InsideInside
NCQA Updates ................................. 2
Transition of Care ............................ 3
Healthy Recipe ................................. 3
Summer Safety ................................ 4
Danger Dehydration ........................ 4
H E A L T H P L A N S
SPBD | 12.00542 Rev. 1 04/15
Main Office
12238 Silicon Drive, Suite 100
San Antonio, Texas 78249
Community Office at
Avenida Guadalupe
1410 Guadalupe Street, Suite 222
San Antonio, Texas 78207
(210) 227-2347 or
(800) 434-2347 (toll-free)
VISIT OUR WEB SITE AT:
www.cfhp.com
HAVE A QUESTION?
SATURDAY, MAY 30
MISSION COUNTY PARK, 6030 Padre Drive
8 a.m. 5K Race Starts
8:30 a.m.-12 p.m. Fitness activities
• Chip-timed race
• Medals for first 500 to
cross finish line
• Food & snacks
• Camp PowerUp Fitness
combine
• Zumba
• Yoga
• Rock climbing wall
• Inflatable
obstacle course
• iCycle bicycle
repair classes
A FREE walk/run with fun fitness activities celebrating our
20th Anniversary
REGISTER AT CFHP5K.COM
First Things First
Community First Health Plans News
Spring/Summer 2015
VALUE-ADDED BENEFITS
Community First has benefits for all of our members to enjoy!
Take a look at the list below and be sure to contact us with
any questions you may have. (*Some exclusions may apply,
but call us to find out if you qualify.)
• Vision benefits
• A prescription discount card your whole family can
use
• Free sports physicals
• 24-hour nurse advice line
• Member gift card programs
• Healthy Expectations prenatal program*
• Smoking cessation program
• Asthma kit
• Asthma pillow cover
• Bus tokens for doctor visits or health classes
• Diabetes program incentive
• Adult lifestyle classes
• Emergency advice kit
• Weight management program
• Newborn & postpartum classes for new fathers
• MP3 player with health podcast
• Expectant mommy baby shower
• New mommy mingle & advice meetings
• Temporary phone help*
• Post-discharge incentives
• Free toddler booster seats
• Bike safety and repair classes
• Zumba classes
• Notary services
First Things First
www.cfhp.com 2
April/May 2014 | CHIP Members
H E A L T H P L A N S
First Things First
www.cfhp.com2
Spring/Summer 2015
NCQA UPDATES
Community First Health Plans provides each our members a
copy of a member handbook for detailed information about
how their health plan works. Member handbooks are mailed to
new members in a new member packet received shortly after
enrollment. A copy of the member handbook can also be found
online at www.cfhp.com/members.
To request a copy of your member handbook, please call our
Member Services department at (210) 227-2347 or toll-free at
1-800-434-2347.
Did you know as a member of Community First Health Plans,
you have certain member rights and member responsibilities?
Information about your member rights and responsibilities can
be found online in your member handbook at www.cfhp.com/
members. You can also call our Member Services department
for a copy of the member handbook. You can reach us at (210)
227-2347 or toll-free at 1-800-434-2347.
Community First Health Plans is committed to ensuring that
your personal health information is secure and confidential.
Our doctors and other providers must do the same. CFHP’s
use of PHI will only be used to administer your health plan
and fulfilling state and federal requirements. Your personal
health information will not be shared with anyone else. We will
not do this without your express written approval. For more
information, please see your member handbook. You can also
view a copy of our Notice of Privacy Practices on website at
www.cfhp.com.
Utilization Management decision making is based only on
appropriateness of care and service and existence of coverage.
Community First Health Plans does not award providers or
other individuals for issuing denials of coverage. Utilization
Management decision makers are not awarded financially to
make decisions that result in underutilization.
Utilization management staff are available to assist you with any
questions or concerns you may have regarding the UM process
and the authorization of care. You may speak with a UM staff
member by calling (210) 227-2347 or toll-free at 1-800-434-2347
during normal business hours, Monday through Friday, 8:30 a.m.
to 5 p.m.
Health and Wellness are important to Community First Health
Plans. Our Preventive Health and Disease Management
department provides a variety of avenues to educate and
remind members of preventive measures they can take. Some of
the programs we offer include:
• New member Health Risk Assessment*
• Personalized Health Program
• Youth in Motion Program
• Flu Shot Direct Mail Campaign
• Women’s Health
• Healthy Expectations Program
• Diabetes in Control Program
• Asthma Matters Program
• Tobacco Cessation Program
• Case Management Services
• Chronic Disease Program
• Behavioral Health Services
Members may enroll in these programs by completing the
General Health or Disease Management survey by mail, face-to-
face, or on the telephone. Contact a CFHP Health Educator at
(210) 227-2347 or toll-free at 1-800-434-2347.
*Some exclusions
may apply, but call
us to find out if you
qualify.
Member Rights and Responsibilities
Health Services and Programs
Utilization Management Process
Privacy and Confidentiality
Member Handbooks
www.cfhp.com
H E A L T H P L A N S
3
Spring/Summer 2015
First Things First
Healthy Recipe! MINI NACHO CUPS
Directions:
1. Place tortilla chips on a plate.
2. Spoon avocado dip onto chips
3. In a small bowl, toss together cherry
tomatoes, cheddar cheese, and green onion.
4. Sprinkle mixture over chips.
Ingredients:
• 8 baked scoop-shape tortilla chips
• 2 tablespoons refrigerated
avocado dip (guacamole)
• 1/4 cup chopped cherry tomatoes
• 1 tablespoon finely shredded
reduced-fat cheddar cheese
• 1 tablespoon thinly sliced green
onion
NUTRITIONAL INFORMATION
Servings Per Recipe: 1. PER SERVING: 132 calories,
6g total fat (2g saturated fat), 5mg cholesterol, 229mg sodium,
15g carbohydrates (4g fiber, 1g sugars), 5g protein.
http://www.diabeticlivingonline.com/recipe/appetizers-snacks/mini-nacho-cups
Many doctors only see patients up to the age of 18. Members
who are approaching adulthood that have not chosen an adult
PCP and need assistance with selection of a doctor may contact
the Member Services department for assistance at (210) 227-2347
or toll-free at 1-800-434-2347.
TRANSITION OF CARE
To better serve our CFHP members and their healthcare needs,
CFHP has created a Community Resource List. The list includes
many, but not all, of the resources available to our members
within our service area, statewide, and nationally. You may
review the list on our website at www.cfhp.com.
COMMUNITY RESOURCES
Part of staying healthy and well includes
obtaining certain immunizations at certain
points in your life. Community First Health
Plans encourages you to talk to your
Primary Care Provider to find out which
immunizations are recommended for you
and your family. You can also find more
information on our website at www.cfhp.
com/members. If you need to talk to a CFHP
Health Educator, you can call us at
(210) 227-2347 or toll-free at 1-800-434-2347.
Immunization Schedule
Are you an expectant mom? If so, then
join Community First would like to invite
you to a baby shower, where we will
provide information about prenatal
care for you and information about your
newborn baby. Participants who attend
will receive a diaper bag* at no cost.
Are you already a new mom or need
some advice from experienced parenting
experts? Then come join Community First
for Mommy Mingle! Mommy Mingle is a
place where mommies and community
members can give tips, ideas, and support for other moms. It’s
the best way to learn from others around you! Community First
also has Dad Chat classes for dad’s who can learn a few tips
on how to help mom or can get parenting ideas for your new
baby. Participants who attend will receive a free toddler booster
seat* at no cost for attending the class and providing proof of a
checkup from your baby’s PCP.
Come join us for one of these fun classes! For more information,
call us at (210) 227-2347. You may also call us toll-free at
1-800-434-2347.
*Restrictions may apply, please call for more information.
BABY SHOWERS, MOMMY
MINGLE AND DAD CHAT
CLASSES
H E A L T H P L A N S
First Things First
www.cfhp.com 4
Spring/Summer 2015
Community First Health Plans has a Nurse Advice Line, available 24 hours a day, 7 days a week, 365 days a year to help you get the
care you need.
CHFP promotes and encourages you to first contact your PCP to direct your medical care. Your PCP serves as your medical home
and will take care of your medical needs. If for any reason you are unable to reach your PCP and need help, the CFHP Nurse Advice
Line is available to you.
Nurses can help you with medical advice, such as what to do for a common cold or how to care for a loved one released from the
hospital. They can also direct you on where you should go for care when the PCP office
is closed or does not hav
