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2021 Directorio De Proveedores Y Farmacias Queens County (Queens)

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2021 Directorio De Proveedores Y Farmacias Queens County (Queens) Senior Whole Health of New York NHC 2021 Directorio de proveedores y farmacias Queens County (Queens) Este directorio de proveedores y farmacias fue actualizado el 09/01/2021.Para obtener información más reciente o si tiene dudas, comuníquese con Servicios para Miembros de Senior Whole Health al 1-877-353-0185 (TTY 711) de 8:00 a. m. a 8:00 p. m. de lunes a viernes (desde el 1.° de octubre hasta el 31 de marzo, los 7 días de la semana) o visite www.SeniorWholeHealthNY.com. Puede haber cambios en la red de proveedores/farmacias durante el año de bene®cios. En nuestro sitio web, se encuentra un Directorio de proveedores/ farmacias actualizado enwww.seniorwholehealthNY.com. Puede llamar a Servicios para Miembros para acceder a un directorio de proveedores actualizado. La red de farmacias o la red de proveedores pueden cambiar en cualquier momento. Recibirá un aviso cuando sea necesario. H5992_2021_14811 Números para recordar SERVICIOS PARA 1-877-353-0185 MIEMBROS TRANSPORTE Logisticare: 1-855-558-1638 Where's My Ride: 1-800-564-0574 SERVICIOS PARA 1-800-877-7195 LA VISIÓN MEDICARE 1-800-MEDICARE 1-800-633-4227 SEGURO SOCIAL 1-800-772-1213 Senior Whole Health of New York NHC Directorio de proveedores y farmacias 2021 Este directorio es válido desde el 09/01/2021. Este directorio contiene una lista de proveedores actuales de la red de Senior Whole Health. Este directorio es para los condados indicados a continuación: Queens County en Nueva York Para cualquier pregunta sobre la información contenida en este directorio, llame a Servicios para Miembros al 1-877-353-0185 de 8:00 a. m. a 8:00 p. m. de lunes a viernes (del 1.° de octubre al 31 de marzo, los 7 días de la semana). Los usuarios de TTY deben llamar al 711. Esta información está disponible en otros idiomas en forma gratuita. Llame a Servicios para Miembros al 1-800-353-0185 (TTY 711) de 8:00 a. m. a 8:00 p. m., de lunes a viernes (del 1.º de octubre al 31 de marzo, los 7 días de la semana). Este documento se encuentra disponible en otros formatos, tales como braille, letra grande o audio. H5992_2021_14811 Accepted SPN Tabla de contenidos Sección 1-- Introducción..................................................................................................................................2 ¿Cuál es el área de servicio de Senior Whole Health of New York NHC?...................................................... 5 ¿Cómo encontrar a los proveedores de Senior Whole Health en su área? ...................................................6 Sección 2 – Lista de proveedores de la red ....................................................................................................7 Proveedores de atención primaria (PCP)........................................................................................................9 Especialistas..................................................................................................................................................55 ndice de contenidos í Hospitales....................................................................................................................................................241 Centros de enfermería especializada (SNF) ...............................................................................................243 Salud mental para pacientes ambulatorios .................................................................................................250 Salud mental para pacientes hospitalizados ...............................................................................................275 Medicaid Advantage Plus............................................................................................................................276 Atención médica domiciliaria (no especializada).........................................................................................288 Proveedores auxiliares................................................................................................................................296 Transporte ...................................................................................................................................................312 Servicios odontológicos...............................................................................................................................318 Servicios oftalmológicos..............................................................................................................................399 Sección 3 – Lista de farmacias de la red.....................................................................................................415 Farmacias minoristas y cadenas de farmacias ...........................................................................................416 Farmacias de pedido por correo..................................................................................................................444 Farmacias de infusión a domicilio ...............................................................................................................445 Farmacias para atención a largo plazo .......................................................................................................446 ÍNDICE ........................................................................................................................................................447 1 Sección 1-- Introducción Este directorio proporciona una lista de las farmacias y los proveedores de la red de Senior Whole Health. Para acceder a información más detallada sobre su cobertura de atención médica, consulte su Evidencia de cobertura (Evidence of Coverage, EOC). Usted tendrá que escoger uno de nuestros proveedores de la red incluidos en este directorio como su médico de atención primaria (Primary Care Physician, PCP). Por lo general, debe obtener los servicios de atención médica por parte de su PCP. Su PCP es un médico con licencia o un enfermero practicante que cumple con los requisitos del Estado y está capacitado para proporcionar atención médica básica. Obtendrá la atención médica básica o de rutina de su PCP. Su PCP también coordinará el resto de los servicios cubiertos que obtiene como miembro del plan. En algunos casos, su PCP necesitará obtener una autorización previa (aprobación previa) de nuestro plan para los servicios o hacer una derivación para ver a un especialista. Puede elegir cualquier PCP incluido en este directorio que acepte nuevos pacientes. Busque el símbolo w ubicado en el listado del PCP. Secci Los proveedores de la red enumerados en este directorio han acordado proporcionarle su ó atención médica, dental, de la vista y servicios y ayuda a largo plazo. Usted puede acudir a n 1-- Introducci cualquiera de nuestros proveedores de la red incluidos en este directorio; sin embargo, algunos servicios pueden requerir una autorización previa. Autorización previa para proveedores no pertenecientes a la red En algunos casos, puede obtener servicios cubiertos de proveedores no pertenecientes a la red. ó n Sin embargo, a menos que se trate de una emergencia, es importante que obtenga nuestra autorización previa antes de consultar a un proveedor fuera de la red (OON). Si no recibe la aprobación previa, es posible que no cubramos los servicios que reciba. Si usted obtiene la aprobación para ver a un proveedor fuera de la red y él o ella quiere que usted regrese para recibir más atención, primero debe verificar que la aprobación cubra más de una visita al proveedor fuera de la red. Si decide consultar a un proveedor fuera de la red, puede recibir una factura del proveedor por el costo total de la atención médica que le brindaron. Debe enviarnos esa factura en lugar de pagarla. Analizaremos la factura y decidiremos si los servicios deberían estar cubiertos. Si es así, le pagaremos directamente al proveedor. Si ya pagó una factura, envíe la factura junto con la documentación de su pago y solicítenos que se le devuelva lo que pagó. Envíenos por correo postal la solicitud de reembolso junto con todas las facturas o recibos a: Senior Whole Health of New York NHC Attn: Member Services 15 MetroTech, 11th Floor Brooklyn, NY 11201 Si tiene preguntas, comuníquese con Servicios para Miembros al 1-877-353-0185 (TTY 711). 2 ¿Qué sucede si necesito atención de emergencia? Puede obtener cobertura para atención médica de emergencia siempre que lo necesite, en cualquier lugar de los Estados Unidos o sus territorios. En una emergencia, debe recibir atención inmediatamente. Usted no tiene que comunicarse con su PCP u obtener autorización previa ni derivación en una emergencia. Puede marcar el 911 para obtener asistencia inmediata por teléfono o ir directamente a la sala de emergencias, hospital o centro de atención de urgencia más cercano. Nuestro plan cubre servicios de ambulancia en situaciones en las que llegar a una sala de emergencias de otra manera podría poner en riesgo su salud. La atención de emergencia siempre puede recibirse del proveedor más cercano disponible dentro o fuera del área de servicio. Una situación es una “emergencia médica” si cree razonablemente que su salud está en riesgo grave. Esto significa que cada segundo cuenta. Algunos ejemplos de “emergencias médicas” son un dolor agudo, una lesión grave o una afección médica o enfermedad grave que empeora. Los médicos que le están brindando atención de emergencia decidirán el momento en que su n ó afección esté estable y que haya terminado la emergencia médica. Cuando eso sucede, tiene derecho de atención de seguimiento para asegurarse de que su afección continúa
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