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  • 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).

    You can get a current list of Sunshine Health network doctors by calling Member Services at 1-866-796-0530 (TDD/TTY 1-800-955-8770) or using our online Find a Provider Tool or looking at our online Provider Directories on SunshineHealth.com. You can also ask Member Services to mail a copy to you.

    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 Physician (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. It’s 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 don’t see your doctor on this list, call Member Services at 1-866-796-0530 (TDD/TTY 1-800-955-8770).

    121208-07-2020

    http://www.SunshineHealth.com

  • CHOOSING AN OB/GYN

    Women may pick any OB/GYN doctor from the Sunshine Health Provider Network. This doctor will take care of female healthcare 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).

    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 doctor’s office, call your doctor’s 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 at 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 for regular check-ups to help you get well and stay well. 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, 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 won’t 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 physician’s 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 Health’s website at www.sunshinehealth.com. You can also call Member Services at 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 Y

    Yes or No: Y- Yes N- No

    Sunshine Health looks forward to serving your healthcare needs!

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

  • ¡BIENVENIDO A SUNSHINE HEALTH!

    ¡Bienvenido a Sunshine Health! Sunshine Health le ofrece atención médica de calidad conveniente y fácil de obtener. Nuestra meta principal es asegurarnos de que usted reciba atención médica de calidad.

    Este es su directorio de proveedores. Las próximas páginas contienen información acerca de cómo usar el directorio.

    Déjenos saber si necesita ayuda para entender este directorio. Contamos con servicios de interpretación gratuitos para usted, incluyendo lenguaje de señas. También contamos con una línea telefónica de idiomas para traducir. Puede llamar a Servicios para Miembros. El número es 1-866-796-0530 (TDD/TTY 1-800-955-8770).

    Puede recibir un listado actualizado de médicos de la red de Sunshine Health llamando a Servicios para Miembros al 1-866-796-0530 (TDD/TTY 1-800-955-8770) o utilizando nuestra Herramienta en línea Find a Provider (Encontrar un proveedor) o refiriéndose a nuestros Directorios de Proveedores en línea en SunshineHealth.com. También puede solicitar a Servicios para Miembros que le envíen por correo una copia.

    FÁCIL DE USAR

    Obtener beneficios de Sunshine Health es fácil. Creemos que la mejor manera de mantener una buena salud es tener una buena relación con su médico de cabecera. Es por ello que usted escoge a su propio Médico de Atención Primaria (PCP, por sus siglas en inglés). Cuando necesita atención, todo lo que tiene que hacer es llamar a su PCP para pedir una cita. Dígales que tiene cobertura de Sunshine Health. Es así de simple.

    CÓMO ELEGIR A SU PCP

    Cada miembro de la familia elegible debe escoger un PCP de nuestra lista. Su PCP tiene la tarea de cuidar de usted y derivarlo a otros profesionales cuando sea necesario. Puede hacer que toda su familia se atienda con un mismo PCP o que cada miembro de la familia elija un PCP diferente.

    Los miembros de la familia pueden elegir entre:

    • Pediatras (sólo atienden a niños) • Medicina General/Familiar (atienden a todos los miembros de la familia) • Medicina Interna (por lo general atienden a adultos) • Un proveedor que trabaja en una clínica (RHC/FQHC)

    Si necesita ayuda o no ve a su médico en esta lista, llame a Servicios para Médicos al 1-866-796-0530 (TDD/TTY 1-800-955-8770).

    http://www.SunshineHealth.com

  • CÓMO ELEGIR OBSTETRA/GINECÓLOGO

    Las mujeres pueden escoger un obstetra/ginecólogo de la Red de Proveedores de Sunshine Health. Este médico se hará cargo de las necesidades médicas de la salud femenina sin referencia de su médico. Un obstetra/ginecólogo puede ayudarle con la salud durante el embarazo, los chequeos anuales y problemas femeninos que tenga. Llame a Servicios para Miembros si necesita ayuda. El número es 1-866-796-0530 (TDD/TTY 1-800-955- 8770).

    PLANIFICACIÓN FAMILIAR

    Los miembros de Sunshine Health pueden obtener servicios de planificación fami

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