Directory of Physicians and Other Health Care Professionals
[Pages:892]Directory of Physicians and Other Health Care Professionals
Directorio de m?dicos y proveedores de atenci?n m?dica
For Members Enrolled in These Programs: ? AHCCCS/Medicaid ? Developmentally Disabled ? Children's Rehabilitative Services
Para los miembros inscritos en los siguientes programas: ? AHCCCS/Medicaid ? Developmentally Disabled ? Children's Rehabilitative Services
Customer Service Servicio al Cliente
1-800-348-4058 (TTY: 711)
CSAZ15MC3692632_001
5/11/2016
We care about you and your family's health.
UnitedHealthcare Community Plan partners with Arizona Health Care Cost Containment System (AHCCCS), Arizona Department of Health Services (ADHS) and Department of Economic Security (DES) to offer many different health plans. We've been here since 1982. You first knew us as Arizona Physicians IPA. Now we're UnitedHealthcare Community Plan. Over the years, the names of some of our plans have changed. But one thing never changes. That's our promise to help you get access to the care you need. UnitedHealthcare Commmunity Plan does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, national origin, veteran status, ancestry, health status or the need for, or cost of, health services.
Welcome to UnitedHealthcare Community Plan
Finding a Provider
This directory will help you find doctors and specialists in your area who participate with UnitedHealthcare Community Plan. It also lists the names and addresses of hospitals, pharmacies and dentists you should use, if you need those services. You can also find a current list of network providers on our website at . To choose or change your Primary Care Provider (PCP) call Customer Service at the number below and let us know. (Sometimes doctors may not accept new patients. If that's the case, we can help you make another selection.)
Customer Service 1-800-348-4058 (TTY: 711)
Choosing a Primary Care Provider (PCP) for you and your family is easy
There are several types of PCPs listed in this directory.
Primary Care Providers
Family General Practice: Internal Medicine: Pediatrician:
Adults and Children Adults Children
Providers listed in this directory are current as of the date listed on the cover. Information is subject to change.
Your Primary Care Physician (PCP)
Your health care is important to us. We carefully screen and pick our doctors so you receive the best care. When you enroll, you will be assigned a Primary Care Physician (PCP). Your PCP is your personal care doctor. Your PCP will provide or arrange the covered services you need. Make sure you talk to your PCP about any health problems you have. That way, your PCP gets to know you and your medical history. Always follow your PCP's instructions and get approval before you get any medical services. If you are pregnant you may choose your Primary Care Obstetrician (PCO) as your primary physician.
Changing Your PCP
Your PCP is an important part of your health care team. You and your PCP need to work together. If for any reason you want to change your PCP, call Member Services. If you change your PCP, you must choose another PCP from the UnitedHealthcare Community Plan Provider Directory. We can help you choose a new PCP or tell you more about the PCPs in our network. If you are pregnant, contact Healthy First Steps at 1-800-599-5985. Member Services can send you a list of our providers at no cost to you. If your PCP does not speak your language, call Member Services. UnitedHealthcare Community Plan will provide you with an interpreter at no cost to you.
Seeing a Specialist
Your PCP is in charge of ALL your covered health care needs. If you need specialty care, your PCP may refer you to a specialist or another doctor. There are four exceptions to this:
? Members with special health care needs may directly access a specialist as appropriate for the condition and identified needs. Preventive services are covered including well exams and screenings.
? Women can make an appointment with an in-network Obstetrician/Gynecologist (OB/GYN) for preventive or routine services without a referral from their PCP. (Please see the UnitedHealthcare Community Plan Provider Directory for a list of doctors).
? All members can self-refer for behavioral health services through their local RBHA. CRS members in the Fully Integrated and Partially Integrated-BH coverage types will get behavioral health services through UnitedHealthcare Community Plan. See section on Behavioral Health Services for more information.
? Members under 21 years of age can self-refer for dental and vision screenings.
CRS Members Children's Rehabilitative Services (CRS)
Children's Rehabilitative Services is a program for individuals with special health care needs. You or your child can receive care at one of four Multi-Specialty Interdisciplinary Clinics (MSICs) in Phoenix, Tucson, Flagstaff or Yuma. At these clinics, you or your child can receive all of your specialty care. Primary and behavioral health services may also be offered. Your assigned MSIC is your health home. In addition to the services provided at the MSIC, CRS Fully Integrated or CRS Partially Integrated- Acute members also have access to a full network of providers, including your community-based PCP and CRS Fully Integrated and CRS Partially Integrated ? BH members also have access to a full network of behavioral health specialists.
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UNITEDHEALTHCARE COMMUNITY PLAN PO BOX 31349 SALT LAKE CITY, UT 84131-0349
UNITEDHEALTHCARE COMMUNITY PLAN PO BOX 31349 SALT LAKE CITY, UT 84131-0349
UNITEDHEALTHCARE COMMUNITY PLAN PO BOX 31349
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How to Use This Directory
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in your area who participate in the following programs:
AHCCCS/Medicaid
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an (80840)
CRS Fully Integrated
CRS Partially Integrated Behavioral Health CRS only
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listings. Check the table of contents to find providers in your county.
Health Plan (80840) 911-03432-06 AHCCCS ID#: A99999999
Member Name: SUBSCRIBER BROWN
PCP: PROVIDER BROWN
Group: 40100 Medicaid
Health Plan (80840)
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40100
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ROVIDER BROWN3141 N 3rd Ave., Phoenix, AZ 85013
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3141 N 3rd Ave., Phoenix, AZ 85013
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Developmentally Disabled (DD)
CRS Partially Integrated ? Acute
Health Plan (80840) 911-03432-06
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PCP: PROVIDER fgouraarapnictetuerefoIrDs.e BROWN
Welcome to UnitedHealthcare Community Plan
Welcome to UnitedHealthcare Community Plan
Welcome to UnitedHealthcare Community Plan
(80840)
Carry this card with
We're glad to have you as a member. UnitedHealthcare Community Plan offers many planWsein're glad to have you as a member. UnitedHealthcare Community Plan offers many planWsein're glad to have you as a member. UnitedHealthcare Community Plan offers many plans in
Arizona. The plan for members through the Division of Developmental Disabilities is calledArizona. The plan for members through the Division of Developmental Disabilities is calledArizona. The plan for members through the Division of Developmental Disabilities is called
Arizona Physicians IPA Developmentally Disabled (DD).
Arizona Physicians IPA Developmentally Disabled (DD).
Arizona Physicians IPA Developmentally Disabled (DD).
This is your new Member ID Card. Please carry it with you at all times. You should presenTt his is your new Member ID Card. Please carry it with you at all times. You should presenTt his is your new Member ID Card. Please carry it with you at all times. You should present
this card when you go to doctor appointments or get covered services from other health this card when you go to doctor appointments or get covered services from other health this card when you go to doctor appointments or get covered services from other health
care providers. For questions about your benefits or your PCP, call the Member Services care providers. For questions about your benefits or your PCP, call the Member Services care providers. For questions about your benefits or your PCP, call the Member Services
number on the back of your ID card.
number on the back of your ID card.
number on the back of your ID card.
0311595524060000000000400000051115 113
you
To help protect your identity and prevent fraud, AHCCCS is adding pictures to its on-line vTeorifhicealptiopnrotect your identity and prevent fraud, AHCCCS is adding pictures to its on-line vTeorifhicealptiopnrotect your identity and prevent fraud, AHCCCS is adding pictures to its on-line verification
tool that providers use to verify your coverage. If you have an Arizona driver's license or sttoaotel tihsastuperdoviders use to verify your coverage. If you have an Arizona driver's license or sttoaotel tihsastuperdoviders use to verify your coverage. If you have an Arizona driver's license or state issued
ID, AHCCCS will get your picture from the Arizona Department of Transportation Motor VeIDhi,cAleHCCCS will get your picture from the Arizona Department of Transportation Motor VeIDhi,cAleHCCCS will get your picture from the Arizona Department of Transportation Motor Vehicle
Division (MVD). When providers pull up the AHCCCS eligibility verification screen, they wiDllisveiseion (MVD). When providers pull up the AHCCCS eligibility verification screen, they wiDllisveiseion (MVD). When providers pull up the AHCCCS eligibility verification screen, they will see
your picture (if available) with your coverage details.
your picture (if available) with your coverage details.
your picture (if available) with your coverage details.
3141 N 3rd Ave., Phoenix, AZ 85013
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Bienvenido(a) a UnitedHealthcare Community Plan
Bienvenido(a) a UnitedHealthcare Community Plan
Bienvenido(a) a UnitedHealthcare Community Plan
Nos complace tenerle como miembro. UnitedHealthcare Community Plan ofrece varios plNanoesscomplace tenerle como miembro. UnitedHealthcare Community Plan ofrece varios plNanoesscomplace tenerle como miembro. UnitedHealthcare Community Plan ofrece varios planes
en Arizona. El plan para los miembros a trav?s de la Divisi?n de Discapacidades del DesaernroAllroizona. El plan para los miembros a trav?s de la Divisi?n de Discapacidades del DesaernroAllroizona. El plan para los miembros a trav?s de la Divisi?n de Discapacidades del Desarrollo
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1-800-445-1638
69T99C-O99N9T9MA 348-4058
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Printed: 04/11/11
Printed: 04/11/11
Group: 40300
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care providers. For questions about Arizona (Arizona Department of Transportation Motor Vehicle Division, MVD).
Cuando los proveedores accedan a la pantalla de verificaci?n de elegibilidad de
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AHCCCS, ver?n una fotograf?a de usted (si est? disponible) junto con los detalles de su cobertura.
AHCCCS, ver?n una fotograf?a de usted (si est? disponible) junto con los detalles de su cobertura.
Group: 10145
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To help protect your identity and prevent fraud, ATHoChCeClpSpirsoatedcdtinyogupricidtuernetsitytoanitsd opnre-lvineentvferariuficda,TtAoioHnhCeClpCpSroitsecatdydoinugr ipdiectnutriteysatnoditpsroenv-elinntefrvaeurdif,icAaHtioCnCCS is adding pictures to i
tool that providers use to verify your coverage. Iftyoooul thavt epraonviAdreizrsonuasedrtoivevre'sriflyicyeonusrecoorvsetraatgeei.stsIofuoyelodtuhahtapvreovaindeArrsizuosneatodrviveerrif'ys ylioceunr sceovoerrsatgaete. Iifsysouuedhave an Arizona driver's l
UNITEDHEALTHCARE COMMUNITY PLAN PO BOX 31349 SALT LAKE CITY, UT 84131-0349
UNITEDHEALTHCARE COMMUNITY PLAN PO BOX 31349 SALT LAKE CITY, UT 84131-0349
UNITEDHEALTHCARE COMMUNITY PLAN PO BOX 31349 SALT LAKE CITY, UT 84131-0349
610494 ACUAZ
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your picture (if available) with your coverage detayiolsu.r picture (if available) with your coverage deytoauilrs.picture (if available) with your coverage details.
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PO BOX 31349 8413S1A-L0T34L9AKE CITY, UT
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en Arizona. El plan para los miembros a trav?s denlaADrizivoinsia?.nEdl eplDaniscpapracloidsamdeiesmdberloDseasatrrarov?llosedneAlraizDoinvais.i?Enl pdleanDpisacraaplaocsidmaideemsbdroesl Daetrsaavr?roslldoe la Divisi?n de Discapacidad
WWee'lrceomgleadtotoUhnaitveedHy(oeDualathisvcaairmse eCimoombnemr.uoUnniftiyteDPdlHaeneavlthecalroe CpommmeunnitytPalalnDoffeisrsamabniylpitlaineWWseesin'lrc)eomgsleaedtotoUllhnaaitvemedHyoeaualat(AhsDcaarrimevzeCiomosmbniemora.uUnnniPtiytoePhdflHayneDasltehiccvairaeeCnloosmpmImuPnitAey PnlDatnaeoflfveDres mliosanapy bpmlainlWWeisteeinin'lreceotmasglea)ldltyostoUehnaitveledlaHyoemualat(hasDcaarAmieveCrmioismzbiemoor.uUnnnnitaiytoePdPlfHaneDhaltyhecsavrieecCliooampnmmusnitIeyPPnlAatnaoDflfeDers vmisaenaylobplpainlmistiineesn)taslelyllama Arizona Physicians IPA Devel
UNITEDHEALTHCARE COUMNIMTUENIDTHYEAPLLTAHNCARE COMMUNITY PLAN
Disabled (DD). Disabled (DD). Disabled (DD). Arizona. The plan for members through the Division of Developmental Disabilities is calledArizona. The plan for members through the Division of Developmental Disabilities is calledArizona. The plan for members through the Division of Developmental Disabilities is called
Arizona Physicians IPA Developmentally Disabled (DD).
Arizona Physicians IPA Developmentally Disabled (DD).
Arizona Physicians IPA Developmentally Disabled (DD).
Esta es su nueva tarjeta de identificaci?n de mieEmsbtraoe. sLls?uvenlauecvoanstaigrjoettaoddoe eidl etinetmifipcoa.ci?n de mEiesmtaberos. sLul?nvueelavacotanrsjiegtoa tdoedoideelnttiiefimcapcoi?. n This is your new Member ID Card. Please carry it with you at all times. You should presenTthis is your new Member ID Card. Please carry it with you at all times. You should presenTthis is your new Member ID Card. Please carry it with you at all times. You should present
this card when you go to doctor appointments or get covered services from other health this card when you go to doctor appointments or get covered services from other health this card when you go to doctor appointments or get covered services from other health
de
miembro.
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Debe presentar esta tarjeta Debe presentar esta tarjeta cu Debe presentar esta tarjeta cuando asista a sus citas con el m?dico o cuando care providers. For questions about your benefits or your PCP, call the Member Services care providers. For questions about your benefits or your PCP, call the Member Services care providers. For questions about your benefits or your PCP, call the Member Services
number on the back of your ID card.
number on the back of your ID card.
number on the back of your ID card.
Sample Provider Listing
Description of Provider Listings
1Board Certification Board certification shows a physician's expert knowledge in a medical specialty. Certification involves a process of testing and evaluation by specialists in the specific area of medicine. A board-certified specialist participates in continuing education to learn about the latest advances in medical science and technology in his/her specialty. You can check the provider's board certifications on the American Board of Medical Specialists (ABMS) website. Go to and click on "Is Your Doctor Certified?"
2Languages other than English spoken by the provider.
3Limitations of the practice, such as age restrictions or the inability to accept new patients.
4Lists which plans/programs the provider participates in: Medicaid
This chart will help you understand each doctor's listing
Listing Group Affiliation
Example Family Practice
Medical Associates
Group Address
123 Main Street
Health Valley, AZ 54321
Provider Name
John Smith, MD 5
Developmentally Disabled/ DD CRS Fully Integrated
Provider Phone Number 555-555-5555 4
Provider Gender
Male
CRS Partially Integrated Acute CRS partially Integrated ?
Behavioral Health CRS only
5Wheelchair picture tells you the provider is wheelchair-accessible.
1 Board Certification Office Hours
Family M 9:00 a.m. ? 5:00 p.m. T 9:00 a.m. ? 5:00 p.m. W 9:00 a.m. ? 5:00 p.m. Th 9:00 a.m. ? 5:00 p.m. F 9:00 a.m. ? 5:00 p.m.
2 Languages
Spanish
3 Limitations
Min. age 18 years old
Existing patients only
All of the information in these provider listings is based upon the provider's application. UnitedHealthcare checks this information when these providers join our network and every three years (or sooner) when the provider is re-credentialed.
Sample Hospital Listing
Description of Hospital Listings
This chart will help you understand each hospital's listing
Listing
Example
Hospital Name
GoodCare Hospital
Hospital Phone Number
222-123-4567
Hospital Address
627 South Wellness Street
Health Valley, AZ 54321
Accreditation
Accredited By: The Joint Commission (Accredited)
Accreditation shows that the hospital has been evaluated by experts in hospital care. An accredited hospital must participate in ongoing reviews to make sure that its operations are up to the latest standards. Please see below for the possible rankings.
The Joint Commission is one entity that accredits hospitals. The following ratings are possible: ? Accredited: The hospital was in compliance with all standards when surveyed or within 90 days of the survey. ? Preliminary Accreditation: The hospital passed a brief review of its compliance with the Joint Commission's standards and will be surveyed more fully shortly. ? Conditional Accreditation: The hospital complies with some, but not all, of the Joint Commission's standards, but will be surveyed more fully shortly. ? Provisional Accreditation: The hospital was not able to address all of the requirements for improvement that the first survey suggested within 45 days, or the hospital failed to show that it has been able to sustain compliance.
Accreditation can also be granted by the American Osteopathic Association (AOA), in which case the listing will read, "Accreditation: AOA (Accredited)."
All of the information in these provider listings is based upon the provider's application. UnitedHealthcare checks this information when these providers join our network and every three years (or sooner) when the provider is re-credentialed.
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