CSCA17MC4152763_000

Danh mc Ngi chm sc

UnitedHealthcare Community Plan of California, Inc.Medi-Cal Sacramento

Dch V Hi Vin

1-866-270-5785, TTY 711

10/23/2017

UnitedHealthcare Community Plan tun th cc lut v quyn cng dn ca Lin bang. UnitedHealthcare Community Plan khng loi tr hoc i x khc bit vi cc hi vin v chng tc, mu da, ngun gc quc gia, tui tc, khuyt tt hoc gii tnh.UnitedHealthcare Community Plan:

Cung cp thit b h tr v cc dch v min ph cho nhng ngi khuyt tt h giao tip vi chng ti, chng hn nh:

Thng dch vin ngn ng k hiu c trnh Thng tin bng vn bn di cc nh dng khc (ch in c ln, bng m thanh, nh dng

in t d truy cp, cc nh dng khc)

Cung cp dch v ngn ng min ph cho nhng ngi c ngn ng chnh khng phi l ting Anh, chng hn nh:

Thng dch vin c trnh Thng tin c vit bng nhng ngn ng khc

Nu qu v cn nhng dch v ny, vui lng gi s in thoi min ph dnh cho hi vin c ghi trn th ID hi vin ca qu v.Nu qu v tin rng UnitedHealthcare Community Plan khng cung cp cho qu nhng dch v ny hoc phn bit i x vi qu v da trn chng tc, mu da, ngun gc quc gia, tui tc, khuyt tt hoc gii tnh, qu v c th np n khiu ni ti iu phi vin v Quyn cng dn qua:

Gi th qua bu in: Civil Rights Coordinator UnitedHealthcare Civil Rights Grievance P.O. Box 30608 Salt Lake City, UTAH 84130

Email: UHC_Civil_Rights@uhc.comQu v cng c th np khiu ni v quyn cng dn ti Vn phng Dn quyn, B Y t v Dch v Nhn sinh Hoa K qua:

Web: Cng thng tin ca Vn phng Khiu ni v Quyn cng dn ti a ch https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

a ch gi th: U.S. Dept. of Health and Human Services 200 Independence Avenue SW Room 509F, HHH Building, Washington DC 20201

in thoi: Min ph 1-800-868-1019, 1-800-537-7697 (TDD).

Chng ti cung cp cc dch v min ph gip qu v giao tip vi chng ti. Chng hn nh, th bng ngn ng khc hoc bn in c ln. Hoc, qu v c th yu cu mt thng dch vin. yu cu tr gip, vui lng gi s in thoi min ph dnh cho hi vin c ghi trn th ID hi vin chng trnh bo him y t ca qu v, TTY 711, th Hai n th Su, t 7 gi sng n 7 gi ti.

CSCA17MC4152763_000

EnglishATTENTION: If you do not speak English, language assistance services, free of charge, are available to you. Call 1-866-270-5785, TTY: 711.

SpanishATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Llame al 1-866-270-5785, TTY 711.

VietnameseLU : Nu qu v ni Ting Vit, chng ti c cc dch v h tr ngn ng min ph cho qu v. Vui lng gi s 1-866-270-5785, TTY 711.

TagalogATENSYON: Kung nagsasalita ka ng Tagalog, may magagamit kang mga serbisyo ng pantulong sa wika, nang walang bayad. Tumawag sa 1-866-270-5785, TTY 711.

Korean: , . 1-866-270-5785, TTY 711 .

Traditional Chinese 1-866-270-5785 TTY 711

Armenian. , : 1-866-270-5785 , TTY. 711.

Russian: -, . . 1-866-270-5785, TTY 711.

Farsi: .

TTY 711( 1-866-270-5785( .Japanese1-866-270-5785TTY 711

Mon-Khmer

1-866-270-5785, TTY 711

HmongCEEB TOOM: Yog koj hais Lus Hmoob, muaj kev pab txhais lus pub dawb rau koj. Thov hu rau 1-866-270-5785, TTY 711.

Punjabi : , 1-866-270-5785, TTY: 711

Arabic: . 5785-270-866-1

711.

CSNM15MC4002372_000

Hindi : 1-866-270-5785, TTY 711.

Thai : 1-866-270-5785, TTY: 711

Cho mng qu v n vi Chng Trnh Cng ng UnitedHealthcare

Cho mngDanh mc s gip qu v tm bc s v bnh vin ti khu vc ca mnh, l nhng ngi hp tc vi UnitedHealthcare Community Plan ti California. Chng ti lm vic vi bc s chm sc chnh (Primary care physician, PCP), bnh vin, chuyn gia v ngi chm sc sc khe khc iu phi cc nhu cu chm sc sc khe ca qu v. Vic chm sc sc khe cho qu v s do cc bc s trong mng li ngi chm sc ca chng ti cung cp. tm danh sch ngi chm sc hin ti, hy truy cp trang mng ca chng ti ti a ch UHCCommunityPlan.com. Nu qu v cn tr gip tm bc s hoc s dng danh mc ny, hy gi Dch v Hi vin theo s in thoi di y. Chng ti rt vui c tr gip cho qu v.

Trong trng hp khn cp, hy gi 911, hoc n phng cp cu gn nht c tr gip.

Chng trnh cho php hi vin, hi vin tim nng, ngi chm sc v cng chng lin h vi Chng trnh c nhn bn sao danh mc ngi chm sc theo s in thoi min ph (1-866-270-5785), nhn bn in t qua trang mng (UHCCommunityPlan.com), hoc gi th ti (Dch v Khch hng ca UnitedHealthcare, PO Box 29675, Hot Springs, AR 71903-9802). Bn sao ca danh mc ngi chm sc c cung cp cho ngi yu cu qua th c ng du ca bu in mun nht l trong vng 5 ngy lm vic k t ngy yu cu theo quy nh ti Mc 1367.27(d).

Dch v Hi vin: 1-866-270-5785, TTY 711

Th ID Hi vin

Ngi chm sc lit k trong danh mc ny c hiu lc k t ngy ghi trn trang ba. Thng tin c th thay i.

Health Plan (80840) 911-87726-04Member ID: 99999999999999 Group Number:CAMCMPMember: SUBSCRIBER M BROWN

PCP Name:PROVIDER BROWNPCP Phone: (999) 999-9999

0000 Administered by UnitedHealthcare Community Plan of California, Inc.

Payer ID: 87726For Member Customer Service: 866-270-5785 TTY 711

For Providers: uhccommunityplan.com 866-270-5785Claims: PO Box 30884, Salt Lake City, UT, 84130-0884

In case of emergency call 911 or go to nearest emergency room. Printed: 01/01/01

Pharmacy Claims: OptumRx, PO Box 29044, Hot Springs, AR, 71903For Pharmacist: 877-305-8952

Rx Bin: 610494Rx Grp: ACUCARx PCN: 4444

This card does not guarantee coverage. To verify benefits or to find a provider, visit the website myuhc.com/communityplan or call. Emergency Services rendered to the Member by non-Contracting providers are reimbursable by the Contractor without Prior Authorization.

UHCCommunityPlan.com

Chn Bc s Chm sc Chnh (Primary Care Physician, PCP)C mt s loi PCP trong danh mc ny. Mi thnh vin c i th trong gia nh c th chn PCP khc nhau trong UnitedHealthcare Community Plan. Ngoi tr trng hp cp cu, PCP ca qu v v nhn vin ca h s cung cp hoc qun l ton b vic chm sc sc khe ca qu v. iu ny bao gm gii thiu qu v ti chuyn gia. PCP c th l bc s gia nh hoc bc s a khoa, bc s ni khoa, bc s nhi khoa hoc ngi chm sc khc c UnitedHealthcare Community Plan chp thun.

i PCPNu qu v mun thay i PCP ca mnh, hy gi cho Dch V Hi Vin. H s gip qu v chn PCP mi. Qu v c th i PCP trong sut nm. Qu v cng c th lin h vi ngi chm sc tm hiu xem ngi chm sc c hp ng vi UnitedHealthcare Community Plan hay khng. Khi gi in, qu v hy chc chn qu v c cp ti UnitedHealthcare Community Plan. Hy hi xem ngi chm sc c nhn bnh nhn mi khng.

Khm Bc s hay Chuyn gia KhcPCP ca qu v c th yu cu qu v n khm chuyn gia. Chuyn gia l bc s chuyn iu tr mt bnh c bit, nh bc s chuyn tr chng d ng hay bc s cha tr tim. Bc s ca qu v s gip qu v tm ng chuyn gia. Nu b bnh phc tp, qu v s cn n thm khm vi chuyn gia nhiu ln. Qu v c th n khm chuyn gia mi khi cn. Nu qu v c nhu cu chm sc sc khe phc tp, mt chuyn gia c th l PCP ca qu v. Nu qu v cn iu ny, vui lng gi Dch v Hi vin. Chng ti s gip qu v tm chuyn gia p ng nhu cu ca qu v.

Dch v Chm sc Sc khe cho Ph nNu qu v l ph n, qu v c th mun khm vi ngi chm sc trong mng li ca chng ti l ngi chuyn cung cp dch v chm sc sc khe cho ph n. Qu v c th nhn nhng dch v ny t ngi chm sc sc khe dnh cho ph n trong mng li m khng cn PCP gii thiu. Cc dch v dnh cho ph n c i th khng cn PCP gii thiu hoc cho php trc ca chng trnh bo him:

Chm sc sn khoa, bao gm chm sc trc sinh, sinh n v chm sc hu sinh. Khm ph khoa nh k. Khm v iu tr ri lon h sinh dc n. Cc vn sc kho khc c iu tr trong ln thm khm vi ngi chm sc sc kho ca

ph n, nu vic iu tr nm trong phm vi thc hnh ca ngi cung cp dch v v dch v khng b loi tr.

Nu qu v cn thm khm vi ngi chm sc sc khe dnh cho ph n khng thuc mng li ca chng ti, qu v phi xin c giy gii thiu t PCP ca qu v.

Cch S dng Danh mc ny

UHCCommunityPlan.com

Ngi chm sc Ngoi Mng liQu v hay PCP ca qu v c th quyt nh rng qu v cn thm khm bc s hay ngi chm sc sc khe khng thuc mng li ca chng ti. PCP ca qu v cn gi cho chng ti c chng ti chp thun cho nhng dch v ny trc khi c bao tr. iu ny c gi l Cho php Trc.

Th gii thiuNgi chm sc trong mng li gip qu v v cc thnh vin c i th trong gia nh nhn chm sc cn thit. Tip cn vi cc chuyn gia c th c iu phi bi PCP ca qu v.

Nh thuc bit a im cc nh thuc, hy gi Dch v Hi vin theo s 1-866-270-5785, TTY 711.

Chm Sc Khn CpQu v khng cn phi c s cho php trc trong cc trng hp khn cp. Hy gi 911 hoc n phng cp cu gn nht. Qu v c th nhn chm sc khn cp 24 gi mt ngy, 7 ngy mt tun.

Bo co Thng tin Khng Chnh xc bo co thng tin khng chnh xc, hy email ti provider_directory_invalid_issues@uhc.com.

Hp th ny dnh cho hi vin bo co cc yu t d liu nhn khu hc c th khng chnh xc (a ch, in thoi, v.v.) pht hin ra trn cc danh mc trc tuyn hoc bng giy. Vic bo co cc vn qua hp th ny s gip cho vn phng ngi chm sc xc minh c tt c d liu nhn khu hc trn danh mc. Hot ng ny c th mt khong 30 ngy.

Cc c nhn cng hy bo co d liu c th khng chnh xc qua in thoi. Cc hi vin ca chng trnh UnitedHealthcare Community Plan hy gi ti s in thoi trn mt sau th ID hi vin ca mnh. Nhng ngi khng phi hi vin chng trnh UnitedHealthcare Community Plan c th gi ti s 1-888-638-6613.

Ngi chm sc nn s dng Cng thng tin Dnh cho Ngi chm sc ca UHC ti a ch unitedhealthcareonline.com hoc s dng H s Hnh ngh ca Ti trn Lin kt. Cc vn v hp ng cn c gii quyt thng qua u mi lin lc Mng li Chng trnh UnitedHealthcare Community ca qu v.

UHCCommunityPlan.com

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V d Danh sch Ngi chm sc

UnitedHealthcare kim chng thng tin ny khi nhng ngi chm sc ny tham gia vo h thng v mi ba nm (hay sm hn) khi ngi chm sc c cp chng ch li.

Chng nhn ca Hi ng Chng nhn ca Hi ng th hin kin thc chuyn mn ca bc s trong mt chuyn khoa y t. Giy chng nhn lin quan n tin trnh th nhim v nh gi qua chuyn gia trong lnh vc y khoa ring bit. Chuyn gia c giy chng nhn ca hi ng tham gia trong vic gio dc lin tc hc hi nhng ci t