CARE1ST COMPLIANCE: DEDICATED TO YOU

Size: px
Start display at page:

Download "CARE1ST COMPLIANCE: DEDICATED TO YOU"

Transcription

1 COMPLIANCE NEWSLETTER FOR MEMBERS 2014 CARE1ST COMPLIANCE: DEDICATED TO YOU Dear Care1st member: At Care1st we have a motto: Yes, it s all about you. We strive to serve you, our member, and one of the ways we do this is by running an ethical company that follows the law and respects your dignity. Care1st staff members have pledged to respect your privacy and ensure that fraud, waste and abuse are absent from this health plan. Having had the privilege of being the Care1st corporate compliance officer for the last 15 years, I am very proud to introduce the first edition of our new Compliance Newsletter for Members. This new newsletter not only highlights what we at Care1st are doing to serve you better, but it also contains important information related to fraud, waste, abuse and privacy issues while providing the opportunity for you to assist us in giving you the respect you deserve and in locating and eliminating fraud and other practices that could interfere with your receiving your full Care1st benefits and services. How Care1st Compliance protects you Care1st has a responsibility to fight fraud, waste and abuse. This task extends to helping you, our member. An example of this protection is a call I recently received from a Care1st member I will call Mary. She went to her local drugstore to pick up her monthly prescription, but the pharmacist refused to give her the medicine, noting it had already been distributed. She contacted Care1st. We learned that recently her purse had been stolen and in that purse was her driver s license, along with the expensive drugs she needed to take every day. We subsequently learned that the thief had used the information on the label of the drug to order a refill and then used the stolen license as identification to pick up the drug. Because the drugstore had surveillance cameras, law enforcement was able to identify the imposter who picked up the prescription, and he is now in prison. Mary was able to get her necessary medicine. We were happy to assist Mary. We do urge you to be careful with the labels on any drugs you may have, since they can be used by a thief to obtain them from a drugstore. In addition, if you have information that anyone is stealing your identity to make use of your Care1st membership, please contact my office immediately. Not only will we work with the police to catch the imposter stealing your benefits, but we will also make sure such thefts don t hurt your ability to obtain necessary health care services. Brooks Jones, CHC Corporate Compliance and Privacy Officer The Care1st fraud hotline is

2 Compliance Newsletter for Members WE SPEAK YOUR LANGUAGE Care1st wants to make sure that you can speak to your doctor and medical staff in your language, including American Sign Language. If your doctor does not speak your language, you have the right to: Ask Care1st or your doctor for an interpreter at no cost to you. Receive interpreting services 24 hours a day, 7 days a week. This means interpreting services are also available to you after normal business hours. By law, your doctor cannot: Ask you to bring your own interpreter or pay for an interpreter. Use your child to interpret for you. Refuse or delay medical care services because you do not speak English or do not speak it well. As a Care1st member, you also have the right to: Get notices about your benefits in your language and in alternative formats, such as Braille, large print or audio. Get health education brochures in your language and in alternative formats. Get written informing materials in your language and in alternative formats. Be referred to community agencies that offer culturally sensitive services. File a grievance if we do not meet your language needs. We can help If you need a free interpreter for your next doctor s visit, please call the Care1st Member Services Department at at least seven days before your appointment. We offer our members a directory of community resources and agencies. It has information on organizations near you that can help you with issues such as domestic violence and elder care. The directory also lists organizations that offer counseling services, social services and interpreter services. You can get health information, learn more about your member benefits and learn how to file a grievance on our website, Information is available in various languages. Members with vision impairment can use the magnification tool on the website to make the text easier to see. Contact us If you need further assistance, please contact the Cultural and Linguistic Department at You can also send an to thorth@care1st.com. Jorge Weingarten, MD Chief Medical Officer CARE1ST HEALTH PLAN CARES is published for members of CARE1ST HEALTH PLAN, 601 Potrero Grande Drive, Monterey Park, CA 91755, telephone , (TTY: 711). H5928_14_421_COMPL Accepted Care1st Health Plan is an HMO plan with a Medicare contract. Enrollment in Care1st Health Plan depends on contract renewal. CARE1ST is an affiliate of LA Care Health Plan in providing Medi-Cal managed care services in Los Angeles County. Copyright 2014 Coffey Communications CUN30418

3 3 FRAUD ALERT: MEDICAL SUPPLIES IN THE MAIL Did you know? Neither Medicare nor Medicaid (Medi-Cal) sells or mails medical supplies. If you receive medical supplies that you or your doctor did not order, you might be the target of a fraud scheme. Take action to protect your Medicare/Medicaid (Medi-Cal) benefits: Refuse medical supplies you did not order. Return unordered medical supplies that are shipped to your home. Report companies that send you these items. Do your part You can protect your identity and your benefits: Never give out your Social Security, Medicare, Medi-Cal, or health plan numbers or banking information to someone you don t know. Carefully review your Plan Statement to ensure all the information is correct. Know that free services DO NOT require you give your plan, Medi-Cal or Medicare number to anyone. Share this information with your friends. To discuss benefit, coverage or claims payment concerns, contact Member Services at (Medicare), (Medi-Cal), (Cal MediConnect), or TTY 711. Source: Centers for Medicare & Medicaid Services Take charge of your health Your doctor is your partner in helping you stay healthy. He or she has free pamphlets on many health topics. Ask your doctor or call Care1st if you d like to get any of these pamphlets. You can also get free health information by going to our website at Living Well Information Line We offer an information line to answer your questions about cholesterol, weight management, exercise, nutrition and diabetes. Please call Care1st Member Services. Ask to speak with Linda Fleischman or Rosa Hernández. Free weight management classes To help you and your family stay healthy, we offer adult, teen and child weight management classes. We offer these classes at our resource center in Huntington Park. To find out when the next series begins, please call Care1st Member Services.

4 Compliance Newsletter for Members BREASTFEEDING YOUR BABY: A HEALTHY CHOICE Did you know that the number of mothers choosing to breastfeed has grown steadily in the last 10 years? Breast milk is becoming the recommended choice for nourishment of newborns and infants everywhere. Why? It is often called the first food. And there are a lot of good health benefits for both the mom and baby. Here are just a few of them. BEFORE YOU START EXERCISING Breast milk is good for your baby It has all the nutrients your baby needs. It is easy to digest. It helps to protect your baby from many illnesses. Breastfeeding is good for you It helps you recover from giving birth. It saves you money and time. It gives you time to enjoy your baby. If you need help getting started, talk to your doctor. You can also call WIC (Women, Infants and Children) at This is a free call. People of all ages can benefit from staying active. But check with your doctor before starting an exercise program if you: Are older than 50 and not used to being active. Have recently had hip surgery. Have dizziness or shortness of breath. Have a chronic condition, such as diabetes or heart disease. For most older adults, brisk walking, bike riding and swimming are safe activities. Whatever you do, pace yourself and increase your activities slowly. Unless your doctor tells you to limit your fluid intake, drink plenty of water. You may be a little tired or sore after exercising, but you should never feel pain. Stop the activity and call your doctor if you feel pain or pressure in your chest, arms or jaw; feel light-headed or short of breath; or feel pain developing in your legs, calves or back. Source: National Institute on Aging

5 5 HIPAA OUR COMMITMENT TO YOUR PRIVACY Your health is personal. That s why we work hard to protect your information. It s our policy and practice. It s also the law. There is a federal law called the Health Insurance Portability and Accountability Act (HIPAA). This law gives you rights over your records. It applies to many providers and programs, including most: Doctors. Nurses. Pharmacists. Hospitals. Health plans. This law also applies to Medicare and Medicaid. Because of HIPAA, you can: Ask to see and get a copy of your health records. You can do this even if you haven t paid your bill. Add corrections to your health records. Ask that certain people not be given details about your health or treatment. Decide if you want to let your health information be used for certain purposes, such as marketing. Get a report on when and why your information was shared or used. File a complaint if you think your rights or privacy have been violated. HIPAA spells out other rights too. For example, you can ask to be contacted at a place other than at home. For instance, you can ask to get test results at work. Why we might share records There are some good and approved reasons to use or share health information. We may need it: To follow the law. For instance, we may need to report flu and other public health risks. For coordinating your treatment and care. To pay providers. For checking out the quality of treatment, providers and institutions. Still, your health information can t be used or shared without your written permission. This can only happen if HIPAA allows it. Always on alert We protect your private health information. It matters to you. And it matters to us. We can answer any questions you might have about: Your rights. Our responsibilities. The steps we take to keep your information safe. If you suspect that your privacy has been violated or if you have questions: Call Care1st s hotline number at us at compliancesiu@ care1st.com. Contact our privacy and corporate compliance officer, Brooks Jones, CHC, at Or contact the Department of Health Care Services (DHCS) privacy officer: privacyofficer@ dhcs.ca.gov. Phone: Fax: Address: C/O Office of HIPAA Compliance DHCS, P.O. Box , MS 4722, Sacramento, CA Website: For our Notice of Privacy Practices (NPP), please go to pdf/medi-cal/care1stnpp LosAngeles.pdf.

6 Compliance Newsletter for Members DID YOU KNOW? Identity theft: Be aware of these schemes Identity theft impacts Medicare/Medicaid (or Medi-Cal) and can lead to higher health care costs. Don t let anybody steal your identity. Current fraud schemes to be on the lookout for include: People using your Medicare/Medi-Cal or health plan member number for reimbursements of services you never received. People calling you to ask for your Medicare/Medi-Cal or health plan numbers. People trying to bribe you to use a doctor you don t know to get services you may not need. Protecting future generations Did you know that reducing Medicare and Medi-Cal fraud is one step towards making sure your grandchildren will have Medicare and/or Medi-Cal when they need it? You can do your part by being on the lookout for fraudulent schemes such as: People going door to door to sell you health care items or services (only your doctor knows what you need). People calling you to ask for your Medicare, Medi-Cal or health plan numbers. People offering you money or other incentives for health care services you don t need. Always check your bill You are one of the first lines of defense against Medicare and Medi-Cal fraud. Do your part and report services or items that you have been billed for but did not receive. Review your plan statement and be on the lookout for this scheme. Make sure you received the services or items billed. Check the number of services billed. Ensure the same service has not been billed more than once. Source: Centers for Medicare & Medicaid Services DO YOUR PART You can protect your identity and your benefits: Never give out your Social Security, Medicare, Medi-Cal, or health plan numbers or banking information to someone you don t know. Carefully review your Plan Statement to ensure all the information is correct. Know that free services DO NOT require you give your plan, Medi-Cal or Medicare number to anyone. Share this information with your friends. To discuss benefit, coverage or claims payment concerns, contact Member Services at (Medicare), (Medi-Cal), (Cal MediConnect), or TTY 711.

7 7 What to do if you suspect fraud or privacy violation If you suspect compliance, ethics or integrity violations or have questions about specific practices, please use the following resources. Contact Care1st Call the Care1st hotline at It s toll-free, anonymous, available 24/7 and operated by trained professionals. the Compliance Department at compliancesiu@care1st.com. Call the corporate compliance officer, Brooks Jones, at Call the Care1st Member Services Department: (Medicare), 8 a.m. to 8 p.m., 7 days a week (Medi-Cal), 8 a.m.. to 6 p.m., Monday through Friday (Cal MediConnect), 8 a.m. to 8 p.m., 7 days a week. TTY 711 hours are same as above. You may also use the Medi-Cal Fraud Hotline Call stopmedicalfraud@dhcs.ca.gov. The Department of Health Care Services (DHCS) asks that anyone who observes or has knowledge of suspicious health care activity call the DHCS Medi-Cal Fraud Hotline tele- phone number, , to report it. The recorded message may be heard in English and four other languages: Span- ish, Vietnamese, Cambodian and Rus- sian. The call is free, and the caller may remain anonymous. You can also stopmedicalfraud@dhcs.ca.gov.

8 Compliance Newsletter for Members STOP MEDICARE FRAUD Deter Protect your personal information. Guard your Medicare and Social Security numbers. Treat them like you would treat your credit cards. If it s free, they don t need your number! Be suspicious of anyone who offers you free medical equipment or services and then requests your Medicare number. It s illegal, and it s not worth it! Do not let anyone borrow or pay to use your Medicare ID card or your identity. Detect Watch out for these common fraud schemes. Just walk away if people approach you in parking lots, shopping centers or other public areas and offer free services, groceries, transportation or other items in exchange for your Medicare number. Simply hang up the phone if someone calls you claiming to be conducting a health survey and asks for your Medicare number. Don t give your information to telephone marketers who claim to be from Medicare or Social Security and ask for payment over the phone or Internet. They may want to steal your money. Source: Office of Inspector General Medicare: Who to contact Contact Care1st Health Plan Call the hotline number at Send to compliancesiu@care1st.com. Or call the National Benefit Integrity (NBI) Medicare Drug Integrity Contractor (MEDIC) at 877-7SAFERX ( ). You may also contact: Department of Health & Human Services Office of Inspector General Hotline Report suspected Medicare fraud: Phone: (800-HHS-TIPS). TTY: Fax: HHSTips@oig.hhs.gov. Online: oig.hhs.gov/fraud/hotline. Medicare Call Center and SMPs Report questionable charges to Medicare: Phone: TTY: (800-MEDICARE). Online: You can also contact your local SMP: SMPs (Senior Medicare Patrols) work locally to empower seniors to fight health care fraud and resolve errors. Find an SMP in your area. Go to or call If your Medicare card is lost or stolen, report it right away. Call Social Security at (TTY: ) for a replacement. Federal Trade Commission s Identity Theft Hotline Report misuse of your personal information: Phone: (877-ID-THEFT). TTY: Online: FTC.gov/idtheft.

MESSAGE FROM Care 1st Health Plan. Notice of Privacy Practices Effective: April 14, 2003

MESSAGE FROM Care 1st Health Plan. Notice of Privacy Practices Effective: April 14, 2003 MESSAGE FROM Care 1st Health Plan Notice of Privacy Practices Effective: April 14, 2003 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO

More information

Protecting Medicare and You from Fraud

Protecting Medicare and You from Fraud CENTERS FOR MEDICARE & MEDICAID SERVICES Protecting Medicare and You from Fraud Read this booklet to learn how to protect yourself and Medicare from fraud, how to identify and report errors and concerns,

More information

Personal Health Care Journal

Personal Health Care Journal Personal Health Care Journal U.S. Administration on Aging Take an active role in your own health care! Protect Detect Report Protect Your Personal Information Treat your Medicare, Medicaid and Social Security

More information

INLAND EMPIRE HEALTH PLAN CODE OF BUSINESS CONDUCT AND ETHICS. Our shared commitment to honesty, integrity, transparency and accountability

INLAND EMPIRE HEALTH PLAN CODE OF BUSINESS CONDUCT AND ETHICS. Our shared commitment to honesty, integrity, transparency and accountability INLAND EMPIRE HEALTH PLAN CODE OF BUSINESS CONDUCT AND ETHICS Our shared commitment to honesty, integrity, transparency and accountability UPDATED: February 2014 TABLE OF CONTENTS Topic Page A. The IEHP

More information

My Health In Motion Personalized Wellness Online

My Health In Motion Personalized Wellness Online SUMMER FALL 2016 2017 A Publication for L.A. Care Members My Health In Motion Personalized Wellness Online Did you know you have personalized wellness information at your fingertips? With just a few clicks

More information

MyHealth. results with your doctor. Talk High. to him or her about how often 3. Eat foods low in saturated 140/90 or higher

MyHealth. results with your doctor. Talk High. to him or her about how often 3. Eat foods low in saturated 140/90 or higher 2016 MyHealth Quarter 3 Anthem Blue Cross Cal MediConnect Plan What is blood pressure? Blood pressure is the amount of force it takes for your heart to push blood through your body. When your blood pressure

More information

Other languages and formats

Other languages and formats Dear member, We re glad you re part of our health plan! It s important to us that you have the most up-to-date information about your benefits. We re sending you the following notices with this letter:

More information

2018 Evidence of Coverage

2018 Evidence of Coverage Los Angeles, Riverside and San Bernardino Counties 2018 Evidence of Coverage SCAN Connections (HMO SNP) Y0057_SCAN_10165_2017F File & Use Accepted DHCS Approved 08232017 08/17 18C-EOC006 January 1 December

More information

PARTICIPANT HANDBOOK. City and County of San Francisco Department of Public Health Updated February 2017

PARTICIPANT HANDBOOK. City and County of San Francisco Department of Public Health Updated February 2017 PARTICIPANT HANDBOOK City and County of San Francisco Department of Public Health Updated February 2017 www.healthysanfrancisco.org Contents About this Handbook...1 What is Healthy San Francisco?...1 Your

More information

A Publication for L.A. Care Members

A Publication for L.A. Care Members SUMMER SPRING 2016 2017 A Publication for L.A. Care Members of Providing Health Care in Los Angeles County 1997-2017 of Providing Health Care in Los Angeles County 1997-2017 It is L.A. Care Health Plan

More information

2017 National Training Program

2017 National Training Program 2017 National Training Program Module 10 Medicare and Medicaid Fraud, Waste, and Abuse Prevention Contents Lesson 1 Fraud, Waste, and Abuse Overview... Lesson 2 CMS Fraud and Abuse Strategies... Lesson

More information

Welcome Baby Postpartum: 2 Month Call. Visit Information

Welcome Baby Postpartum: 2 Month Call. Visit Information Welcome Baby Postpartum: 2 Month Call Parent Coach: Date: / / Start time: hour(s) minute(s) Client ID #: Visit Information Supervisor: Attempted call #1: Changes in address or phone Attempted call #2:

More information

Assessment. SMP Foundations Training Kit. Table of Contents

Assessment. SMP Foundations Training Kit. Table of Contents SMP Foundations Training Kit Assessment Table of Contents Participant Assessment Questions and Answer Form Assessment Questions... 10 Pages Answer Form... 2 Pages Trainer s Resources Answer Key... 2 Pages

More information

Health in Handbook. a guide to Medicare rights & health in Pennsylvania #6009-8/07

Health in Handbook. a guide to Medicare rights & health in Pennsylvania #6009-8/07 Health in Handbook a guide to Medicare rights & health in Pennsylvania #6009-8/07 Tips for Staying Healthy works hard to make sure that the health care you receive is the best care possible. There are

More information

Spring 2016 INSIDE: Community Health Group s. 34th Anniversary. Message from the CEO

Spring 2016 INSIDE: Community Health Group s. 34th Anniversary. Message from the CEO INSIDE: Medicare Stars Team Utilization Management New Member Portal Meals on Wheels Spring 2016 Message from the CEO Community Health Group is fast approaching our 34th anniversary. Time does fly incredibly

More information

community. Welcome to the Pennsylvania UnitedHealthcare Community Plan for Kids CHIP Member Handbook CSPA15MC _001

community. Welcome to the Pennsylvania UnitedHealthcare Community Plan for Kids CHIP Member Handbook  CSPA15MC _001 Welcome to the community. Pennsylvania UnitedHealthcare Community Plan for Kids CHIP Member Handbook CSPA15MC3673270_001 www.chipcoverspakids.com Telephone Numbers Member Services Monday Friday, 8:00 a.m.

More information

Medi-Cal. Member Handbook. A helpful guide to getting services (Combined Evidence of Coverage and Disclosure Form)

Medi-Cal. Member Handbook. A helpful guide to getting services (Combined Evidence of Coverage and Disclosure Form) Medi-Cal Member Handbook A helpful guide to getting services (Combined Evidence of Coverage and Disclosure Form) Benefit Year 2016 AS A HEALTH NET COMMUNITY SOLUTIONS MEMBER, YOU HAVE THE RIGHT TO Respectful

More information

A. Members Rights and Responsibilities

A. Members Rights and Responsibilities APPLIES TO: A. This policy applies to all IEHP Medi-Cal Members. POLICY: A. For the purpose of this policy, a Delegate is defined as a medical group, IPA or any contracted organization delegated to provide

More information

WE WELCOME CARE1ST PROVIDERS TO OUR QUALITY OUTREACH PARTNERSHIP

WE WELCOME CARE1ST PROVIDERS TO OUR QUALITY OUTREACH PARTNERSHIP www.care1st.com PROVIDER S U M M E R 1 0 Newsletter WE WELCOME CARE1ST PROVIDERS TO OUR QUALITY OUTREACH PARTNERSHIP Our Quality Outreach Department is delighted to partner with providers by giving you

More information

Is it the Flu or is it a Cold?

Is it the Flu or is it a Cold? IN THIS ISSUE: Know Your Rights and Responsibilities pg. 3 Fa l l 2 0 1 0 Changes for Medicare Members pg. 4 Surviving the Holidays pg. 6 Is it the Flu or is it a Cold? It s that time of year again. It

More information

LIVING WILL AND ADVANCE DIRECTIVES. Exercise Your Right: Put Your Healthcare Decisions in Writing.

LIVING WILL AND ADVANCE DIRECTIVES. Exercise Your Right: Put Your Healthcare Decisions in Writing. LIVING WILL AND ADVANCE DIRECTIVES Exercise Your Right: Put Your Healthcare Decisions in Writing. Maryland Advance Directive A Message from the Maryland Attorney General Adults can decide for themselves

More information

EVIDENCE OF COVERAGE Molina Medicare Options Plus HMO SNP

EVIDENCE OF COVERAGE Molina Medicare Options Plus HMO SNP Molina Medicare Options Plus HMO SNP Member Services CALL (800) 665-0898 Calls to this number are free. 7 days a week, 8 a.m. to 8 p.m., local time. Member Services also has free language interpreter services

More information

LIVING WILL AND ADVANCE DIRECTIVES. Exercise Your Right: Put Your Healthcare Decisions in Writing

LIVING WILL AND ADVANCE DIRECTIVES. Exercise Your Right: Put Your Healthcare Decisions in Writing LIVING WILL AND ADVANCE DIRECTIVES Exercise Your Right: Put Your Healthcare Decisions in Writing Maryland Advance Directive A Message from the Maryland Attorney General Adults can decide for themselves

More information

Alignment. Alignment Healthcare

Alignment. Alignment Healthcare Alignment CODE OF CONDUCT Alignment Healthcare Our commitment to ethical conduct and compliance depends on all Alignment Healthcare personnel. If you find yourself in an ethical dilemma or suspect inappropriate

More information

Cal MediConnect Plan Choice Book. Medicare and Medi-Cal. To the addressee or guardian of: John B. Sample 1234 Any Street ANY CITY, CA 90000

Cal MediConnect Plan Choice Book. Medicare and Medi-Cal. To the addressee or guardian of: John B. Sample 1234 Any Street ANY CITY, CA 90000 CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES Health Care Options, P.O. Box 989009 West Sacramento, CA 95798-9860 To the addressee or guardian of: John B. Sample 1234 Any Street ANY CITY, CA 90000 Cal

More information

CUSTOMER SERVICE MEMBER FOCUS A NEW WAY TO REACH. Hawai i 2017 Issue I NUMBERS TO KNOW

CUSTOMER SERVICE MEMBER FOCUS A NEW WAY TO REACH. Hawai i 2017 Issue I NUMBERS TO KNOW Hawai i 2017 Issue I MEMBER FOCUS A NEW WAY TO REACH CUSTOMER SERVICE At Ohana, we strive to provide the best member experience possible for you each and every day. We know navigating health care is challenging,

More information

MEMBER HANDBOOK. Health Net HMO for Raytheon members

MEMBER HANDBOOK. Health Net HMO for Raytheon members MEMBER HANDBOOK Health Net HMO for Raytheon members A practical guide to your plan This member handbook contains the key benefit information for Raytheon employees. Refer to your Evidence of Coverage booklet

More information

Understanding Balance Billing. A Primer for L.A. Care Contracted Providers

Understanding Balance Billing. A Primer for L.A. Care Contracted Providers Understanding Balance Billing A Primer for L.A. Care Contracted Providers Purpose for this Training 1. With new managed care programs (i.e. Cal MediConnect, Covered California, PASC- SEIU), members and

More information

Pharmacies Medicare Part D Training Obligations and Medicare Training Resources

Pharmacies Medicare Part D Training Obligations and Medicare Training Resources Pharmacies Medicare Part D raining Obligations and Medicare raining Resources. Your obligation - MS regulations require that all pharmacies contracted with Medicare Part D Plan Sponsors, such as the Medco

More information

Errata (Correction Sheet) for 2016 Anthem Blue Cross Medi-Cal Member Handbook/Evidence of Coverage CHANGES EFFECTIVE: January 1, 2017

Errata (Correction Sheet) for 2016 Anthem Blue Cross Medi-Cal Member Handbook/Evidence of Coverage CHANGES EFFECTIVE: January 1, 2017 Errata (Correction Sheet) for 2016 Anthem Blue Cross Medi-Cal Member Handbook/Evidence of Coverage CHANGES EFFECTIVE: January 1, 2017 There are changes to the Anthem Blue Cross Medi-Cal Member Handbook/Evidence

More information

Evidence of Coverage January 1 December 31, 2014

Evidence of Coverage January 1 December 31, 2014 L.A. Care Health Plan Medicare Advantage (HMO SNP) Evidence of Coverage January 1 December 31, 2014 Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of L.A. Care Health

More information

Welcome to LifeWorks NW.

Welcome to LifeWorks NW. Welcome to LifeWorks NW. Everyone needs help at times, and we are glad to be here to provide support for you. We would like your time with us to be the best possible. Asking for help with an addiction

More information

Self-Insured Schools of California: Schools Helping Schools

Self-Insured Schools of California: Schools Helping Schools Schools Helping Schools SISC III SELF-INSURED SCHOOLS OF CALIFORNIA ACCESS+ HMO PLAN Self-Insured Schools of California: Schools Helping Schools 2012 Enrollment Guide 2012 Enrollment Guide Schools Helping

More information

Rights and Responsibilities

Rights and Responsibilities 1-800-659-5764 New medical procedures review You have benefits as a member. One of them is that we look at new medical advances. Some of these are like new equipment, tests, and surgery. Each situation

More information

It defines basic terms and lists basic principles that all LSUHSC-NO faculty, staff, residents and students must understand and follow.

It defines basic terms and lists basic principles that all LSUHSC-NO faculty, staff, residents and students must understand and follow. Office of Compliance Programs Revised: July 18, 2017 HIPAA Privacy HIPAA Privacy Workforce Training The Health Insurance Portability & Accountability Act (HIPAA) requires that the University train all

More information

MEDICARE CARE1ST DUAL PLUS PLAN SUMMARY OF BENEFITS.

MEDICARE CARE1ST DUAL PLUS PLAN SUMMARY OF BENEFITS. ine 1-800-544-0088 www.care1st.com CARE1ST DUAL PLUS PLAN SUMMARY OF BENEFITS MEDICARE 2009 COUNTIES: LOS ANGELES - ORANGE - SAN BERNARDINO - SAN DIEGO H5928_09_004_SNP_SB 10/2008 Section I Introduction

More information

Welcome to the County Medical Services Program!

Welcome to the County Medical Services Program! Welcome to the! As an eligible member of the (CMSP), you will receive an Advanced Medical Management, Inc. (AMM) CMSP Identification (ID) Card and a State of California Benefits Identification Card (BIC).

More information

Spring 2016 Health & Wellness Newsletter

Spring 2016 Health & Wellness Newsletter Spring 2016 Health & Wellness Newsletter In This Issue Check out what Molina offers online... 1-3 Annual Checkup...3 Are You Taking Any Medicine?...3 Benefits of Health Programs for Woman...4 Your Extra

More information

Guide to Accessing Quality Health Care Spring 2017

Guide to Accessing Quality Health Care Spring 2017 Guide to Accessing Quality Health Care Spring 2017 MolinaHealthcare.com 5771749DM0217 MyMolina MyMolina is a secure web portal that lets you manage your own health from your computer. MyMolina.com is easy

More information

HPSM Medi-Cal Benefits A Guide on How to Get Your Health Care

HPSM Medi-Cal Benefits A Guide on How to Get Your Health Care HPSM Medi-Cal Benefits A Guide on How to Get Your Health Care Health care and insurance benefits can be difficult to understand. This guide introduces you to your basic Medi-Cal benefits, to the Health

More information

NOTICE OF PRIVACY PRACTICES

NOTICE OF PRIVACY PRACTICES NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Who Presents this

More information

Member Handbook. Effective Date: January 1, Revised October 30, 2017

Member Handbook. Effective Date: January 1, Revised October 30, 2017 Member Handbook Effective Date: January 1, 2018 Revised October 30, 2017 2017 NH Healthy Families. All rights reserved. NH Healthy Families is underwritten by Granite State Health Plan, Inc. MED-NH-17-004

More information

member handbook blueshieldca.com/bscbluegroove

member handbook blueshieldca.com/bscbluegroove member handbook blueshieldca.com/bscbluegroove With Main Groove, you get a Personal Physician from our medical provider network, and predictable, lower outof-pocket costs than with Basic Groove, plus access

More information

SUMMARY OF THE STATE GRANT OPPORTUNITIES IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT: H.R (May 24, 2010)

SUMMARY OF THE STATE GRANT OPPORTUNITIES IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT: H.R (May 24, 2010) National Conference of State Legislatures 444 North Capitol Street, N.W., Suite 515 Washington, D.C. 20001 SUMMARY OF THE STATE GRANT OPPORTUNITIES IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT: H.R.

More information

Medicare Fraud & Abuse: Prevention, Detection, and Reporting ICN

Medicare Fraud & Abuse: Prevention, Detection, and Reporting ICN Medicare Fraud & Abuse: Prevention, Detection, and Reporting ICN 908103 1 Disclaimers This presentation was current at the time it was published or uploaded onto the web. Medicare policy changes frequently

More information

Appeals and Grievances

Appeals and Grievances Appeals and Grievances Community HealthFirst MA Special Needs Plan (HMO SNP) As a Community HealthFirst Medicare Advantage Special Needs Plan enrollee, you have the right to voice a complaint if you have

More information

2019 Health Net Seniority Plus Amber I (HMO SNP) H0562: 055 Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco

2019 Health Net Seniority Plus Amber I (HMO SNP) H0562: 055 Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco 2019 Health Net Seniority Plus Amber I (HMO SNP) H0562: 055 Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco and Tulare Counties, CA H0562_19_7837SB_055_M_Accepted

More information

San Francisco Health Plan. Evidence of Coverage and Disclosure Form

San Francisco Health Plan. Evidence of Coverage and Disclosure Form San Francisco Health Plan Evidence of Coverage and Disclosure Form 2016 Welcome to the San Francisco Health Plan San Francisco Health Plan (SFHP) is here to help you with your health care needs. Let s

More information

NOTICE OF PRIVACY PRACTICES MedQuest Effective April 2003 Revised January 2014

NOTICE OF PRIVACY PRACTICES MedQuest Effective April 2003 Revised January 2014 NOTICE OF PRIVACY PRACTICES MedQuest Effective April 2003 Revised January 2014 THIS NOTICE OF PRIVACY PRACTICES applies only to care and treatment you receive at this facility or other Novant Health facilities

More information

2015 Summary of Benefits

2015 Summary of Benefits 2015 Summary of Benefits Health Net Cal MediConnect Plan (Medicare-Medicaid Plan) Los Angeles County, CA H3237_2015_0291 CMS Accepted 09082014 Health Net Cal MediConnect Summary of Benefits! This is a

More information

Advocare. Connection. Advocare plans are here to stay. Preventing three silent threats

Advocare. Connection. Advocare plans are here to stay. Preventing three silent threats Advocare Connection Preventing three silent threats Page 4 Advocare plans are here to stay Page 3 Nonprofit Organization U.S. Postage Paid Security Health Plan of Wisconsin, INC. Security Health Plan of

More information

What you need to know about your benefits Gold Coast Health Plan (GCHP) Combined Evidence of Coverage (EOC) and Disclosure Form MEMBER HANDBOOK

What you need to know about your benefits Gold Coast Health Plan (GCHP) Combined Evidence of Coverage (EOC) and Disclosure Form MEMBER HANDBOOK What you need to know about your benefits Gold Coast Health Plan (GCHP) Combined Evidence of Coverage (EOC) and Disclosure Form 2018 MEMBER HANDBOOK 2 Other languages and formats Other languages You can

More information

CommuniCare Advantage Cal MediConnect Plan (Medicare-Medicaid Plan): Summary of Benefits

CommuniCare Advantage Cal MediConnect Plan (Medicare-Medicaid Plan): Summary of Benefits This is a summary of health services covered by CommuniCare Advantage Cal MediConnect Plan for 2014. This is only a summary. Please read the Member Handbook for the full list of benefits. CommuniCare Advantage

More information

SMP Complex Interactions Training Manual

SMP Complex Interactions Training Manual SMP Complex Interactions Training Manual SMP Resource Center Table of Contents Acknowledgments... i About the SMP Resource Center... i Training Overview... ii Chapter 1: Complex Interactions and the SMP

More information

Member Handbook STAR+PLUS Members with Medicare and Medicaid Coverage.

Member Handbook STAR+PLUS Members with Medicare and Medicaid Coverage. Member Handbook STAR+PLUS Bexar, El Paso, Harris, Jefferson, Lubbock, Medicaid Rural West, Tarrant, and Travis Service Areas Members with Medicare and Medicaid Coverage TX-MHB-0090-15 06.16 1-800-600-4441

More information

Objectives. By the end of this educational encounter, the clinician will be able to:

Objectives. By the end of this educational encounter, the clinician will be able to: Resident s Rights WWW.RN.ORG Reviewed May, 2016, Expires May, 2018 Provider Information and Specifics available on our Website Unauthorized Distribution Prohibited 2016 RN.ORG, S.A., RN.ORG, LLC By Melissa

More information

2012 Medicare Compliance Plan

2012 Medicare Compliance Plan 2012 Medicare Compliance Plan Document maintained by: Gay Ann Williams Medicare Compliance Officer 1 Compliance Plan Governance The Medicare Compliance Plan is updated annually and is approved by the Boards

More information

Member Handbook. Real. Solutions. Amerigroup Florida, Inc. Florida Statewide Medicaid Managed Care Long-Term Care Program

Member Handbook. Real. Solutions. Amerigroup Florida, Inc. Florida Statewide Medicaid Managed Care Long-Term Care Program Real Solutions B-TXMHB-0004-11 05.11 FL-MHB-0023-13 10.13 Member Handbook Amerigroup Florida, Inc. Florida Statewide Medicaid Managed Care Long-Term Care Program 1-877-440-3738 n www.myamerigroup.com/fl

More information

Changes to icare s Mail Order Pharmacy Provider. March IN THIS ISSUE icare MEDICARE SNP PLAN INFORMATION...

Changes to icare s Mail Order Pharmacy Provider. March IN THIS ISSUE icare MEDICARE SNP PLAN INFORMATION... NEWSLETTER FOR MEMBERS OF INDEPENDENT CARE HEALTH PLAN icarenews Changes to icare s Mail Order Pharmacy Provider Independent Care Health Plan (icare) is pleased to announce a new partnership with NoviXus

More information

Section 2. Member Services

Section 2. Member Services Section 2 Member Services i. Introduction 2 ii. Programs and Enrollment Information 7 iii. Identifying HPSM Members 8 iv. Member Eligibility 10 v. Identification Cards and Co-Payments 12 vi. PCP Selection

More information

Notice of privacy practices

Notice of privacy practices Notice of privacy practices This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Our staff are committed

More information

ADULT LONG-TERM CARE SERVICES

ADULT LONG-TERM CARE SERVICES ADULT LONG-TERM CARE SERVICES Long-term care is a broad range of supportive medical, personal, and social services needed by people who are unable to meet their basic living needs for an extended period

More information

Residents Rights. Objectives. Introduction

Residents Rights. Objectives. Introduction Residents Rights Objectives By the end of this educational encounter, the clinician will be able to: 1. Identify basic resident rights 2. Relate how resident rights impact daily nursing practice 3. Apply

More information

Do You Qualify? Please Read Carefully:

Do You Qualify? Please Read Carefully: Do You Qualify? Please Read Carefully: You are NOT eligible if any of these apply: I am pregnant I am under the age of 18 I have more than two children in my custody My child(ren) is(are) three years old

More information

ALLINA HOSPITALS & CLINICS IDENTITY THEFT INVESTIGATION PROTOCOL CHECKLIST

ALLINA HOSPITALS & CLINICS IDENTITY THEFT INVESTIGATION PROTOCOL CHECKLIST ALLINA HOSPITALS & CLINICS IDENTITY THEFT INVESTIGATION PROTOCOL CHECKLIST I. Intake! Each site must identify a Designated Lead - security lead at the facility OR, if there is no security lead, the facility

More information

NOTICE OF PRIVACY PRACTICES UNIVERSITY OF CALIFORNIA RIVERSIDE CAMPUS HEALTH CENTER

NOTICE OF PRIVACY PRACTICES UNIVERSITY OF CALIFORNIA RIVERSIDE CAMPUS HEALTH CENTER NOTICE OF PRIVACY PRACTICES UNIVERSITY OF CALIFORNIA RIVERSIDE CAMPUS HEALTH CENTER Effective Date: April 14, 2003 THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND

More information

INFORMED CONSENT FOR TREATMENT

INFORMED CONSENT FOR TREATMENT INFORMED CONSENT FOR TREATMENT I (name of patient), agree and consent to participate in behavioral health care services offered and provided at/by Children s Respite Care Center, a behavioral health care

More information

WELCOME. Payment will be expected at the time of service. Please remember our 24 hour cancellation notice.

WELCOME. Payment will be expected at the time of service. Please remember our 24 hour cancellation notice. WELCOME Those of us at Crossroads Counseling want to thank you for choosing to work with us and we want to make your time with us as productive as possible. In order to expedite the intake process, please

More information

Quick start guide (TTY 711) AVA-MEM

Quick start guide (TTY 711) AVA-MEM Quick start guide www.anthem.com/vamedicaid 1-800-901-0020 (TTY 711) AVA-MEM-0732-17 Welcome to the Anthem HealthKeepers Plus plan We re glad you chose us! This booklet will help you learn how to use your

More information

Compliance Program Code of Conduct

Compliance Program Code of Conduct City and County of San Francisco Department of Public Health Compliance Program Code of Conduct Purpose of our Code of Conduct The Department of Public Health of the City and County of San Francisco is

More information

Scripts for the Transition to Medi-Cal

Scripts for the Transition to Medi-Cal Scripts for the Transition to Medi-Cal Question: Where can we get the latest information on the transition plan? The State Law has changed and requires children enrolled

More information

A University of Hawai'i Cooperative Extension Service Project.

A University of Hawai'i Cooperative Extension Service Project. A University of Hawai'i Cooperative Extension Service Project www.ctahr.hawaii.edu/tcym Increase your knowledge about Course Objectives financial planning Improve your ability to make informed decisions

More information

PeachCare for Kids. Handbook

PeachCare for Kids. Handbook PeachCare for Kids Handbook Table of Contents What is PeachCare for Kids?...2 Who is eligible?...3 How do you apply for PeachCare for Kids?...3 Who will be your child s primary doctor?...4 Your child s

More information

Avmed medicare. Keeping You Informed

Avmed medicare. Keeping You Informed Avmed medicare Keeping You Informed Summer/July 2016 inside Your Primary Care Physician... 2 Preventive Healthcare... 2 Transferring Your Medical Records... 3 Mental Health Benefits... 3 Medical Technology...

More information

Volunteer Application Package

Volunteer Application Package Volunteer Application Package April, 2016 This program is supported by the Georgia Department of Human Services/Division of Aging Services/GeorgiaCares Program with financial assistance, in whole or in

More information

Evidence of Coverage SANTA CLARA FAMILY HEALTH PLAN MEDI-CAL. Toll Free: TTY:

Evidence of Coverage SANTA CLARA FAMILY HEALTH PLAN MEDI-CAL. Toll Free: TTY: SANTA CLARA FAMILY HEALTH PLAN MEDI-CAL Evidence of Coverage 2016-2017 Toll Free: 1-800-260-2055 TTY: 1-800-735-2929 Hours: 8:30 a.m. to 5:00 p.m., Monday - Friday (except holidays). If you have questions,

More information

We want to thank you for your interest in the Orion Weight Loss Program. We are looking forward to helping you reach your weight loss goal.

We want to thank you for your interest in the Orion Weight Loss Program. We are looking forward to helping you reach your weight loss goal. Appointment Date: Appointment Time: Dear Orion Member, We want to thank you for your interest in the Orion Weight Loss Program. We are looking forward to helping you reach your weight loss goal. Enclosed

More information

Virginia Medicaid Fraud Control Unit

Virginia Medicaid Fraud Control Unit VIRGINIA ATTORNEY GENERAL S OFFICE Virginia Medicaid Fraud Control Unit SPECIAL POINTS OF INTEREST: Services Case Spotlight INSIDE THIS ISSUE: Types of Medicaid Benefits Who is eligible for Medicaid Where

More information

Health Coverage + Care

Health Coverage + Care SACRAMENTO WOMEN S GUIDE TO Health Coverage + Care Women in Sacramento County have new options for getting health coverage and care. Use this guide to find out which option is right for you. This guide

More information

1.2 ADULT CLIENT INTAKE FORM: Client Information

1.2 ADULT CLIENT INTAKE FORM: Client Information 1.2 ADULT CLIENT INTAKE FORM: Client Information FOR OFFICIAL USE ONLY: Client Number Effective Insurance No OH No CLIENT INFORMATION Client name of significant other CHILDREN INFORMATION of birth of birth

More information

Your Guide to keeping your Kaiser Permanente Medicare health plan

Your Guide to keeping your Kaiser Permanente Medicare health plan Your Guide to keeping your Kaiser Permanente Medicare health plan KP Library: 42-35102677_Corbis_RF_LG_CMYK.psd Your Kaiser Permanente group Medicare health plan is changing and we re still here for you.

More information

Member Handbook. Amerigroup Florida, Inc (TTY 711) Florida Statewide Medicaid Managed Care Long-Term Care Program

Member Handbook. Amerigroup Florida, Inc (TTY 711) Florida Statewide Medicaid Managed Care Long-Term Care Program Member Handbook Amerigroup Florida, Inc. Florida Statewide Medicaid Managed Care Long-Term Care Program 1-877-440-3738 (TTY 711) www.myamerigroup.com/fl Amerigroup Florida, Inc. Member Handbook Florida

More information

Getting the most from your health plan

Getting the most from your health plan Getting the most from your health plan A Healthy Michigan Plan handbook and Certificate of Coverage We re here for you Call us Priority Health Choice, Inc. 888.975.8102 Hours: Monday Thursday 7:30 a.m.

More information

Patient rights and responsibilities

Patient rights and responsibilities Patient rights and responsibilities (Also: Billing FAQs) Legacy Health Patient Information: Rights/Responsibilities, It s OK to Ask, Billing FAQs 1 Patient rights and responsibilities Your hospital experience

More information

National Policy Library Document

National Policy Library Document Page 1 of 11 National Policy Library Document Policy Name: Medicare Compliance: Compliance Officer and Compliance Committee Policy No.: HR328-133757 Policy Author: Author Title: Author Department: Sheryl

More information

The Purpose of this Code of Conduct

The Purpose of this Code of Conduct The Purpose of this Code of Conduct This Code of Conduct provides a framework to guide us in meeting our obligations as employees and volunteers of HPC Healthcare, Inc., and its current and future affiliates,

More information

A Guide to Accessing Quality Health Care

A Guide to Accessing Quality Health Care A Guide to Accessing Quality Health Care Spring 2015 MolinaHealthcare.com 37894DM0115 Molina Healthcare s Quality Improvement Plan and Program Your health care is important to us. We want to hear how we

More information

HIPAA for CNAs. This course has been awarded one (1.0) contact hour. This course expires on May 31, 2020.

HIPAA for CNAs. This course has been awarded one (1.0) contact hour. This course expires on May 31, 2020. HIPAA for CNAs This course has been awarded one (1.0) contact hour. This course expires on May 31, 2020. Copyright 2015 by RN.com. All Rights Reserved. Reproduction and distribution of these materials

More information

Medicare Supplement Plans

Medicare Supplement Plans KPShealth plans P R O V I D E R N E T W O R K If you have questions about any of our Medicare Supplement plans or about the application process, please feel free to contact us at 360-478-6786, or toll

More information

Self-Insured Schools of California: Schools Helping Schools

Self-Insured Schools of California: Schools Helping Schools Self-Insured Schools of California: Schools Helping Schools Blue Shield of California Access+ HMO Plan 2016/2017 Enrollment Guide Blue Shield of California offers health benefits to school districts that

More information

An Interview With. Thomas P. Lenox. Supervisory Special Agent, Drug Enforcement Administration. Interview by Roneet Lev, MD

An Interview With. Thomas P. Lenox. Supervisory Special Agent, Drug Enforcement Administration. Interview by Roneet Lev, MD An Interview With Thomas P. Lenox Supervisory Special Agent, Drug Enforcement Administration Interview by Roneet Lev, MD 24 april 2013 DPart 1 Dr. Lev: First of all, thank you for agreeing to be in San

More information

Caregiver Stress. F r e q u e n t l y A s k e d Q u e s t i o n s. Q: Who are our nation's caregivers?

Caregiver Stress. F r e q u e n t l y A s k e d Q u e s t i o n s. Q: Who are our nation's caregivers? Caregiver Stress Q: What is a caregiver? A: A caregiver is anyone who provides help to another person in need. Usually, the person receiving care has a condition such as dementia, cancer, or brain injury

More information

Assessing the Quality of California Dual Eligible Demonstration Health Plans

Assessing the Quality of California Dual Eligible Demonstration Health Plans M A Y 2 0 1 2 Assessing the Quality of California Dual Eligible Demonstration Health Plans T A B L E O F C O N T E N T S Overview... 1 Introduction... 2 Table 1: Plan Rating Overview... Summary of Quality

More information

HH Health System-Shoals, LLC dba Helen Keller Hospital Notice of Privacy Practices

HH Health System-Shoals, LLC dba Helen Keller Hospital Notice of Privacy Practices HH Health System-Shoals, LLC dba Helen Keller Hospital Notice of Privacy Practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

More information

PARAGOULD DOCTORS CLINIC PRIVACY NOTICE

PARAGOULD DOCTORS CLINIC PRIVACY NOTICE PARAGOULD DOCTORS CLINIC PRIVACY NOTICE Protected Health Information THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE

More information

Member Handbook. STAR+PLUS Nursing Facility

Member Handbook. STAR+PLUS Nursing Facility STAR+PLUS Nursing Facility Member Handbook Bexar, El Paso, Harris, Jefferson, Lubbock, Medicaid Rural West, Tarrant and Travis Service Areas 1-800-600-4441 www.myamerigroup.com/tx TX-MHB-0108-17 12.17

More information

SMP Foundations Training Manual

SMP Foundations Training Manual SMP Foundations Training Manual SMP Resource Center Table of Contents Acknowledgements... i About the SMP Resource Center... i Training Overview... ii Updates Since August 2014...iii Chapter 1: SMP Program

More information

Code of Ethical Conduct The Right Thing to Do and How to Do it Right!

Code of Ethical Conduct The Right Thing to Do and How to Do it Right! Code of Ethical Conduct The Right Thing to Do and How to Do it Right! Princeton HealthCare System consists of the following units and programs: University Medical Center of Princeton at Plainsboro Princeton

More information

East Bay Paratransit 1750 Broadway Oakland, CA 94612

East Bay Paratransit 1750 Broadway Oakland, CA 94612 East Bay Paratransit 1750 Broadway Oakland, CA 94612 Information Materials and Application Instructions for East Bay Paratransit Thank you for your interest in East Bay Paratransit. Please read the information

More information

West Allis Health Department

West Allis Health Department Have a Safe and Healthy Day! West Allis Health Department Get 6-8 hours of sleep each day Eat lots of fruits and vegetables Drink fluids Be physically active Use seat belts / car seats Be tobacco free

More information