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First Things First - Community First Health Plans · PDF file 2016-11-15 · First Things First 2 April/May 2014 CHIP Members H EAL TH PLANS First Things First 2 Spring/Summer 2015

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  • 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

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