Provider Directory

2017 - 2018 | University Family Care Customer Care: (800) 582-8686 Introduction Welcome to University Family Care. This directory was prepared to help you access University Family Care providers. This directory lists University Family Care's providers. It also includes basic onformation about how to get covered services with University Family Care. To get more information about your health care needs, please see your Member Handbook or call our Customer Care Center at (800) 582-8686. TTY users should call 711. Your Primary Care Provider (PCP) is your assigned doctor and he/she plays an important role in your health care. The term "PCP" will be used throughout this dirctory. Generally, you must get your health care coverage from your PCP. Your Primary Dentist Provider (PDP) is your assigned dentist and he/she plays an important role in your dental care. The term "PDP" will be used throughout this directory. What is the service area for University Family Care? The counties in our service area are Cochise, Gila, Graham, Greenlee, La Paz, Maricopa, Pima, Pinal, Santa Cruz, Yuma and Yavapai. How do you find University Family Care providers in your area? This directory is organized by city and by specialty. To find a provider, please locate the city where you would like to see a provider, and then locate the type of provider that you wish to see. You will notice that all Primary Care Providers (PCPs) are grouped together under each city, and each specialty provider is listed by the type of medicine that he or she practices. You can also visit www.ufcaz.com to find a provider, or you can call our Customer Care Center at (800) 582-8686. TTY users should call 711. Can the list of plan providers change? Yes, University Family Care may add or remove providers from our provider directory. To get current information about University Family Care plan providers in your area, you can visit www.ufcaz.com or call our Customer Care Center at (800) 582-8686. TTY users should call 711. I Introduction Atención of Cliente: (800) 582-8686 2017 - 2018 | University Family Care Choosing Your Primary Care Provider (PCP) What is a PCP? When you become a member of University Family Care, you must choose a plan provider to be your PCP. Your PCP is a physician, nurse practitioner, or other heathcare professional that meets your state requirements and is trained to give you basic medical care. You will get your routine or basic care from your PCP. Your PCP can also coordinate the rest of the covered services you need. In most cases, you must see your PCP to get a referral before you see any other healthcare provider. How do you choose a PCP? It is important you choose a PCP who makes you feel comforatble. You should stay with that provider so you get the best possible care. Please call our Customer Care Center and we will help you. • When you select a doctor please call the Customer Care Center at (800) 582-8686. TTY user should call 711. Your selected PCP will be noted in your file. • If you are having problems with your PCP, please call our Customer Care Center. We are here to help you. How to change your PCP If you would like to change your PCP, please call our Customer Care Center and we will help you. You may also change your PCP by sending us your request in writing to the address shown on the cover. • Changes you make will normally occur the same day as the request. • We encourage you not to change your PCP more than 5 times a year. Referral to Specialists Some medical services need prior approval by UFC. If they do, your PCP will arrange for a prior authorization for these services. UFC must review thse requests. Your PCP's office will let you know if the prior authorization was approved. You can also call our Customer Care Center to find out the status. If your PCP's request is denied, UFC will let you know by mail. The letter sent by UFC will also tell you about your appeal rights and how to request an appeal or hearing. NOTE: Women 18 and older can have a Woman's Well Check-up that includes a pap and/or mammogram screening once a year without a referral from their PCP. Please contact our Customer Care Center for more information about Women's Well Check-up. Introduction II 2017 - 2018 | University Family Care Customer Care: (800) 582-8686 Urgent Care and Emergency Room Use Do not go to the Emergency Room for normal health care. The Emergency Room is for emergencies only! If you need urgent care but the condition is not life threatening, contact your PCP office any time. Your PCP's office will decide the level of care you need. In addition, if you need care after office hours, on weekends or holidays call our Customer Care Center. Examples of urgent symptoms (non-emergency) are: • Vomiting for more than 6 hours (if young child call PCP) • Diarrhea for more than 6 hours (if younf child call PCP) • Sprained Ankle • Minor Burns • A minor allergic reaction • Rashes • Flu • Sore throat with fever • Earache What to Do in Case of an Emergency Medical emergencies are sudden conditions, which are life and death situations. They may lead to disability or death if not treated as soon as possible. No prior authorization is necessary for emergency care. Examples of medical emergencies are: • Extreme shortness of breath • Fainting • Poisoning • Chest Pains • Uncontrolled bleeding • Seizures If you experience any of the above, go to the nearest Emergency Room or call 911. As a member of University Family Care, you have the right to seek emergency services at any hospital or other Emergency Room facility (in or out of our network). The Emergency Room is not a place to treat earaches, colds or the flu. For these conditions contact your PCP's office. Please remember it is very important to tell the Emergency Department staff that you are a University Family Care member and show your UFC ID Card. If you are unable to do this, have a family member or friend tell the Emergency Department staff that you are a University Family Care member. If you need emergency care while out of the county or state, please show your UFC ID Card to the doctor/hospital so they can call your PCP to let them know of your situation. III Introduction Atención of Cliente: (800) 582-8686 2017 - 2018 | University Family Care For More Information For more detailed information about your University Family Care coverage, please review your Member Handbook. If you have questions about University Family Care, please call our Customer Care Center at (800) 582-8686. TTY users should call 711. We are available 24 hours a day, 7 days a week. Or, visit www.ufcaz.com. Primary Dental Provider If you are 20 years of age or younger, you will be assigned to Primary Dental Provider (PDP). PDP is also called a Dental Home. You can visit a Primary Dental Provider or dentist without visiting your PCP first. How do you choose a PDP? It is important you choose a PDP that makes you feel comfortable. You should stay with that provider so you get the best possible care. Please call out Customer Care Center and we will help you. • When you select a dentist please call the Customer Care Center at (800) 582-8686. TTY users should call 711. Your selected PDP will be noted in your file. • If you are having problems with your PDP, please call our Customer Care Center. We are here to help you. How to change your PDP If you would like to change your PDP, please call our Customer Care Center and we will help you. You may also change your PDP by sending us your request in writing to the address shown on the cover. • Changes you make will normally occur on the same day we receive your request. • We encourage you not to change your PDP more than 5 times a year. Introduction IV 2017 - 2018 | University Family Care Customer Care: (800) 582-8686 Pharmacy Directory This directory provides a list of University Family Care's network pharmacies. This directory is for Cochise, Gila, Graham, Greenlee, La Paz, Maricopa, Pima, Pinal, Santa Cruz, Yavapai and Yuma Counties. All network pharmacies may not be listed in this directory. For additional information please contact University Family Care at (800) 582-8686. TTY users should call 711. Or, visit www.ufcaz.com. This directory includes some basic information about how to fill your prescriptions with University Family Care. To get a complete description of your prescription coverage, including how to fill your prescriptions, please read your Member Handbook. We call the pharmacies on this list our "network pharmacies" because we have made arrangements with them tp provide prescription drugs to Plan members. A network pharmacy is a pharmacy where members can get prescription drug benefits provided by University Family Care. How do I find a University Family Care network pharmacy in my area? To find a pharmacy near you is easy and convenient. To use this book, look for the county and city and then search for a pharmacy you are looking for. The most up-to-date is located on our pharmacy locator online. For additional information please visit www.ufcaz.com or call our Customer Care Center (800) 582-8686. TTY users should call 711. How do I fill a prescription at a network pharmacy? To fill your prescription at a network pharmacy, you must show you UFC ID Card.

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