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B – UFC/ACC Provider Directory

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B – UFC/ACC Provider Directory 2021 Provider Directory Central AHCCCS Complete Care Welcome Welcome to Banner – University Family Care/ACC (B – UFC/ACC). B – UFC/ACC’s comprehensive network of providers has been built to treat behavioral and physical health care needs for all members. Building our provider network is a collaborative effort and together we select providers for our members. All providers are required to provide a wide range of services in a culturally sensitive manner specific to your needs, this includes specialty services for all age ranges. The service area covered in this provider directory is Gila, Maricopa and Pinal. How do you find B – UFC/ACC providers in your area? Our provider directory includes a listing of our in-network providers who offer physical and behavioral health services. Providers are listed alphabetically, by city, specialty, and provider’s last name. All providers included in the directory accept Medicaid. The directory includes a listing of services that may be available to adults who are: Determined to have a serious mental illness (SMI) Eligible for Medicaid (also called the Arizona Health Care Cost Containment System, or AHCCCS) Determined to have general mental health and/or substance abuse issues A listing of all available providers can be found online at www.BannerUHP.com The online directory includes the following details: locations, telephone numbers and languages. Internet services are offered at most public libraries at no cost, if you are unable to access the internet form home. The online directory is available in other formats, such as large print and other languages. To request a copy of this directory in another language, call our Customer Care Center at (800) 582-8686. TTY users should call 711. Complete Care Primary Care Your health care program is designed to manage your physical and behavioral health, this is what we call “Complete Care”. Providers will work together to evaluate and help you manage your whole health care needs, this includes medication and case management. Your Primary Care Provider (PCP) is your assigned doctor and he/she plays an important role in your health care. Members do have a choice of providers. The role of your PCP is to help coordinate your healthcare needs. You can choose any PCP in this directory. You can also choose to allow your PCP and your behavioral health team to share information. AUGUST 2021 B – UFC/ACC I How to change your PCP If you would like to change your PCP, please call our Customer Care Center and we will help you. The directory includes a listing of services that may be available to adults who are: Changes you make will normally occur on the same day we receive the request. We encourage you to not change your PCP more than 5 times a year. 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. Specialty Care Referrals You may go to any of the providers listed in this directory. Some services and specialists may require a referral. That means you have to get approval in advance. Your PCP will give you a referral to see a specialist if he or she thinks you need specialized treatment. A specialist is a doctor who provides health care services for a specific disease or part of the body. Some examples of specialists include: Oncologists, who specialize in treating cancer Cardiologists, who treat heart conditions Orthopedists, who treat bone, joint or muscle conditions B – UFC/ACC must review all referral requests. Your PCP’s office will let you know if your prior authorization request is approved. If your PCP’s request is denied, B – UFC/ACC will let you know by mail. The letter sent by B – UFC/ACC will also tell you about your appeal rights and how to request an appeal or a hearing. It’s very important to get a referral from your PCP before you see a specialist. If you don’t have a referral before you get services from a specialist, you may have to pay for these services yourself. If the specialist wants you to come back for follow up visits, be sure to check with your PCP to find out if these visits are included under your original referral. If they aren’t included, your PCP can help you get a new referral for the additional visits. If there are specific hospitals you wish to use, find out whether your PCP uses these hospitals. Certain health care services require prior authorization from B – UFC/ACC, this means the service must be approved by B – UFC/ACC before it will be covered. Examples are services such a; hospitalization or outpatient surgery. Please check your Member Handbook for a complete list of services that require prior authorization. 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. III AGOSTO 2021 B – UFC/ACC What services don’t require approval in advance from a PCP? There are some services you can get on your own. That means you don’t need a referral from your PCP. You must see a B – UFC/ACC in network provider for these services. Services include: Routine women’s health care such as breast exams, mammograms (X rays of the breast), Pap tests and pelvic exams, Flu and pneumonia vaccinations (as long as you get them from a B – UFC/ACC provider). NOTE: Women 18 and older can have a Women’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 the Women’s Well Check-up. Changes to Providers listed in the Directory Yes, changes can occur, sometimes we add or remove providers. B – UFC/ACC posts a monthly directory on our website. Providers may be added or removed after the directory was printed. To get current information about B – UFC/ACC plan providers in your area, you can visit ww.BannerUFC.com/ACC or call our Customer Care Center at (800) 582-8686. TTY 711. What if you have a medical emergency? Get medical help as quickly as possible. Call 911 for help. You can also go to the nearest emergency room or urgent care center. You don’t need to get prior approval. You don’t need to get a referral. You may get covered emergency medical care whenever you need it, anywhere in the United States. Ambulance services are covered in the United States when other means of transportation would endanger your health. Important Reminder 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. Please remember it is very important to tell the Emergency Department staff that you are a B – UFC/ACC member and show your B – UFC/ACC Member ID Card. If you are unable to do this, have a family member or friend tell the Emergency Department staff that you are a B – UFC/ACC member. If you need emergency care while out of the county or state, please show your B – UFC/ACC ID Card to the doctor/hospital so they can call your PCP to let him or her know of your situation. Examples of urgent symptoms (non-emergencies) are: Vomiting for more than 6 hours (if young child, call PCP) Diarrhea for more than 6 hours (if young child, call PCP) Sprained ankle Minor burns A minor allergic reaction Rashes Flu Sore throat with a fever Earache AUGUST 2021 B – UFC/ACC III In addition, if you need care after office hours, on weekends or holidays call our Customer Care Center at (800) 582-8686. TTY 711. Your rights to services You and your family have the right to receive services that meet your needs. You have the right to receive them in a timely manner. If you experience any problems getting timely services, call please call our Customer Care Center at (800) 582-8686. TTY users should call 711. We are a vailable 24 hours a day, 7 days a week. Or, visit www.BannerUFC.com/ACC. Out of Network Providers “Out of Network Providers” are providers that are not part of the B – UFC/ACC network. If you use non contracted providers without getting prior approval from your PCP or B – UFC/ACC, you may have to pay the full cost of the services. You must use network providers, except in emergency or urgent care situations or for out of area renal dialysis or other services. If you get routine care from out of network providers, neither AHCCCS nor B – UFC/ACC will be responsible for the costs What should you do if you get a bill from an out of Network Provider, and you think that it should be paid by B – UFC/ACC? We cover certain health care services that you get from non contracted providers. These include care for a medical emergency, urgently needed care, renal (kidney) dialysis that you get when you’re outside the B – UFC/ACC service area, and care that has been approved in advance by B – UFC/ACC. If you get a bill for the services, don’t pay it. Send the bill to the address listed below for processing.
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