Today's Options PFFS Provider Directory - Universal American ...

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Contracted Hospitals.....................................................................................................................Hospitals listed in this directory are contracted to provide inpatient and outpatient hospitalservices. Your Primary Care Physician (PCP) will need to coordinate and arrange any necessaryhospital or specialty care and obtain prior authorization, if required. Please refer to your Evidenceof Coverage for limitations that apply to hospital coverage.Accessing Services outside the Plan Service Area.....................................................................................................................You can access elective services outside your Plan service area from any participating Today’sOptions PFFS provider in any market and you will only be responsible for in-network out-ofpocketcosts for services rendered by these providers. Please call Member Services who can assistyou in locating a participating Today’s Options PFFS provider.Emergency Room Services.....................................................................................................................You have a lot of options when deciding where to get medical care, such as Primary Care Physicianoffices, urgent care centers and hospital emergency rooms. We encourage you to contact yourPrimary Care Physician if you are not certain where to get the medical care you need. He or she isfamiliar with your medical history and can help manage your medical care.With Today’s Options PFFS, you are always covered for emergencies. Emergency health servicesare provided by qualified physicians and healthcare providers and are needed to evaluate orstabilize an emergency medical condition. An emergency medical condition generally refers to aninjury or illness that happens suddenly and includes acute symptoms of sufficient severity,including severe pain. Emergency medical conditions appear to a prudent layperson that, withoutimmediate medical attention, the illness or injury could result in: Serious jeopardy to your health Serious impairment to a bodily function Serious dysfunction of any organ or partExamples of emergency medical conditions may include: Loss of consciousness Intense and uncontrollable pain Severe shortness of breath that prevents you from talking An accident involving a head injury or possible broken bonesvi
If you experience an emergency medical condition, do not hesitate to seek medical care. You arenot required to use contracted Today’s Options PFFS hospitals or doctors for emergency medicalconditions.Simply:1. Call 911 or go to the nearest emergency medical facility.2. Present your Today’s Options PFFS ID card.3. Notify your physician within 48 hours or as soon as possible (or have someone do it for you).4. Contact your physician for any necessary follow-up care or instructionsEmergency services are eligible for coverage under your Evidence of Coverage and will be coveredregardless of whether the hospital is in our contracted network. If you receive services in ahospital emergency room, you are responsible for the copayment as specified in your Evidence ofCoverage. If you have an emergency admission to a non-contracted hospital, Today’s Options PFFSmay work with your PCP to move you to a contracted hospital when it is safe to do so.24/7 Health Hotline.....................................................................................................................Health concerns or questions can occur at any time of the day or night. Our toll-free 24/7 HealthHotline provides you with a team of friendly, experienced Registered Nurses who will help guideyou to make the best medical and well-being decisions. Today’s Options PFFS’s 24/7 HealthHotline is only a phone call away, 24-hours-a-day, 7 days a week, even on holidays. Whether youneed more information about your condition, or if you are unsure if you should see your doctor,24/7 Health Hotline can assist you with answers.Mental Health and Substance Abuse Services Through APSHealthcare.....................................................................................................................A mental health and substance abuse benefit provides coverage for addressing treatment ofdepression and drug or alcohol abuse. We use APS Healthcare’s network of mental health andsubstance abuse professionals to provide you a wide array of treatment options from acuteinpatient care to individual outpatient counseling. You will enjoy the sense of security that comesfrom knowing that specialized care is available when you need it.vii
Page 3: Welcome!...........................
Page 10 and 11: What Happens When I Call APS Health
Page 13 and 14: Physician Specialties*.............
Page 15 and 16: ¡Bienvenido!......................
Page 17 and 18: ÍndiceIntroducción ..............
Page 19 and 20: Introducción......................
Page 21 and 22: Si sufre una afección médica de e
Page 23 and 24: Reclamos...........................
Page 25 and 26: Especialidades médicas*...........
Page 27: Hospitals / Hospitales.............
Page 30 and 31: MaineHospitals / HospitalesHospital
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Specialists / Especialistas........
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Specialists / EspecialistasMaineSpe
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MaineSpecialists / EspecialistasSpe
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Skilled Nursing FacilitiesCentros d
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MaineSkilled Nursing Facilities / C
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Ancillary (Alternate) ProvidersProv
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MaineAncillary (Alternate) Provider
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MaineAncillary (Alternate) Provider
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MaineBehavioral Health Providers /
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Index / IndiceBBabbitt, Ann M, MD..
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Index / IndiceBrewer, John C, DO ..
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Index / IndiceCorbett, Jeffery P, D
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Index / IndiceErvin, Edmund D, MD .
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Index / IndiceGreatorex, Patricia S
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Index / IndiceHumphrey, Charles C,
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Index / IndiceKramer, Christine, DO
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Index / IndiceMarks, Jennifer E, DO
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Index / IndiceNNaaz, Uzma, MD......
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Index / IndicePlace, James N, MD ..
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Index / IndiceSSabbagh, Iyad, MD ..
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Index / IndiceStaton, Megan A, MD .
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Index / IndiceWahlig, John B, MD ..
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