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Freestanding Facilities Directory. Your Guide to Finding Network Freestanding Outpatient Facilities in Your Area

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Freestanding Facilities Directory. Your Guide to Finding Network Freestanding Outpatient Facilities in Your Area Freestanding facilities directory. Your guide to finding network freestanding outpatient facilities in your area. New York, 2018, Volume II Welcome Thank you for choosing an Oxford plan from UnitedHealthcare. We want to help you get the most from your health plan. Here are a few ideas and reminders to get you started. Your choice of a facility is your own. This information is not an endorsement of a particular facility’s suitability for your needs. You will normally have lower out-of-pocket costs by visiting a facility in your network. These facilities have agreed to provide financial discounts and participate in programs to help you have a good member experience. Our provider network changes frequently. For the most current list of facilities and other health care providers, visit your health plan member website, or call the toll-free phone number on your health plan ID card or 1-800-444-6222, Monday through Friday, 8 a.m. to 6 p.m. ET. TTY users can dial 711. Health4Me®—the go-to phone app Use network providers for your health. to save money. If you’re registered on your health plan’s member website, Network providers, including physicians, specialists, you can also access your family’s health information anytime, pharmacies, hospitals and other standalone facilities have anywhere through the Health4Me mobile app (available for agreed to accept lower rates for covered services. If you seek iPhone® and Android® operating systems). The free care outside the network, you may be responsible for a larger Health4Me app gives you: part, or all, of the charges. Typically, providers outside the network will not accept the same lower rates as our • 24 hours a day access to a registered nurse and your network providers. benefits information. • Help finding a nearby physician, hospital or other facility PLEASE NOTE: Certain physicians and health care in your network. professionals may charge additional fees for non-covered health services and will be unavailable to members who are not able or • An “Easy Connect” feature that lets you ask for a call-back willing to pay for the additional services. from a Customer Care expert. For more complete information, call the toll-free phone number Download the free Health4Me mobile app today. on your health plan ID card or 1-800-444-6222. TTY users Our network meets can dial 711. credentialing standards. What is urgent care? We check the credentials of health care professionals—from Illnesses and injuries that are of a less serious nature than physicians and therapists to labs and hospitals—before we an emergency may require urgent care. Urgent care centers accept them in our network. We look at professionals’ training are usually open evenings, weekends and holidays, and are and experience, using standards developed with national designed to give patients fast, effective service. Urgent care accrediting organizations. centers commonly treat conditions like: Where to find your benefit • Minor injuries and cuts. coverage information. • Upper respiratory infections. • Ear infections. This directory only has information on network freestanding • Sprains. outpatient facilities. You can find your benefit coverage details in your Certificate of Coverage or Summary Plan • Sore throats. Description (depending on your plan), or on your health • Urinary tract infections. plan’s member website. What to do in an emergency. An opportunity to save. Symptoms that can signal an emergency can include, but are Although emergency medical conditions should always be not limited to: evaluated and treated at a hospital emergency room, going to • Difficulty breathing. an urgent care center will save you money for non-emergency • Bleeding that can’t be controlled with local pressure. care. Most plans have a lower copayment when you visit an urgent care center as opposed to a hospital emergency room. • Sudden change in mental status such as unusual behavior, confusion or decreased alertness. • Sudden severe pain anywhere in the body. • Vomiting blood. If you have any of these symptoms, you should: • Call 911 or go to the nearest hospital emergency room. • Notify your physician as soon as possible. • Notify us within 24 hours or as soon as reasonably possible. Member rights and responsibilities. You have the right to: You have the responsibility to: • Be treated with respect and dignity by our personnel, network • Know and confirm your benefits before receiving treatment. physicians and other health care professionals. • Contact an appropriate health care professional when you • Privacy and confidentiality for treatments, tests and have a medical need or concern. procedures you receive. See the Notice of Privacy Practices • Show your health plan ID card before receiving health in your health plan documents for a description of how we care services. protect your personal health information. • Pay any necessary copayment at the time you • Voice concerns about the service and care you receive. receive treatment. • Register complaints and appeals concerning your health plan • Use emergency room services only for injury and illnesses or the care provided to you. that, in the judgment of a reasonable person, require • Get timely responses to your concerns. immediate treatment to avoid jeopardy to life or health. • Candidly talk with your doctor about the appropriate and • Keep scheduled appointments. medically necessary treatment options for your conditions, • Provide information needed for your care. regardless of cost or benefit coverage. • Follow the agreed-upon instructions and guidelines of doctors • Access to doctors, health care professionals and other health and health care professionals. care facilities. • Participate in understanding your health problems and • Participate in decisions about your care with your doctor and developing mutually agreed-upon treatment goals. other health care professionals. • Notify your employer of any changes in your address or • Receive and make recommendations about the organization’s family status. rights and responsibilities policies. • Log in to your health plan member website or call the toll-free • Get information about our services, network doctors and phone number on your health plan ID card when you have a health care professionals. question about your eligibility, benefits, claims and more. • Be informed about, and refuse to participate in, any • Log in to your health plan member website or call the toll-free experimental treatment. phone number on your health plan ID card before receiving • Have coverage decisions and claims processed according to services to verify that your doctor or health care professional regulatory standards, when applicable. participates in your network. • Choose an advance directive to designate the kind of care you wish to receive should you be unable to express your wishes. HIPAA standards for privacy of individually identifiable health information. To review our Privacy Policy and Notice of Privacy Practices describing how medical information about our members may be used and disclosed, and how members can get access to this information, visit your health plan’s member website. An important note about our services. We do not provide health services or practice medicine. Rather, we arrange for physicians and other health care professionals to participate in a network. Network physicians and health care professionals are independent contractors and are not employees of Oxford or UnitedHealthcare. We make payments to network physicians and health care professionals through various types of contractual arrangements. These contractual arrangements may include financial incentives (e.g., bonuses, capitation) to promote the delivery of health care in a cost-efficient and effective manner. Such financial incentives should not impact your access to covered health services. If you have any questions about whether there are any financial incentives in your doctor’s contract with us, feel free to ask your doctor. We make decisions about health plan coverage. These decisions are administrative decisions and are for payment purposes only. We are not liable for any act or omission of a physician or other health care professional. Our philosophy states that the doctor-patient relationship is sacred — all medical decisions rest between you and your physician. It means freedom to choose, along with the responsibility to act. • You’re responsible for choosing your own physician. • You must decide if the doctor you choose is right for you. • You must decide with your doctor what care you should receive. • Your doctor is solely responsible for the quality of the care you receive. تنبيه: إذا كنت تتحدث العربية (Arabic)، فإن خدمات المساعدة اللغوية المجانية متاحة لك. Oxford Health Insurance, Inc. (OHI) and Oxford Health Plans LLC do not يُرجى اﻻتصال برقم الهاتف المجاني المدرج على بطاقة التعريف الخاصة بك. treat members differently because of sex, age, race, color, disability or national origin. ATANSYON: Si w pale Kreyòl ayisyen (Haitian Creole), ou kapab If you think you were treated unfairly because of your sex, age, race, benefisye sèvis ki gratis pou ede w nan lang pa w. Tanpri rele color, disability or national origin, you can send a complaint to the Civil nimewo gratis ki sou kat idantifikasyon w. Rights Coordinator. ATTENTION : Si vous parlez français (French), des services d’aide linguistique vous sont proposés gratuitement. Veuillez appeler le Online: [email protected] numéro de téléphone gratuit figurant sur votre carte d’identification. Mail: Civil
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