Provider Directory Directorio de ProveedoresSOUTHEAST

SunshineHealth.com

1301 International ParkwaySuite 400Sunrise, Florida 33323

1-866-796-0530SunshineHealth.com

2015 Sunshine Health Plan. All Rights Reserved. SH_MMA_PRVDIR_SOUTHEAST_010915

WELCOME TO SUNSHINE HEALTH! Welcome to Sunshine Health! Sunshine Health gives you quality healthcare that is convenient and easy to get. Our main goal is making sure you get high-quality healthcare.

This is your provider directory. The next few pages have information on how to use the directory. Let us know if you need help understanding this. Interpreter services are provided free of charge to you. This includes sign language. We also have a telephone language line to help with translations. You can call Member Services. The number is 1-866-796-0530 (TDD/TTY 1-800-955-8770).

Sunshine Healths network is always growing. You can get a current list of doctors by calling Member Services. The number is 1-866-796-0530 (TDD/TTY 1-800-955-8770) and on the web at www.sunshinehealth.com.

EASY TO USE

Getting benefits from Sunshine Health is easy. We believe the best way for you to keep good health is to have a good relationship with your family doctor. That is why you pick your own Primary Care Doctor (PCP). When you need care, all you have to do is call your PCP for an appointment. Tell them you are covered by Sunshine Health. Its that simple.

CHOOSING YOUR PCP

Each eligible family member is asked to choose a PCP from our list. Your PCP has the job of taking care of you and sending you to other doctors when you need them. You can have the entire family see one PCP or each family member may pick a different PCP.

Family members can choose from:

Pediatricians (they only see children) General/Family Practice (they see everyone in your family) Internal Medicine (they usually see adults) A provider working in a clinic (RHC/FQHC)

If you need help or dont see your doctor on this list, call Member Services. The number is 1-866-796-0530 (TDD/TTY 1-800-955-8770).

CHOOSING AN OB/GYN

Women may pick any OB/GYN doctor from the Sunshine Health Provider Network. This doctor will take care of female health care needs without a referral from your doctor. An OB/GYN can help you with pregnancy care, yearly check-ups and any female problems you may have. Call Member Services if you need help. The number is 1-866-796-0530 (TDD/TTY 1-800-955- 8770).

http://www.sunshinestatehealth.com/

BEHAVIORAL HEALTH

Behavioral Health refers to mental health, alcohol, and drug abuse services. Sunshine Healths behavioral health provider, Cenpatico, has a group of doctors that can help you. They are listed in this directory. You can also call Cenpatico at 1-800-716-5650, 24 hours a day, 7 days a week. You do not need a referral from your doctor for behavioral health services from an in-network provider.

FAMILY PLANNING

Sunshine Health members can get family planning services without a referral from their doctor. You can get your services directly from your doctor. You can also go to any family planning clinic that takes your Medicaid form. Call Member Services if you need help choosing a family planning provider. The number is 1-866-796-0530 (TDD/TTY 1-800-955-8770).

ACCESSIBILITY

If you use a wheelchair, walker or other aids and need help getting into your doctors office, call your doctors office. Call before you get there. This way someone will be ready to help you when you get there. If you would like help talking with your doctor about your special needs, call Member Services. The number is 1-866-796-0530 (TDD/TTY 1-800-955-8770).

TAKING CARE OF YOU AND YOUR FAMILY

We want you and your family to make appointments. We want you to make them for regular check-ups. Benefits with Sunshine Health include:

Screenings Diagnostic x-rays Lab Tests Mammograms Eye Exams

IF YOU HAVE TO BE HOSPITALIZED If you need to go to the hospital, your PCP or a specialist will admit you to a hospital where he/she is affiliated. The hospitals you would go to are listed in this directory.

REFERRALS TO SPECIALISTS

Your PCP MUST coordinate referrals to Specialists, Hospitals, and Ancillary Providers.

IMMEDIATE AND EMERGENCY CARE

If you have a serious illness or injury that needs immediate attention, first call your PCP. They know your medical history best. With Sunshine Health, you have access to medical services 24 hours a day, 365 days a year. In case of a possible life threatening emergency, call 911, or go to the nearest emergency room. If you are put in the hospital, please call or have someone else call Sunshine Health within 48-hours, to let us know of your medical situation.

Some examples of emergencies are:

Severe pain of any kind Change in mental status Change in neurological status Complications of pregnancy Chest pain Poisoning Acute Allergic Reactions Severe Shortness of Breath Abdominal pain

Multiple episodes of vomiting or diarrhea

Bleeding that wont stop Injuries that cause loss of function to

a body part Symptoms of substance abuse Psychiatric disturbances Overdose of medication

FOR ADDITIONAL INFORMATION

If you want to recommend a doctor who is not part of this directory or have any questions, please send them to:

Sunshine Health 1301 International Parkway

Suite 400 Sunrise, FL 33323

1-866-796-0530 (TDD/TTY 1-800-955-8770)

ABOUT THIS DIRECTORY

The following information is collected from the physicians applications during the initial contracting and credentialing process:

Name Gender Practice Name Office Location Phone Numbers Languages Specialties Acceptance of New Patients Handicap Accessibility Hospital Affiliation

You can get Board certification information from the American Board of Medical Specialties or the American Osteopathic Association. You can get updated information about specialty certifications by visiting www.abms.org. For the most up to date information about a provider or hospital, please visit Sunshine Healths website at www.sunshinehealth.com. You can also call the Member Services department. The number is 1-866-796-0530 (TDD/TTY 1-800-955-8770).

The following are abbreviations you will see throughout this directory.

Accreditation:

ABCPO American Board for Certification of Prosthetics and Orthotics ACR American College of Radiology AOA American Osteopathic Association CAP College of American Pathologists CARF Commission on Accreditation of Rehabilitation Facilities CHAPS Community Health Accreditation Program CCAC Continuing Care Accreditation Commission CLIA Clinical Laboratory Improvement Amendment Certification COLA Commission on Office Laboratory Accreditation JCAHO Joint Commission on Accreditation of Healthcare Organizations NCQA National Committee for Quality Assurance URAC Utilization Review Accreditation Commission

Yes or No: Y- Yes N- No

Sunshine Health looks forward to serving your healthcare needs!

http://www.abms.org/http://www.sunshinestatehealth.com/

BIENVENIDO(A) A SUNSHINE HEALTH!

Bienvenido(a) a Sunshine Health! Sunshine Health le da atencin mdica de calidad que es conveniente y fcil de obtener. Nuestra meta principal es asegurarnos de que usted reciba atencin mdica de alta calidad.

Este es su directorio de proveedores. Las pginas siguientes tienen informacin sobre cmo usar el directorio. Infrmenos si necesita ayuda para entender esto. Los servicios de intrprete se le ofrecen de manera gratuita. Esto incluye lenguaje de seas. Adems tenemos una lnea telefnica de idiomas para ayudar con traducciones. Puede llamar a Servicios para los Miembros. El nmero es 1-866-796-0530 (TDD/TTY 1-800-955-8770).

La red de Sunshine Health siempre est creciendo. Puede obtener una lista actualizada de mdicos llamando a Servicios para los Miembros. El nmero es 1-866-796-0530 (TDD/TTY 1-800-955-8770) y en el Internet en www.sunshinehealth.com.

FCIL DE USAR

Es fcil obtener beneficios de Sunshine Health. Creemos que la mejor forma en que usted puede mantener buena salud es tener una buena relacin con su mdico familiar. Es por esto que usted elige su propio mdico de atencin primaria (PCP). Cuando necesite atencin, todo lo que tiene que hacer es llamar a su PCP para una cita. Dgales que est cubierto por Sunshine Health. Es as de sencillo.

CMO ELEGIR A SU PCP

A cada familiar elegible se le pide que elija un PCP de nuestra lista. Su PCP tiene la funcin de cuidarlo(a) y de enviarlo(a) a otros mdicos cuando los necesite. Puede hacer que toda la familia vea a un PCP o cada familiar puede elegir un PCP distinto.

Los familiares pueden elegir de:

Pediatras (solo ven a nios) Mdicos generales/de familia (ven a cualquiera en su familia) Medicina interna (normalmente ven a adultos) Un proveedor que trabaje en una clnica (RHC/FQHC)

Si necesita ayuda o no ve a su mdico en esta lista, llame a Servicios para los Miembros. El nmero es 1- 866-796-0530 (TDD/TTY 1-800-955-8770).

CMO ELEGIR A UN GINECO-OBSTETRA

Las mujeres pueden elegir a un mdico gineco-obstetra de la red de proveedores de Sunshine Health. Este mdico se ocupar de las necesidades de atencin mdica femenina sin una referencia de su mdico. Un gineco-obstetra le puede ayudar con cuidado del embarazo, controles anuales y los problemas femeninos que pudiera tener. Llame a Servicios para los Miembros si necesita ayuda. El nmero es 1-866-796-0530 (TDD/TTY 1-800-955-8770).

http://www.sunshinestatehealth.com/

SALUD DEL COMPORTAMIENTO

Salud del comportami