liver biopsy in infants with persistent jaundice: can a combination of PTCC and liver biopsy reduce unnecessary laparotomy?

    Pediatric radiology 2012 Jan

    Authors: Jensen MK, Biank VF, Moe DC, Simpson PM, Li SH, Telega GW
    Abstract
    Historically, HIDA is the initial diagnostic test in the evaluation of biliary atresia (BA). Non-excreting HIDA scans can yield false-positive results leading to negative laparotomy.
    Cholestatic infants must be evaluated promptly to exclude biliary atresia (BA) and other treatable hepatic conditions. Intraoperative cholangiogram (IOC) is the gold standard for diagnosing BA, but requires surgical intervention. Percutaneous transhepatic cholecysto-cholangiography (PTCC) and liver biopsy are less invasive and have been described in small case series. We hypothesized that PTCC and liver biopsy effectively exclude BA, thus avoiding unnecessary IOC.
    Retrospective review of cholestatic infants who underwent PTCC, biopsy or cholescintigraphy at a tertiary children's hospital from August 1998 to January 2009. Group differences were evaluated and the receiver operator curve and safety of PTCC determined.
    One-hundred twenty-eight cholestatic infants were reviewed. Forty-six (36%) underwent PTCC. Forty-one out of 46 (89%) had simultaneous PTCC and liver biopsy. PTCC was completed successfully in 19/23 (83%) children despite a small or absent GB on initial US. Negative laparotomy rate was 1/6 (17%) for simultaneous PTCC/liver biopsy. Complications occurred in 4/46 including bleeding (n=2), fever with elevated transaminases (n=1) and oxygen desaturations (n=1).
    PTCC, particularly when performed in combination with simultaneous liver biopsy, effectively excludes BA in cholestatic infants with acceptable morbidity. PTCC can frequently be performed when a contracted gallbladder is seen on initial US exam. Negative laparotomy rate is lowest when PTCC is coupled with simultaneous liver biopsy.
    PMID: 21786124 [PubMed - as supplied by publisher]
  • Association of Crohn's disease, thiopurines, and primary epstein-barr virus infection with hemophagocytic lymphohistiocytosis.

    The Journal of pediatrics 2011 Nov

    Authors: Biank VF, Sheth MK, Talano J, Margolis D, Simpson P, Kugathasan S, Stephens M
    Abstract
    To assess the incidence of hemophagocytic lymphohistiocytosis (HLH) in a well-defined population of children with inflammatory bowel disease (IBD) and evaluate the common clinical and laboratory characteristics of individuals with IBD who developed HLH.
    We conducted a retrospective study of all children who developed HLH over an 8-year period. The incidence of HLH in patients with IBD was calculated using US census data and a statewide project examining the epidemiology of pediatric IBD.
    Among children in Wisconsin, 20 cases of HLH occurred during the study period; 5 cases occurred in children with IBD. Common characteristics include: Crohn's disease (CD), thiopurine administration, fever lasting more than 5 days, lymphadenopathy, splenomegaly, anemia, lymphopenia, and elevated serum triglycerides and ferritin. Of the patients, 4 had primary Epstein-Barr virus infections. The incidence of HLH among all children in Wisconsin was 1.5 per 100 000 per year. The risk was more than 100-fold greater for children with CD (P < .00001).
    Pediatric patients with CD are at increased risk for developing HLH; primary Epstein-Barr virus infection and thiopurine administration may be risk factors.
    PMID: 21722918 [PubMed - as supplied by publisher]
  • Next-generation sequencing facilitates the diagnosis in a child with twinkle mutations causing cholestatic liver failure.

    Journal of pediatric gastroenterology and nutrition 2012 Feb

    Authors:
    Abstract
    PMID: 21681116 [PubMed - as supplied by publisher]

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