2013 Practitioner and Provider Manual - Presbyterian Healthcare ...
2013 Practitioner and Provider Manual - Presbyterian Healthcare ...
2013 Practitioner and Provider Manual - Presbyterian Healthcare ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
<strong>Presbyterian</strong> Customer Service CenterProtection of Information Disclosed to PlanSponsors, Employers, or Government AgenciesFederal law limits the information that <strong>Presbyterian</strong>may disclose to employers regarding theiremployees to “summary information” <strong>and</strong>“information regarding enrollment <strong>and</strong>disenrollment.” <strong>Presbyterian</strong> may provide moredetailed PHI regarding employees to plan sponsors(self-insured employer groups) only when theemployer has certified to <strong>Presbyterian</strong> that theyhave informed employees about this use of theirinformation by making certain amendments to theplan documents or the employee (or their legallyauthorized representative) consents to the releaseof information.Cultural CompetencyThe ability to communicate effectively with patients<strong>and</strong> members affects their ability to underst<strong>and</strong>information about their health care, complete aprescribed course of treatment, <strong>and</strong> be involved inhealth care decisions that affect them. Beingculturally competent, sensitive, <strong>and</strong> aware is key to<strong>Presbyterian</strong>’s mission to improve the health of thepatients, members, <strong>and</strong> communities <strong>Presbyterian</strong>serves.Cultural competency enhances communication <strong>and</strong>treatment effectiveness. For health care providers,being culturally competent includes awareness ofthe existence of culturally diverse populations <strong>and</strong>the potential for racial <strong>and</strong> ethnic health caredisparities. All cultures have unique views <strong>and</strong>practices in regard to illness <strong>and</strong> well-being thataffect the health care decisions they make.<strong>Presbyterian</strong> requires all staff to complete annualcultural competency training to educate staff on theimportance of respecting diversity, including culture<strong>and</strong> language preferences.<strong>Presbyterian</strong> provides information to members in aculturally sensitive manner, including to thoselimited in English language proficiency or readingskills, those with diverse cultural <strong>and</strong> ethnicbackgrounds, <strong>and</strong> those with physical or mentaldisabilities. <strong>Presbyterian</strong> recommends registeringfor online Cultural Sensitivity competencies athttps://www.thinkculturalhealth.hhs.gov/ or by usingthe Cultural Sensitivity Competencies link whenlogging in to myPRES. Supported by the Office ofMinority Health at the United States Department ofHealth <strong>and</strong> Human Services, <strong>and</strong> accredited byCiné-Med, the online competencies offered aredesigned to assist health care professionals deliverculturally competent care to an increasingly diversepopulation of members.Translation ServicesParticipating network practitioners <strong>and</strong> providersare required by contract to provide or coordinatetranslation services for their patients. Our CustomerService Center is also available to assist providerswith translation services for <strong>Presbyterian</strong>Centennial Care members through CertifiedLanguage International (CLI). CLI, a third-partycontractor, provides translation services in morethan 170 languages including Spanish, Navajo,Vietnamese, Portuguese, <strong>and</strong> Russian.<strong>Practitioner</strong>s <strong>and</strong> providers can contact CLI directlyto coordinate translation services for theirCentennial Care members. <strong>Practitioner</strong>s <strong>and</strong>19-112014 <strong>Practitioner</strong> <strong>and</strong> <strong>Provider</strong> <strong>Manual</strong> - Ver. 3
Change language