DR. JAMES RICHARD HALIBURTON MD
Accepted Insurance for NPI 1063737021
Psychiatry & Neurology - Psychiatry in Springfield, IL

Q: What managed care network types are accepted by this provider?

DR. JAMES RICHARD HALIBURTON MD is enrolled across the following managed care network types: HMO, POS. HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.

Quality Rating: 91.96 out of 100 score

NPI Status: Active since April 02, 2010

Contact Information

319 E MADISON ST FL 3
SPRINGFIELD, IL
ZIP 62701
Phone: (217) 545-8000
Fax: (217) 545-2275

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Accepted Health Plans and Insurance Coverage

This registry outlines the health plan networks and insurance coverage profiles associated with DR. JAMES RICHARD HALIBURTON MD, a practicing psychiatry & neurology professional in Springfield, IL. Compiled from official data resources, this interface is designed to help you determine if your policy is accepted at this practice location. Currently, the provider is listed across 31 individual coverage options managed by medical networks, including networks like Baylor Scott and White Health Plan, and WellPoint. Please use the filtering dashboard below to search for your specific plan by name, narrow results by a single carrier corporate network, or toggle between plan types (HMO, PPO, EPO) to check your status before coordinating an upcoming clinic visit.

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Fitler by Network Type

Baylor Scott and White Health Plan

BSW Diabetes Care Gold HMO 014

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460014

BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460001

BSW Elite Gold HMO 004

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460004

BSW Elite Gold HMO 012

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460012

BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460003

BSW Prime Silver HMO 008

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460008

BSW Prime Silver HMO 005

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460005

BSW Savers Bronze HMO H S A 006

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460006

BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460007

BSW Savers Bronze HMO H S A 009

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: BSWPREMIERHMO Tier

Accepted Plan ID Variations

40788TX0460009

WellPoint

Wellpoint Essential Bronze 4000 HSA (+ Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040002

Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040004

Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040003

Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040005

Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030003

Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030002

Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030004

Wellpoint Essential Catastrophic (+ Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040006

Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040007

Wellpoint Essential Gold 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040008

Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040009

Wellpoint Essential Gold POS 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030005

Wellpoint Essential Gold POS 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030006

Wellpoint Essential Gold POS 700 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030007

Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040011

Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040012

Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040010

Wellpoint Essential Silver 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

HMO Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0040013

Wellpoint Essential Silver POS 2500 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030008

Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030009

Wellpoint Essential Silver POS 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives)

POS Group

Market Classification Rank: Individual Coverage Framework

Assigned Option Status: PARTICIPATING Tier

Accepted Plan ID Variations

47501TX0030001

No coverage plans found coordinating with your query criteria.

Coverage Information & FAQs

What insurance does DR. JAMES RICHARD HALIBURTON MD accept?

This provider accepts health insurance plans managed by the following insurance companies: Baylor Scott and White Health Plan, WellPoint. You can filter specific policies or search for unique plans using the open dashboard controls located above.

Is this provider enrolled to accept Medicare?

Yes, registry files confirm this provider accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment for covered services. Additionally, the provider is officially enrolled in the PECOS program (Provider Enrollment, Chain, and Ownership System), verifying that they are certified to order, refer, or prescribe services to Medicare beneficiaries.

What managed care network types are accepted by this provider?

DR. JAMES RICHARD HALIBURTON MD is enrolled across the following managed care network types: HMO, POS.

HMO (Health Maintenance Organization): Requires receiving care through the network of clinicians and facilities, often requiring primary doctor referrals to access specialist treatments.
POS (Point of Service): Bridges elements of HMO and PPO rules. It generally mandates an in-network primary care physician referral for specialized services but retains partial out-of-network lookup allowances at heightened cost tiers.