Presbyterian Senior Care (HMO) and Presbyterian MediCare PPO | Fall 2016 | Your Story

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Presbyterian Health Plan
Online Provider Directory
Presbyterian Health Plan, Inc.
and Presbyterian Insurance
Company, Inc. (Presbyterian)
have a Web-based provider
directory on .
Choose “Find a Doctor” in the
red box on the right of the
screen. Both members and
non-members can search for
providers using this online
tool. In the directory, you
can search the following
information:
■
■ Name
■
■ Gender (male/female)
■
■ Specialty
■
■ Hospitals where they
practice
■
■ Board certification
■
■ If they are accepting new
patients
■
■ Languages they speak in the
office
■
■ Office locations and phone
numbers
You can search using one
or more of the items listed
above. To get all of the
information you want, fill in
as many blanks as you want
on the search page. The search
page also has instructions for
both Smartphone users and
personal computer users.
The online provider directory
is refreshed (updated)
each day to make sure that
information is current.
You can also get provider
information on paper or
by phone by calling the
Presbyterian Customer
Service Center.
People all over the United
States are being lied to by con
artists who use Social Security
or Medicare to tempt you.
These crooks mail out offers
for Social Security services. At
a small fee, they say that they
can help you with getting:
■
■ A corrected Social Security
card with a bride’s new
married name on it
■
■ A replacement of a lost or
stolen Social Security card
■
■ A Social Security number for
a child
(All of these services and more
are offered for free at your
local Social Security office.)
These people go as far as to
say that the Social Security
needs money so bad that
unless you send in money
such as a membership fee
or donation to their address,
you could lose your benefits.
Some of these companies are
even offering updates to your
Social Security benefits if you
give them your information.
They then sell your private
information to criminals that
use your information for many
different things like identity
theft.
If you get one of these ads in
the mail do not throw it away!
The only way we are going
to stop them is to get the
information to the authorities.
Send the complete mailing,
including the envelope, to:
■
■ Office of the Inspector
General Fraud Hotline
Social Security Administration
P.O. Box 17768
Baltimore, MD 21235
■
■ New Mexico Attorney General
Attn.: Fraud Department
P.O. Box 1508
Santa Fe, NM 87504-1508
New
procedures,
drugs, and
devices—are
they right for
you?
You may often hear about
newmedical treatments
and procedures.
Presbyterian Health
Plan’s New Technology
Assessment Committee
looks at new treatments,
drugs, and devices to see
if your health plan will
cover them.
The group looks at many
things to make choices
about new treatments,
drugs, or devices. Some
of the questions they ask
are:
■
■ Is it safe? Does it work
well? Is it better than
what is used now?
■
■ Howmuch will it cost?
■
■ Are people trained to
use it?
The New Technology
Assessment Committee
includes doctors from
the health plan and the
local area. It also includes
other clinical staff.
These healthcare experts
help to make sure that
the new treatments
and procedures have
been tested and well-
researched before they
are covered as health
plan benefits.
Did you know that flyers are being
mailed to you trying to trick you?
If you feel that you have
been a victim of medical
fraud or abuse, please
contact Presbyterian Health
Plan at our confidential
voicemail 1-505-923-5959 or
1-800-239-3147. Or email us
at