Directory of Physicians

CSFL.15.999.03.9.006

Florida

Directory

of Physicians

Directorio de m?dicos

Region 3 ? UnitedHealthcare Community Plan Medicaid (MMA)

Service Area/?rea de Servicio: Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, and Union Counties/Condados

CSFL22MD0006981_003

5/2/2024

CSFL.15.999.03.9.006

Introduction

This Provider Directory is to help you get to know the UnitedHealthcare Community Plan Region 3 Network, which includes primary doctors, specialist doctors, hospitals and other providers. We take great pride in our organization, the UnitedHealthcare Community Plan, and the quality service we provide to our members. We look forward to helping you as a member of the UnitedHealthcare of Florida family.

Customer Service

1-888-716-8787, TTY 711 for hearing impaired

Hours: 8 a.m.?7 p.m., Monday?Friday

| Customer Service 1-888-716-8787

CSFL.15.999.03.9.006

Welcome

Welcome to the UnitedHealthcare Community Plan Region 3 network of providers. Our doctors and hospitals are ready to meet your health care needs. This Plan requires that you select a primary doctor who will help you with your care. If you have any questions, please call Customer Service at 1-888-716-8787, available 8 a.m.?7 p.m., Monday?Friday.

This is your directory

The primary doctors, specialists, hospitals and others are the providers that make up the Plan Network listed in this directory. This Plan requires you to choose a primary doctor. All providers in this directory were contracted with the network at the time it was printed. Since the listing may have changed after printing, please check when making an appointment to make sure your provider is in network by calling Customer Service at 1-888-716-8787, available 8 a.m.?7 p.m., Monday?Friday. You may also log on to to view our online provider directory. Your doctor may determine you have a medical condition requiring special services not available from providers in your network. You are eligible for coverage of these medically necessary services when they are authorized in advance by your doctor. You do not need a referral if you have special health care needs. The out-of-network provider should contact Provider Services at 1-877-842-3210 for help. Payment for care for medically necessary services is subject to the limits of your health plan coverage. These limits are in your enrollee handbook. Some providers may choose not to perform certain services based on religious or moral beliefs.

| Customer Service 1-888-716-8787

CSFL.15.999.03.9.006

Reporting incorrect information

To report incorrect information, email provider_directory_invalid_issues@. This email is for members to report potential inaccuracies for demographic (address, phone, etc.) data elements identified on the online or paper directories. Reporting issues via this email will result in an outreach to the provider's office to verify all directory demographic data. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Community Plan members should call the number on the back of their member ID card. Non-UnitedHealthcare Community Plan members can call 1-888-638-6613. Providers should go to portal to use the My Practice Profile tool in the UnitedHealthcare Provider Portal under the Practice Management drop-down. Contractual issues should be addressed through your UnitedHealthcare Network contact at contactus.

How we screen our doctors

UnitedHealthcare reviews providers' credentials at the time they apply for admission to the network and regularly from then on. This is done to make sure they meet UnitedHealthcare's quality standards. Some of the things that UnitedHealthcare reviews include:

? Medical licenses ? Training and board certificates ? Network hospital admitting privileges ? Medical practice records Credentials for providers are verified with public and private groups. Final evaluation, recommendation and admission of a provider to the UnitedHealthcare network is supported by a panel. The panel includes valued providers based in your own community.

What is a network?

A network is a group of physicians, specialists, hospitals, outpatient centers, home health groups, pharmacies, lab services and other providers who are contracted to provide services.

| Customer Service 1-888-716-8787

CSFL.15.999.03.9.006

The primary doctor

When you become a member, you will be given a primary care doctor. The primary doctor is your personal or family doctor. They will help with all your medical care. When required, they will refer you to a specialist, other providers, or hospitals.

Each family member can choose a primary care doctor. You may change your doctor by calling Customer Service. You may choose to have all family members who are on UnitedHealthcare's Medicaid Plan served by the same primary care provider. You may also choose a different primary care provider based on each person's needs. Members see their doctors by appointment, except for emergency situations.

A referral from your primary doctor is required before seeing most specialists. You do not need a referral if you have special health care needs. The following specialty providers do not require an authorization:

? OB/GYN ? Podiatry ? Dermatologist ? Optometry ? Chiropractor ? Behavioral Health/Substance Abuse Professionals

Referrals are only for specialty visits. You do not need a referral if you have been identified as having special health care needs. The following services do not require a referral:

? Emergency services at an emergency room or hospital ? Flu shots and pneumonia vaccinations ? Kidney dialysis services from a certified dialysis facility when you are temporarily outside

the Health Plan's service area ? Routine women's health care, such as breast exams, screening mammograms, Pap tests,

and pelvic exams, as long as you get them from an in-network provider ? Routine eye exams and hearing exams, eyeglasses, contacts, or hearing aids from an

in-network provider

If you do not have a referral before seeing a specialist for a service not listed above, the service will not be paid.

| Customer Service 1-888-716-8787

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