Directory of Physicians and Other Health Care …€¦ · Directory of Physicians and Other Health Care Professionals ... is directory will help you nd doctors and ... You can also

Directory of Physicians andOther Health Care ProfessionalsDirectorio de mdicos y proveedoresde atencin mdica

For Members Enrolled in These Programs: AHCCCS/Medicaid DevelopmentallyDisabled ChildrensRehabilitativeServices

Para los miembros inscritos en los siguientes programas: AHCCCS/Medicaid DevelopmentallyDisabled ChildrensRehabilitativeServices

CustomerServiceServicioalCliente:

1-800-348-4058 (TTY:711)

919-10039/13

9/24/2013AZ Medicaid

AZMA_CRS

We care about you and your familys health. UnitedHealthcareCommunityPlanpartnerswithArizonaHealthCareCostContainmentSystem(AHCCCS),ArizonaDepartmentofHealthServices(ADHS)andDepartmentofEconomicSecurity(DES)tooffermanydifferenthealthplans.

Wevebeenheresince1982.YoufirstknewusasArizonaPhysiciansIPA.NowwereUnitedHealthcareCommunityPlan. Overtheyears,thenamesofsomeofourplanshavechanged. Butonethingneverchanges.Thatsourpromisetohelpyougetaccesstothecareyouneed.

UnitedHealthcaredoesnotdiscriminateonthebasisofrace,color,religion,sex,sexualorientation,age,disability,nationalorigin,veteranstatus,ancestry,healthstatusorneedforhealthservicesinthereceiptofhealthservices.

UHCCommunityPlan.com

Welcome to UnitedHealthcare Community Plan

FindingaProviderThis directory will help you find doctors and specialists in your area who participate with UnitedHealthcare Community Plan. It also lists the names and addresses of hospitals, pharmacies and dentists you should use, if you need those services.

You can also find a current list of network providers on our website at UHCCommunityPlan.com.

To choose or change your Primary Care Provider (PCP) call Customer Service at the number below and let us know. (Sometimes doctors may not accept new patients. If thats the case, we can help you make another selection.)

Customer Service 1-800-348-4058 (TTY: 711)

Providers listed in this directory are current as of the date listed on the cover. Information is subject to change.

ChoosingaPrimaryCareProvider(PCP)foryouand yourfamilyiseasy.There are several types of PCPs listed in this directory.

FamilyPractice: Adults and Children

InternalMedicine: Adults

Pediatrician: Children

Primary Care Providers

UHCCommunityPlan.comAZMA_CRS

How to Use This Directory

Thisdirectorywillhelpyoufinddoctorsandspecialistsinyourareawhoparticipateinthefollowingprograms:

AHCCCS/Medicaid Developmentally Disabled (DD)

Childrens Rehabilitative Services (CRS) CRS Fully Integrated CRS Partially Integrated Acute CRS Partially Integrated Behavioral Health CRS only

Check your member ID card to confirm the program/plan you are enrolled in. The different plans are numbered for this directory. Providers that participate in your plan will have your plan number in their listings. Check the table of contents to find providers in your county.

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RUN_DATE 20110419 11:56:01 DATA_SEQ_NO 0000001 CLIENT_NUMBER 003115 UHG_TYPE DIG1CARD DOC_ID DOC_SEQ_ID 0000004 NAME CHRISTIAN ,BRITNEY MAILSET_NUMBER 0000005 CUSTDIAMOND_KEY1 00A00128537 CUSTDIAMOND_KEY2 40300 CUSTDIAMOND_KEY3 BRITNEY CUSTDIAMOND_KEY4 HCAC/Rxonly CUSTDIAMOND_KEY5 D30

Printed: 04/11/11

Claims:

Pharmacy Claims: For Pharmacists: 877-305-8952

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nible)

junto

con l

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talles

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su co

bertu

ra.

OptumRx, PO Box 29044, Hot Springs, AR 71903

ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM Member Identification Card

Member Name: SUBSCRIBER BROWN PCP: PROVIDER BROWNPCP PHONE:(999) 999-9999

Carry this card with you at all times. Present it when you get service. You may be asked for a picture ID. Using the card inappropriately is a violation of law. This card is not a guarantee for services.

PO Box 5290, Kingston, NY 12402-5290

AHCCCS ID#: A99999999 Group: 40300

DD

999 N 1st Ave., Phoenix, AZ 99999

Developmentally DisabledCard Type DA

To verify benefits, visit: www.uhccommunityplan or call 1-800-348-4058

Member Services: (800) 348-4058 For Providers: www.uhccommunityplan 1-800-445-1638

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Claims:


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munit

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its on

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prov

iders

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ify yo

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vera

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ense

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rizon

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rtatio

n Moto

r Veh

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cture

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ith yo

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vera

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tails.

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enve

nido(

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lthca

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ommu

nity P

lan

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ompla

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nerle

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miem

bro.

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dHea

lthca

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ommu

nity P

lan of

rece

vario

s plan

es

en A

rizon

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plan

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iembr

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ivisio

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Dev

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su nu

eva t

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in de

miem

bro.

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la co

nsigo

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mpo.

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su

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PCP

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e al n

mer

o de S

ervic

ios pa

ra M

iembr

os qu

e figu

ra

al re

verso

de su

tarje

ta de

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ar a

prote

ger s

u ide

ntida

d y ev

itar e

l frau

de, A

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rafa

s en l

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rove

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rizon

a o

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denti

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o, AH

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a de

la D

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n de V

ehcu

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utomo

tores

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epar

tamen

to de

Tran

spor

te de

Ar

izona

(Ariz

ona D

epar

tmen

t of T

rans

porta

tion M

otor V

ehicl

e Divi

sion,

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. Cu

ando

los p

rove

edor

es ac

ceda

n a la

panta

lla de

verifi

caci

n de e

legibi

lidad

de

AHCC

CS, v

ern

una f

otogr

afa d

e uste

d (si

est

dispo

nible)

junto

con l

os de

talles

de

su co

bertu

ra.



Member Name: SUBSCRIBER BROWN PCP: PROVIDER BROWN PCP PHONE: (999) 999-9999



CRS ID#: 299999999

Group: 10145CRS

Partially Integrated-Acute

MSIC: DMG Childrens Rehabilitative Services 3141 N 3rd Ave., Phoenix, AZ 85013 (800) 000-0000

CRS Partially Integrated - AcuteCard Type DD




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ve yo

u as a

mem

ber. U

nited

Healt

hcar

e Com

munit

y Plan

offer

s man

y plan

s in

Arizo

na. T

he pl

an fo

r mem

bers

throu

gh th

e Divi

sion o

f Dev

elopm

ental

Disa

bilitie

s is c

alled

Ar

izona

Phy

sician

s IPA

Dev

elopm

ental

ly Di

sable

d (DD

).

This

is yo

ur ne

w Me

mber

ID C

ard.

Plea

se ca

rry it

with

you a

t all t

imes

. You

shou

ld pr

esen

t thi

s car

d whe

n you

go to

docto

r app

ointm

ents

or ge

t cov

ered

servi

ces f

rom

other

healt

h ca

re pr

ovide

rs. F

or qu

estio

ns ab

out y

our b

enefi

ts or

your

PCP

, call

the M

embe

r Ser

vices

nu

mber

on th

e bac

k of y

our I

D ca

rd.

To he

lp pr

otect

your

iden

tity an

d pre

vent

fraud

, AHC

CCS

is ad

ding p

ictur

es to

its on

-line v

erific

ation

too

l that

prov

iders

use t

o ver

ify yo

ur co

vera

ge. If

you h

ave a

n Ariz

ona d

river

s lic

ense

or st

ate is

sued

ID

, AHC

CCS

will g

et yo

ur pi

cture

from

the A

rizon

a Dep

artm

ent o

f Tra

nspo

rtatio

n Moto

r Veh

icle

Divis

ion (M

VD).

Whe

n pro

vider

s pull

up th

e AHC

CCS

eligib

ility v

erific

ation

scre

en, th

ey w

ill se

e yo

ur pi

cture

(if av

ailab

le) w

ith yo

ur co

vera

ge de

tails.

Bi

enve

nido(

a) a

Unite

dHea

lthca

re C

ommu

nity P

lan

Nos c

ompla

ce te

nerle

como

miem

bro.

Unite

dHea

lthca

re C

ommu

nity P

lan of

rece

vario

s plan

es

en A

rizon

a. El

plan

para

los m

iembr

os a

trav

s de l

a Divi

sin d

e Disc

apac

idade

s del

Desa

rrollo

(D

ivisio

n of D

evelo

pmen

tal D

isabil

ities)

se lla

ma A

rizon

a Phy

sician

s IPA

Dev

elopm

ental

ly

Disa

bled (

DD).

Es

ta es

su nu

eva t

arjet

a de i

denti

ficac

in de

miem

bro.

Llve

la co

nsigo

todo

el tie

mpo.

De

be pr

esen

tar es

ta tar

jeta c

uand

o asis

ta a s

us ci

tas co

n el m

dico

o cu

ando

recib

a se

rvicio

s cub

iertos

de ot

ros p

rove

edor

es de

aten

cin m

dica

. Si ti

ene p

regu

ntas s

obre

su

s ben

eficio

s o su

PCP

, llam

e al n

mer

o de S

ervic

ios pa

ra M

iembr

os qu

e figu

ra

al re

verso

de su

tarje

ta de

iden

tifica

cin.

Para

ayud

ar a

prote

ger s

u ide

ntida

d y ev

itar e

l frau

de, A

HCCC

S es

t inc

luyen

do

fotog

rafa

s en l

a her

rami

enta

de ve

rifica

cin e

n lne

a que

los p

rove

edor

es ut

ilizan

pa

ra ve

rifica

r su c

ober

tura.

Si us

ted tie

ne un

a lice

ncia

de co

nduc

ir de A

rizon

a o

una t

arjet

a de i

denti

ficac

in em

itida p

or el

estad

o, AH

CCCS

obten

dr s

u foto

graf

a de

la D

ivisi

n de V

ehcu

los A

utomo

tores

del D

epar

tamen

to de

Tran

spor

te de

Ar

izona

(Ariz

ona D

epar

tmen

t of T

rans

porta

tion M

otor V

ehicl

e Divi

sion,

MVD)

. Cu

ando

los p

rove

edor

es ac

ceda

n a la

panta

lla de

verifi

caci

n de e

legibi

lidad

de

AHCC

CS, v

ern

una f

otogr

afa d

e uste

d (si

est

dispo

nible)

junto

con l

os de

talles

de

su co

bertu

ra.



Member Name: SUBSCRIBER BROWN



CRS ID#: 299999999Group: 99135

CRS Only

MSIC: DMG Childrens Rehabilitative Services3141 N 3rd Ave., Phoenix, AZ 85013 (800) 000-0000

CRS Only Card Type DB



N

A

L

P

Y

T I

N

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R

A

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9

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B

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P

9

4 3

0 -

1 3

1 4

8

T U

,

Y

T I

C

E

K

A

L

T L

A

S

Health Plan (80840) 911-03432-06


5113

060

4255

900

0040

0000

050

0000

011

15

311


Printed: 04/11/11

Claims:


ARIZONA DRAFT

9

9

9

9

9

9

>

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

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B

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B

I

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C

S

B

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S

T

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H

W

Y

N

A

3

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1

9

9

9

9

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U

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H

W

Y

N

A

Welc

ome t

o Unit

edHe

althc

are C

ommu

nity P

lan

We'r

e glad

to ha

ve yo

u as a

mem

ber. U

nited

Healt

hcar

e Com

munit

y Plan

offer

s man

y plan

s in

Arizo

na. T

he pl

an fo

r mem

bers

throu

gh th

e Divi

sion o

f Dev

elopm

ental

Disa

bilitie

s is c

alled

Ar

izona

Phy

sician

s IPA

Dev

elopm

ental

ly Di

sable

d (DD

).

This

is yo

ur ne

w Me

mber

ID C

ard.

Plea

se ca

rry it

with

you a

t all t

imes

. You

shou

ld pr

esen

t thi

s car

d whe

n you

go to

docto

r app

ointm

ents

or ge

t cov

ered

servi

ces f

rom

other

healt

h ca

re pr

ovide

rs. F

or qu

estio

ns ab

out y

our b

enefi

ts or

your

PCP

, call

the M

embe

r Ser

vices

nu

mber

on th

e bac

k of y

our I

D ca

rd.

To he

lp pr

otect

your

iden

tity an

d pre

vent

fraud

, AHC

CCS

is ad

ding p

ictur

es to

its on

-line v

erific

ation

too

l that

prov

iders

use t

o ver

ify yo

ur co

vera

ge. If

you h

ave a

n Ariz

ona d

river

s lic

ense

or st

ate is

sued

ID

, AHC

CCS

will g

et yo

ur pi

cture

from

the A

rizon

a Dep

artm

ent o

f Tra

nspo

rtatio

n Moto

r Veh

icle

Divis

ion (M

VD).

Whe

n pro

vider

s pull

up th

e AHC

CCS

eligib

ility v

erific

ation

scre

en, th

ey w

ill se

e yo

ur pi

cture

(if av

ailab

le) w

ith yo

ur co

vera

ge de

tails.

Bi

enve

nido(

a) a

Unite

dHea

lthca

re C

ommu

nity P

lan

Nos c

ompla

ce te

nerle

como

miem

bro.

Unite

dHea

lthca

re C

ommu

nity P

lan of

rece

vario

s plan

es

en A

rizon

a. El

plan

para

los m

iembr

os a

trav

s de l

a Divi

sin d

e Disc

apac

idade

s del

Desa

rrollo

(D

ivisio

n of D

evelo

pmen

tal D

isabil

ities)

se lla

ma A

rizon

a Phy

sician

s IPA

Dev

elopm

ental

ly

Disa

bled (

DD).

Es

ta es

su nu

eva t

arjet

a de i

denti

ficac

in de

miem

bro.

Llve

la co

nsigo

todo

el tie

mpo.

De

be pr

esen

tar es

ta tar

jeta c

uand

o asis

ta a s

us ci

tas co

n el m

dico

o cu

ando

recib

a se

rvicio

s cub

iertos

de ot

ros p

rove

edor

es de

aten

cin m

dica

. Si ti

ene p

regu

ntas s

obre

su

s ben

eficio

s o su

PCP

, llam

e al n

mer

o de S

ervic

ios pa

ra M

iembr

os qu

e figu

ra

al re

verso

de su

tarje

ta de

iden

tifica

cin.

Para

ayud

ar a

prote

ger s

u ide

ntida

d y ev

itar e

l frau

de, A

HCCC

S es

t inc

luyen

do

fotog

rafa

s en l

a her

rami

enta

de ve

rifica

cin e

n lne

a que

los p

rove

edor

es ut

ilizan

pa

ra ve

rifica

r su c

ober

tura.

Si us

ted tie

ne un

a lice

ncia

de co

nduc

ir de A

rizon

a o

una t

arjet

a de i

denti

ficac

in em

itida p

or el

estad

o, AH

CCCS

obten

dr s

u foto

graf

a de

la D

ivisi

n de V

ehcu

los A

utomo

tores

del D

epar

tamen

to de

Tran

spor

te de

Ar

izona

(Ariz

ona D

epar

tmen

t of T

rans

porta

tion M

otor V

ehicl

e Divi

sion,

MVD)

. Cu

ando

los p

rove

edor

es ac

ceda

n a la

panta

lla de

verifi

caci

n de e

legibi

lidad

de

AHCC

CS, v

ern

una f

otogr

afa d

e uste

d (si

est

dispo

nible)

junto

con l

os de

talles

de

su co

bertu

ra.







Medicaid


MedicaidCard Type DF




Group numbers include: 40100401104012040130401404016040500

N

A

L

P

Y

T

I N

U

M

M

O

C

E

R

A

C

H

T L

A

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H

D

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N

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9

4 3

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9 4

3 0

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3 1

4 8

T

U

, Y

T

I C

E

K

A

L

T L

A

S

Health Plan (80840) 911-03432-06


5113

060

4255

900

0040

0000

050

0000

011

15

311


Printed: 04/11/11

Claims:


ARIZONA DRAFT

9

9

9

9

9

9

>

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

N

W

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R

B

R

E

B

I

R

C

S

B

U

S

T

E

E

R

T

S

E

R

E

H

W

Y

N

A

3

2

1

9

9

9

9

9

S

U

,

E

R

E

H

W

Y

N

A

Welc

ome t

o Unit

edHe

althc

are C

ommu

nity P

lan

We'r

e glad

to ha

ve yo

u as a

mem

ber. U

nited

Healt

hcar

e Com

munit

y Plan

offer

s man

y plan

s in

Arizo

na. T

he pl

an fo

r mem

bers

throu

gh th

e Divi

sion o

f Dev

elopm

ental

Disa

bilitie

s is c

alled

Ar

izona

Phy

sician

s IPA

Dev

elopm

ental

ly Di

sable

d (DD

).

This

is yo

ur ne

w Me

mber

ID C

ard.

Plea

se ca

rry it

with

you a

t all t

imes

. You

shou

ld pr

esen

t thi

s car

d whe

n you

go to

docto

r app

ointm

ents

or ge

t cov

ered

servi

ces f

rom

other

healt

h ca

re pr

ovide

rs. F

or qu

estio

ns ab

out y

our b

enefi

ts or

your

PCP

, call

the M

embe

r Ser

vices

nu

mber

on th

e bac

k of y

our I

D ca

rd.

To he

lp pr

otect

your

iden

tity an

d pre

vent

fraud

, AHC

CCS

is ad

ding p

ictur

es to

its on

-line v

erific

ation

too

l that

prov

iders

use t

o ver

ify yo

ur co

vera

ge. If

you h

ave a

n Ariz

ona d

river

s lic

ense

or st

ate is

sued

ID

, AHC

CCS

will g

et yo

ur pi

cture

from

the A

rizon

a Dep

artm

ent o

f Tra

nspo

rtatio

n Moto

r Veh

icle

Divis

ion (M

VD).

Whe

n pro

vider

s pull

up th

e AHC

CCS

eligib

ility v

erific

ation

scre

en, th

ey w

ill se

e yo

ur pi

cture

(if av

ailab

le) w

ith yo

ur co

vera

ge de

tails.

Bi

enve

nido(

a) a

Unite

dHea

lthca

re C

ommu

nity P

lan

Nos c

ompla

ce te

nerle

como

miem

bro.

Unite

dHea

lthca

re C

ommu

nity P

lan of

rece

vario

s plan

es

en A

rizon

a. El

plan

para

los m

iembr

os a

trav

s de l

a Divi

sin d

e Disc

apac

idade

s del

Desa

rrollo

(D

ivisio

n of D

evelo

pmen

tal D

isabil

ities)

se lla

ma A

rizon

a Phy

sician

s IPA

Dev

elopm

ental

ly

Disa

bled (

DD).

Es

ta es

su nu

eva t

arjet

a de i

denti

ficac

in de

miem

bro.

Llve

la co

nsigo

todo

el tie

mpo.

De

be pr

esen

tar es

ta tar

jeta c

uand

o asis

ta a s

us ci

tas co

n el m

dico

o cu

ando

recib

a se

rvicio

s cub

iertos

de ot

ros p

rove

edor

es de

aten

cin m

dica

. Si ti

ene p

regu

ntas s

obre

su

s ben

eficio

s o su

PCP

, llam

e al n

mer

o de S

ervic

ios pa

ra M

iembr

os qu

e figu

ra

al re

verso

de su

tarje

ta de

iden

tifica

cin.

Para

ayud

ar a

prote

ger s

u ide

ntida

d y ev

itar e

l frau

de, A

HCCC

S es

t inc

luyen

do

fotog

rafa

s en l

a her

rami

enta

de ve

rifica

cin e

n lne

a que

los p

rove

edor

es ut

ilizan

pa

ra ve

rifica

r su c

ober

tura.

Si us

ted tie

ne un

a lice

ncia

de co

nduc

ir de A

rizon

a o

una t

arjet

a de i

denti

ficac

in em

itida p

or el

estad

o, AH

CCCS

obten

dr s

u foto

graf

a de

la D

ivisi

n de V

ehcu

los A

utomo

tores

del D

epar

tamen

to de

Tran

spor

te de

Ar

izona

(Ariz

ona D

epar

tmen

t of T

rans

porta

tion M

otor V

ehicl

e Divi

sion,

MVD)

. Cu

ando

los p

rove

edor

es ac

ceda

n a la

panta

lla de

verifi

caci

n de e

legibi

lidad

de

AHCC

CS, v

ern

una f

otogr

afa d

e uste

d (si

est

dispo

nible)

junto

con l

os de

talles

de

su co

bertu

ra.






CRS ID#: 299999999Group: 10115

CRS Fully Integrated


CRS Fully IntegratedCard Type DC



N

A

L

P

Y

T

I N

U

M

M

O

C

E

R

A

C

H

T L

A

E

H

D

E

T I

N

U

9

4 3

1 3

X

O

B

O

P

9 4

3 0

- 1

3 1

4 8

T

U

, Y

T

I C

E

K

A

L

T L

A

S

Health Plan (80840) 911-03432-06


5113

060

4255

900

0040

0000

050

0000

011

15

311


Printed: 04/11/11

Claims:


ARIZONA DRAFT

9

9

9

9

9

9

>

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

N

W

O

R

B

R

E

B

I

R

C

S

B

U

S

T

E

E

R

T

S

E

R

E

H

W

Y

N

A

3

2

1

9

9

9

9

9

S

U

,

E

R

E

H

W

Y

N

A

Welc

ome t

o Unit

edHe

althc

are C

ommu

nity P

lan

We'r

e glad

to ha

ve yo

u as a

mem

ber. U

nited

Healt

hcar

e Com

munit

y Plan

offer

s man

y plan

s in

Arizo

na. T

he pl

an fo

r mem

bers

throu

gh th

e Divi

sion o

f Dev

elopm

ental

Disa

bilitie

s is c

alled

Ar

izona

Phy

sician

s IPA

Dev

elopm

ental

ly Di

sable

d (DD

).

This

is yo

ur ne

w Me

mber

ID C

ard.

Plea

se ca

rry it

with

you a

t all t

imes

. You

shou

ld pr

esen

t thi

s car

d whe

n you

go to

docto

r app

ointm

ents

or ge

t cov

ered

servi

ces f

rom

other

healt

h ca

re pr

ovide

rs. F

or qu

estio

ns ab

out y

our b

enefi

ts or

your

PCP

, call

the M

embe

r Ser

vices

nu

mber

on th

e bac

k of y

our I

D ca

rd.

To he

lp pr

otect

your

iden

tity an

d pre

vent

fraud

, AHC

CCS

is ad

ding p

ictur

es to

its on

-line v

erific

ation

too

l that

prov

iders

use t

o ver

ify yo

ur co

vera

ge. If

you h

ave a

n Ariz

ona d

river

s lic

ense

or st

ate is

sued

ID

, AHC

CCS

will g

et yo

ur pi

cture

from

the A

rizon

a Dep

artm

ent o

f Tra

nspo

rtatio

n Moto

r Veh

icle

Divis

ion (M

VD).

Whe

n pro

vider

s pull

up th

e AHC

CCS

eligib

ility v

erific

ation

scre

en, th

ey w

ill se

e yo

ur pi

cture

(if av

ailab

le) w

ith yo

ur co

vera

ge de

tails.

Bi

enve

nido(

a) a

Unite

dHea

lthca

re C

ommu

nity P

lan

Nos c

ompla

ce te

nerle

como

miem

bro.

Unite

dHea

lthca

re C

ommu

nity P

lan of

rece

vario

s plan

es

en A

rizon

a. El

plan

para

los m

iembr

os a

trav

s de l

a Divi

sin d

e Disc

apac

idade

s del

Desa

rrollo

(D

ivisio

n of D

evelo

pmen

tal D

isabil

ities)

se lla

ma A

rizon

a Phy

sician

s IPA

Dev

elopm

ental

ly

Disa

bled (

DD).

Es

ta es

su nu

eva t

arjet

a de i

denti

ficac

in de

miem

bro.

Llve

la co

nsigo

todo

el tie

mpo.

De

be pr

esen

tar es

ta tar

jeta c

uand

o asis

ta a s

us ci

tas co

n el m

dico

o cu

ando

recib

a se

rvicio

s cub

iertos

de ot

ros p

rove

edor

es de

aten

cin m

dica

. Si ti

ene p

regu

ntas s

obre

su

s ben

eficio

s o su

PCP

, llam

e al n

mer

o de S

ervic

ios pa

ra M

iembr

os qu

e figu

ra

al re

verso

de su

tarje

ta de

iden

tifica

cin.

Para

ayud

ar a

prote

ger s

u ide

ntida

d y ev

itar e

l frau

de, A

HCCC

S es

t inc

luyen

do

fotog

rafa

s en l

a her

rami

enta

de ve

rifica

cin e

n lne

a que

los p

rove

edor

es ut

ilizan

pa

ra ve

rifica

r su c

ober

tura.

Si us

ted tie

ne un

a lice

ncia

de co

nduc

ir de A

rizon

a o

una t

arjet

a de i

denti

ficac

in em

itida p

or el

estad

o, AH

CCCS

obten

dr s

u foto

graf

a de

la D

ivisi

n de V

ehcu

los A

utomo

tores

del D

epar

tamen

to de

Tran

spor

te de

Ar

izona

(Ariz

ona D

epar

tmen

t of T

rans

porta

tion M

otor V

ehicl

e Divi

sion,

MVD)

. Cu

ando

los p

rove

edor

es ac

ceda

n a la

panta

lla de

verifi

caci

n de e

legibi

lidad

de

AHCC

CS, v

ern

una f

otogr

afa d

e uste

d (si

est

dispo

nible)

junto

con l

os de

talles

de

su co

bertu

ra.






CRS ID#: 299999999Group: 99125

CRSPartially Integrated-

BHMSIC: DMG Childrens Rehabilitative Services

3141 N 3rd Ave., Phoenix, AZ 85013 (800) 000-0000

CRS Partially Integrated - BHCard Type DE



N

A

L

P

Y

T

I N

U

M

M

O

C

E

R

A

C

H

T L

A

E

H

D

E

T I

N

U

9

4 3

1 3

X

O

B

O

P

9

4 3

0 -

1 3

1 4

8

T U

,

Y

T I

C

E

K

A

L

T L

A

S

Health Plan (80840) 911-03432-06


5113

060

4255

900

0040

0000

050

0000

011

15

311


Printed: 04/11/11

Claims:


ARIZONA DRAFT

9

9

9

9

9

9

>

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

N

W

O

R

B

R

E

B

I

R

C

S

B

U

S

T

E

E

R

T

S

E

R

E

H

W

Y

N

A

3

2

1

9

9

9

9

9

S

U

,

E

R

E

H

W

Y

N

A

Welc

ome t

o Unit

edHe

althc

are C

ommu

nity P

lan

We'r

e glad

to ha

ve yo

u as a

mem

ber. U

nited

Healt

hcar

e Com

munit

y Plan

offer

s man

y plan

s in

Arizo

na. T

he pl

an fo

r mem

bers

throu

gh th

e Divi

sion o

f Dev

elopm

ental

Disa

bilitie

s is c

alled

Ar

izona

Phy

sician

s IPA

Dev

elopm

ental

ly Di

sable

d (DD

).

This

is yo

ur ne

w Me

mber

ID C

ard.

Plea

se ca

rry it

with

you a

t all t

imes

. You

shou

ld pr

esen

t thi

s car

d whe

n you

go to

docto

r app

ointm

ents

or ge

t cov

ered

servi

ces f

rom

other

healt

h ca

re pr

ovide

rs. F

or qu

estio

ns ab

out y

our b

enefi

ts or

your

PCP

, call

the M

embe

r Ser

vices

nu

mber

on th

e bac

k of y

our I

D ca

rd.

To he

lp pr

otect

your

iden

tity an

d pre

vent

fraud

, AHC

CCS

is ad

ding p

ictur

es to

its on

-line v

erific

ation

too

l that

prov

iders

use t

o ver

ify yo

ur co

vera

ge. If

you h

ave a

n Ariz

ona d

river

s lic

ense

or st

ate is

sued

ID

, AHC

CCS

will g

et yo

ur pi

cture

from

the A

rizon

a Dep

artm

ent o

f Tra

nspo

rtatio

n Moto

r Veh

icle

Divis

ion (M

VD).

Whe

n pro

vider

s pull

up th

e AHC

CCS

eligib

ility v

erific

ation

scre

en, th

ey w

ill se

e yo

ur pi

cture

(if av

ailab

le) w

ith yo

ur co

vera

ge de

tails.

Bi

enve

nido(

a) a

Unite

dHea

lthca

re C

ommu

nity P

lan

Nos c

ompla

ce te

nerle

como

miem

bro.

Unite

dHea

lthca

re C

ommu

nity P

lan of

rece

vario

s plan

es

en A

rizon

a. El

plan

para

los m

iembr

os a

trav

s de l

a Divi

sin d

e Disc

apac

idade

s del

Desa

rrollo

(D

ivisio

n of D

evelo

pmen

tal D

isabil

ities)

se lla

ma A

rizon

a Phy

sician

s IPA

Dev

elopm

ental

ly

Disa

bled (

DD).

Es

ta es

su nu

eva t

arjet

a de i

denti

ficac

in de

miem

bro.

Llve

la co

nsigo

todo

el tie

mpo.

De

be pr

esen

tar es

ta tar

jeta c

uand

o asis

ta a s

us ci

tas co

n el m

dico

o cu

ando

recib

a se

rvicio

s cub

iertos

de ot

ros p

rove

edor

es de

aten

cin m

dica

. Si ti

ene p

regu

ntas s

obre

su

s ben

eficio

s o su

PCP

, llam

e al n

mer

o de S

ervic

ios pa

ra M

iembr

os qu

e figu

ra

al re

verso

de su

tarje

ta de

iden

tifica

cin.

Para

ayud

ar a

prote

ger s

u ide

ntida

d y ev

itar e

l frau

de, A

HCCC

S es

t inc

luyen

do

fotog

rafa

s en l

a her

rami

enta

de ve

rifica

cin e

n lne

a que

los p

rove

edor

es ut

ilizan

pa

ra ve

rifica

r su c

ober

tura.

Si us

ted tie

ne un

a lice

ncia

de co

nduc

ir de A

rizon

a o

una t

arjet

a de i

denti

ficac

in em

itida p

or el

estad

o, AH

CCCS

obten

dr s

u foto

graf

a de

la D

ivisi

n de V

ehcu

los A

utomo

tores

del D

epar

tamen

to de

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spor

te de

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izona

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ona D

epar

tmen

t of T

rans

porta

tion M

otor V

ehicl

e Divi

sion,

MVD)

. Cu

ando

los p

rove

edor

es ac

ceda

n a la

panta

lla de

verifi

caci

n de e

legibi

lidad

de

AHCC

CS, v

ern

una f

otogr

afa d

e uste

d (si

est

dispo

nible)

junto

con l

os de

talles

de

su co

bertu

ra.







Medicaid


MedicaidCard Type DF




Group numbers include: 40100401104012040130401404016040500

N

A

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P

Y

T

I N

U

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M

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A

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Health Plan (80840) 911-03432-06


5113

060

4255

900

0040

0000

050

0000

011

15

311


Printed: 04/11/11

Claims:


ARIZONA DRAFT

9

9

9

9

9

9

>

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

N

W

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B

R

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B

I

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C

S

B

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S

T

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W

Y

N

A

3

2

1

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9

9

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H

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N

A


Welc

ome t

o Unit

edHe

althc

are C

ommu

nity P

lan

We'r

e glad

to ha

ve yo

u as a

mem

ber. U

nited

Healt

hcar

e Com

munit

y Plan

offer

s man

y plan

s in

Arizo

na. T

he pl

an fo

r mem

bers

throu

gh th

e Divi

sion o

f Dev

elopm

ental

Disa

bilitie

s is c

alled

Ar

izona

Phy

sician

s IPA

Dev

elopm

ental

ly Di

sable

d (DD

).

This

is yo

ur ne

w Me

mber

ID C

ard.

Plea

se ca

rry it

with

you a

t all t

imes

. You

shou

ld pr

esen

t thi

s car

d whe

n you

go to

docto

r app

ointm

ents

or ge

t cov

ered

servi

ces f

rom

other

healt

h ca

re pr

ovide

rs. F

or qu

estio

ns ab

out y

our b

enefi

ts or

your

PCP

, call

the M

embe

r Ser

vices

nu

mber

on th

e bac

k of y

our I

D ca

rd.

To he

lp pr

otect

your

iden

tity an

d pre

vent

fraud

, AHC

CCS

is ad

ding p

ictur

es to

its on

-line v

erific

ation

too

l that

prov

iders

use t

o ver

ify yo

ur co

vera

ge. If

you h

ave a

n Ariz

ona d

river

s lic

ense

or st

ate is

sued

ID

, AHC

CCS

will g

et yo

ur pi

cture

from

the A

rizon

a Dep

artm

ent o

f Tra

nspo

rtatio

n Moto

r Veh

icle

Divis

ion (M

VD).

Whe

n pro

vider

s pull

up th

e AHC

CCS

eligib

ility v

erific

ation

scre

en, th

ey w

ill se

e yo

ur pi

cture

(if av

ailab

le) w

ith yo

ur co

vera

ge de

tails.

Bi

enve

nido(

a) a

Unite

dHea

lthca

re C

ommu

nity P

lan

Nos c

ompla

ce te

nerle

como

miem

bro.

Unite

dHea

lthca

re C

ommu

nity P

lan of

rece

vario

s plan

es

en A

rizon

a. El

plan

para

los m

iembr

os a

trav

s de l

a Divi

sin d

e Disc

apac

idade

s del

Desa

rrollo

(D

ivisio

n of D

evelo

pmen

tal D

isabil

ities)

se lla

ma A

rizon

a Phy

sician

s IPA

Dev

elopm

ental

ly

Disa

bled (

DD).

Es

ta es

su nu

eva t

arjet

a de i

denti

ficac

in de

miem

bro.

Llve

la co

nsigo

todo

el tie

mpo.

De

be pr

esen

tar es

ta tar

jeta c

uand

o asis

ta a s

us ci

tas co

n el m

dico

o cu

ando

recib

a se

rvicio

s cub

iertos

de ot

ros p

rove

edor

es de

aten

cin m

dica

. Si ti

ene p

regu

ntas s

obre

su

s ben

eficio

s o su

PCP

, llam

e al n

mer

o de S

ervic

ios pa

ra M

iembr

os qu

e figu

ra

al re

verso

de su

tarje

ta de

iden

tifica

cin.

Para

ayud

ar a

prote

ger s

u ide

ntida

d y ev

itar e

l frau

de, A

HCCC

S es

t inc

luyen

do

fotog

rafa

s en l

a her

rami

enta

de ve

rifica

cin e

n lne

a que

los p

rove

edor

es ut

ilizan

pa

ra ve

rifica

r su c

ober

tura.

Si us

ted tie

ne un

a lice

ncia

de co

nduc

ir de A

rizon

a o

una t

arjet

a de i

denti

ficac

in em

itida p

or el

estad

o, AH

CCCS

obten

dr s

u foto

graf

a de

la D

ivisi

n de V

ehcu

los A

utomo

tores

del D

epar

tamen

to de

Tran

spor

te de

Ar

izona

(Ariz

ona D

epar

tmen

t of T

rans

porta

tion M

otor V

ehicl

e Divi

sion,

MVD)

. Cu

ando

los p

rove

edor

es ac

ceda

n a la

panta

lla de

verifi

caci

n de e

legibi

lidad

de

AHCC

CS, v

ern

una f

otogr

afa d

e uste

d (si

est

dispo

nible)

junto

con l

os de

talles

de

su co

bertu

ra.







DD


Developmentally DisabledCard Type DA



N

A

L

P

Y

T I

N

U

M

M

O

C

E

R

A

C

H

T

L A

E

H

D

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,

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T I

C

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K

A

L

T L

A

S

Health Plan (80840) 911-03432-06


5113

060

4255

900

0040

0000

050

0000

011

15

311


Printed: 04/11/11

Claims:


ARIZONA DRAFT

9

9

9

9

9

9

>

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

N

W

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B

R

E

B

I

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C

S

B

U

S

T

E

E

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T

S

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H

W

Y

N

A

3

2

1

9

9

9

9

9

S

U

,

E

R

E

H

W

Y

N

A

Welc

ome t

o Unit

edHe

althc

are C

ommu

nity P

lan

We'r

e glad

to ha

ve yo

u as a

mem

ber. U

nited

Healt

hcar

e Com

munit

y Plan

offer

s man

y plan

s in

Arizo

na. T

he pl

an fo

r mem

bers

throu

gh th

e Divi

sion o

f Dev

elopm

ental

Disa

bilitie

s is c

alled

Ar

izona

Phy

sician

s IPA

Dev

elopm

ental

ly Di

sable

d (DD

).

This

is yo

ur ne

w Me

mber

ID C

ard.

Plea

se ca

rry it

with

you a

t all t

imes

. You

shou

ld pr

esen

t thi

s car

d whe

n you

go to

docto

r app

ointm

ents

or ge

t cov

ered

servi

ces f

rom

other

healt

h ca

re pr

ovide

rs. F

or qu

estio

ns ab

out y

our b

enefi

ts or

your

PCP

, call

the M

embe

r Ser

vices

nu

mber

on th

e bac

k of y

our I

D ca

rd.

To he

lp pr

otect

your

iden

tity an

d pre

vent

fraud

, AHC

CCS

is ad

ding p

ictur

es to

its on

-line v

erific

ation

too

l that

prov

iders

use t

o ver

ify yo

ur co

vera

ge. If

you h

ave a

n Ariz

ona d

river

s lic

ense

or st

ate is

sued

ID

, AHC

CCS

will g

et yo

ur pi

cture

from

the A

rizon

a Dep

artm

ent o

f Tra

nspo

rtatio

n Moto

r Veh

icle

Divis

ion (M

VD).

Whe

n pro

vider

s pull

up th

e AHC

CCS

eligib

ility v

erific

ation

scre

en, th

ey w

ill se

e yo

ur pi

cture

(if av

ailab

le) w

ith yo

ur co

vera

ge de

tails.

Bi

enve

nido(

a) a

Unite

dHea

lthca

re C

ommu

nity P

lan

Nos c

ompla

ce te

nerle

como

miem

bro.

Unite

dHea

lthca

re C

ommu

nity P

lan of

rece

vario

s plan

es

en A

rizon

a. El

plan

para

los m

iembr

os a

trav

s de l

a Divi

sin d

e Disc

apac

idade

s del

Desa

rrollo

(D

ivisio

n of D

evelo

pmen

tal D

isabil

ities)

se lla

ma A

rizon

a Phy

sician

s IPA

Dev

elopm

ental

ly

Disa

bled (

DD).

Es

ta es

su nu

eva t

arjet

a de i

denti

ficac

in de

miem

bro.

Llve

la co

nsigo

todo

el tie

mpo.

De

be pr

esen

tar es

ta tar

jeta c

uand

o asis

ta a s

us ci

tas co

n el m

dico

o cu

ando

recib

a se

rvicio

s cub

iertos

de ot

ros p

rove

edor

es de

aten

cin m

dica

. Si ti

ene p

regu

ntas s

obre

su

s ben

eficio

s o su

PCP

, llam

e al n

mer

o de S

ervic

ios pa

ra M

iembr

os qu

e figu

ra

al re

verso

de su

tarje

ta de

iden

tifica

cin.

Para

ayud

ar a

prote

ger s

u ide

ntida

d y ev

itar e

l frau

de, A

HCCC

S es

t inc

luyen

do

fotog

rafa

s en l

a her

rami

enta

de ve

rifica

cin e

n lne

a que

los p

rove

edor

es ut

ilizan

pa

ra ve

rifica

r su c

ober

tura.

Si us

ted tie

ne un

a lice

ncia

de co

nduc

ir de A

rizon

a o

una t

arjet

a de i

denti

ficac

in em

itida p

or el

estad

o, AH

CCCS

obten

dr s

u foto

graf

a de

la D

ivisi

n de V

ehcu

los A

utomo

tores

del D

epar

tamen

to de

Tran

spor

te de

Ar

izona

(Ariz

ona D

epar

tmen

t of T

rans

porta

tion M

otor V

ehicl

e Divi

sion,

MVD)

. Cu

ando

los p

rove

edor

es ac

ceda

n a la

panta

lla de

verifi

caci

n de e

legibi

lidad

de

AHCC

CS, v

ern

una f

otogr

afa d

e uste

d (si

est

dispo

nible)

junto

con l

os de

talles

de

su co

bertu

ra.






CRS ID#: 299999999Group: 10115

CRS Fully Integrated


CRS Fully IntegratedCard Type DC



N

A

L

P

Y

T I

N

U

M

M

O

C

E

R

A

C

H

T

L A

E

H

D

E

T

I N

U

9 4

3 1

3

X

O

B

O

P

9

4 3

0 -

1 3

1 4

8

T U

,

Y

T I

C

E

K

A

L

T L

A

S

Health Plan (80840) 911-03432-06


5113

060

4255

900

0040

0000

050

0000

011

15

311


Printed: 04/11/11

Claims:


ARIZONA DRAFT

9

9

9

9

9

9

>

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

N

W

O

R

B

R

E

B

I

R

C

S

B

U

S

T

E

E

R

T

S

E

R

E

H

W

Y

N

A

3

2

1

9

9

9

9

9

S

U

,

E

R

E

H

W

Y

N

A

Welc

ome t

o Unit

edHe

althc

are C

ommu

nity P

lan

We'r

e glad

to ha

ve yo

u as a

mem

ber. U

nited

Healt

hcar

e Com

munit

y Plan

offer

s man

y plan

s in

Arizo

na. T

he pl

an fo

r mem

bers

throu

gh th

e Divi

sion o

f Dev

elopm

ental

Disa

bilitie

s is c

alled

Ar

izona

Phy

sician

s IPA

Dev

elopm

ental

ly Di

sable

d (DD

).

This

is yo

ur ne

w Me

mber

ID C

ard.

Plea

se ca

rry it

with

you a

t all t

imes

. You

shou

ld pr

esen

t thi

s car

d whe

n you

go to

docto

r app

ointm

ents

or ge

t cov

ered

servi

ces f

rom

other

healt

h ca

re pr

ovide

rs. F

or qu

estio

ns ab

out y

our b

enefi

ts or

your

PCP

, call

the M

embe

r Ser

vices

nu

mber

on th

e bac

k of y

our I

D ca

rd.

To he

lp pr

otect

your

iden

tity an

d pre

vent

fraud

, AHC

CCS

is ad

ding p

ictur

es to

its on

-line v

erific

ation

too

l that

prov

iders

use t

o ver

ify yo

ur co

vera

ge. If

you h

ave a

n Ariz

ona d

river

s lic

ense

or st

ate is

sued

ID

, AHC

CCS

will g

et yo

ur pi

cture

from

the A

rizon

a Dep

artm

ent o

f Tra

nspo

rtatio

n Moto

r Veh

icle

Divis

ion (M

VD).

Whe

n pro

vider

s pull

up th

e AHC

CCS

eligib

ility v

erific

ation

scre

en, th

ey w

ill se

e yo

ur pi

cture

(if av

ailab

le) w

ith yo

ur co

vera

ge de

tails.

Bi

enve

nido(

a) a

Unite

dHea

lthca

re C

ommu

nity P

lan

Nos c

ompla

ce te

nerle

como

miem

bro.

Unite

dHea

lthca

re C

ommu

nity P

lan of

rece

vario

s plan

es

en A

rizon

a. El

plan

para

los m

iembr

os a

trav

s de l

a Divi

sin d

e Disc

apac

idade

s del

Desa

rrollo

(D

ivisio

n of D

evelo

pmen

tal D

isabil

ities)

se lla

ma A

rizon

a Phy

sician

s IPA

Dev

elopm

ental

ly

Disa

bled (

DD).

Es

ta es

su nu

eva t

arjet

a de i

denti

ficac

in de

miem

bro.

Llve

la co

nsigo

todo

el tie

mpo.

De

be pr

esen

tar es

ta tar

jeta c

uand

o asis

ta a s

us ci

tas co

n el m

dico

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aten

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obre

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eficio

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PCP

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verso

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ayud

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l frau

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HCCC

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t inc

luyen

do

fotog

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a her

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rifica

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n lne

a que

los p

rove

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ilizan

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ober

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Si us

ted tie

ne un

a lice

ncia

de co

nduc

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rizon

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denti

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estad

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u foto

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est

dispo

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junto

con l

os de

talles

de

su co

bertu

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CRS ID#: 299999999Group: 99135

CRS Only

MSIC: DMG Childrens Rehabilitative Services3141 N 3rd Ave., Phoenix, AZ 85013 (800) 000-0000

CRS Only Card Type DB



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Claims:


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