Provider Guide - the Culinary Health Fund

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Provider Guide October 2012 Programs Healthy Pregnancy Program The Culinary Health Fund’s Healthy Pregnancy Program strongly encourages Culinary participants, their spouses and/or eligible female domestic partners to seek prenatal healthcare within the first trimester, and to continue with regularly scheduled antepartum visits. As a part of our efforts to promote healthier pregnancies, a benefit payment of $100 will be paid to participants and their managing physician who participate in the Healthy Pregnancy Program and complete the requirements. For physicians to receive their additional $100 reimbursement, please submit the Healthy Pregnancy Program Certification Form located in the back of this book or on our website at www.culinaryhealthfund.org, along with the Culinary patients’ antepartum records and visit summary to: 1901 Las Vegas Blvd. South, Suite 107 Las Vegas, NV 89104 Fax (702) 892-7326 If you have any further questions regarding the additional reimbursement, please contact Provider Services at 702-892-7313. Culinary Diabetes Program The Culinary Diabetes Program was developed to provide assistance with the management of diabetes among Culinary Health Fund participants, spouses and/or eligible domestic partners, and dependents. This program offers: • FREE meters • FREE Diabetic Education • FREE lancets, test strips, syringes and other diabetic supplies at the Culinary Pharmacy. • Insulin pumps: Required prior authorization through American Health Holding, Inc. (AHH). • Diabetic Shoe benefit: Eligible members can have two pairs per Calendar • Year (January 1 – December 31) with a $55 per pair co-pay. For a complete list of Diabetic Education classes locations, please visit the website at www.culinaryhealthfund.org. 16 Culinary Health Fund Administrative Services, LLC
October 2012 Provider Guide Programs Immediate Cardiac Evaluation Program (ICEP) The Culinary Health Fund introduced a cardiology initiative that provides participants with an alternative to waiting long hours in emergency rooms for low-level cardiac symptoms. This Program was developed to provide physicians with the necessary resources to facilitate direct access to participating cardiology offices for immediate evaluation of patients with cardiac symptoms. The following is a list of cardiology offices (Immediate Cardiac Evaluation Centers, or ICEC) that have committed to provide timely cardiac evaluations the same or next day, for your patients with chest pain, palpitations, new onset atrial fibrillation, etc. 1) Advanced Cardiovascular Specialists 3201 S. Maryland Pkwy. #502 Contact: Myrna Phone: 702-733-8600 Fax: 702-733-0374 2) Keith G Boman MD, FACC 601 S. Rancho Dr. #D28 Contact: Shannon Phone: 702-383-0677 Fax: 702-383-0688 3) Siena Cardiology 2641 W. Horizon Ridge Pkwy. #120 Contact: Gerri Phone: 702-616-0091 Fax: 702-616-2329 4) Hearth Center Of Nevada 1815 E. Lake Mead Blvd. #110 4275 S. Burnham Ave. #370 6850 N. Durango Dr. #210 700 Shadow Lane #240 866 Seven Hills Dr. #102 Contact: Jessica/Carina (Any Issues: Susan Levine) Phone: 702-384-0022 Fax: 702-384-0529 5) Nevada Cardiology Associates 3121 S. Maryland Pkwy. #512 3150 N. Tenaya Way #460 Contact: Petra Phone: 702-233-4733 Fax: 702-233-1001 The Fund encourages providers to utilize the ICEP as a resource that will improve access for your patients requiring timely cardiac evaluations and help avoid defaulting to the emergency room. If the first office contacted is unable to accommodate your requested time/location, or should you have any addition questions regarding this program, please contact the Provider Service Line at (702) 892-7313. Culinary Health Fund Administrative Services, LLC 17
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Page 35 and 36: CULINARY HEALTH FUND ADMINISTRATIVE
Page 37: HIGH TECH DIAGNOSTIC SERVICE REVIEW
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