Read all plan benefits and details for Keystone First. You can create your own personalized OnLine account by registering here. If you have any questions about this payment, please … Community HealthChoices (CHC) is Pennsylvania’s managed care long-term services and supports (LTSS) program. Refer to Summary of Benefits for additional dental benefit information. <>/ExtGState<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Community Care is a proud part of the UPMC Insurance Services Division, which also includes UPMC Health Plan, WorkPartners, and UPMC for You (Medical Assistance). This service is best for minor issues such as colds, the flu, sore throats, skin rashes, and other nonemergency conditions. Susan E. Calderbank, DMD. Community Behavioral Health . UPMC Community HealthChoices . x��]mO�H������0��-�� �:f������N���B�us����W� 3�M�R)qb;~����뭛�Ӫ.�d���ys|Z���6����r�����*?��n�eV�����s��~γy^�����S���9��B2��ǩdU~x������������`p���၀�8,�,�:�vu7|�����M�x(��w����^M�W? Medical Assistance redetermination assistance. Community HealthChoices. Cleanings. PA Health & Wellness (Community HealthChoices) X Provider Alerts. Health coaches. This allowance can be used toward purchasing new glasses (one frame and two lenses) or contact lenses (one pair) and one fitting per year. Here are some examples of the kinds of HCBS covered by UPMC Community HealthChoices: Behavioral health services are offered through the existing network of behavioral health managed care organizations (BH-MCOs). UPMC Community HealthChoices participants located in Pennsylvania at the time of the service will have a virtual visit with a UPMC-employed provider. You do not need a referral to see the dentist. UPMC Community HealthChoices Northwest 4,782 $1,707,942.54 6/22/2020 7/1/2020 AmeriHealth Caritas Lehigh/Capital 8,715 $3,112,655.63 6/22/2020 7/1/2020 Pennsylvania Health & Wellness Lehigh/Capital 6,611 $2,361,189.49 6/22/2020 7/1/2020 UPMC Community HealthChoices Lehigh/Capital 6,886 $2,459,408.68 6/22/2020 7/1/2020 . UPMC Cole Port Allegany Community Health Center45 Pine Street, Port Allegany, PA 16743 (Map) 814-642-2505: Book Appointment. Browse doctors by specialty, procedure, service, or equipment to find the best fit for you! UPMC Community HealthChoices participants who are Nursing Facility Clinically Eligible (NFCE), may be eligible for additional services including: Enhanced community transition services. The UPMC Mobile Dental Center has closed. Hosted by UPMC Careers. PA Health & Wellness . English (PDF) Arabic (PDF) Cambodian (PDF) Russian (PDF) Simplified Chinese (PDF) Spanish (PDF) Vietnamese (PDF) Participants. Contact Us 24/7 Phone Lines Behavioral Health. ** This service lets you access a UPMC provider via live video from your computer, tablet, or smartphone—anytime, day or night. Practice Locations Phone; Susan E Calderbank, DMD43 Clinton Street, Greenville, PA 16125 (Map) 724-588-1600: Book Appointment. To find the BH-MCO in your county, call the UPMC Community HealthChoices Health Care Concierge Team. Behavioral Health. An authorized representative from your organization is required to complete the Third-party Compliance Program Attestation on behalf of your organization on an annual basis. UPMC Community HealthChoices will administer this benefit in conjunction with a nursing home transition team, led by the participant, which will develop a budget for distributing these funds to support the facility-to-community transition. UPMC AnywhereCare virtual visits are not covered services when UPMC Community HealthChoices participants are traveling outside of Pennsylvania. The allowance can be used on a variety of items, including household supplies, essential furniture, general moving expenses, security deposits and other items associated with personal and environmental health and safety assurances. CHC Southwest Provider Summit Presentations. Find care with UPMC Health Plan's Provider Directory. If you are dually eligible for Medicare and Medical Assistance (Medicaid) or receive long-term services and supports, you are eligible for Community HealthChoices. Welcome to Community HealthChoices! PRESS RELEASE. Email: CHCproviders@upmc.edu. UPMC Community HealthChoices; The same three CHC MCOs will be used across the state. Services have been moved to the UPMC Presbyterian Dental Center at UPMC Montefiore. If you are a member of UPMC for Life Complete Care or any other Medicare plan, your Medicare copays will not change under UPMC Community HealthChoices. UPMC Community HealthChoices participants who are Nursing Facility Clinically Eligible (NFCE), may be eligible for additional services including: Enhanced community transition services. These services are based on your needs, as documented in your person-centered service plan by your service coordinator. Home- and Community-based Services; Nursing Facility; Physical Health; Service Coordination; AmeriHealth Caritas Pennsylvania Overview; UPMC Community HealthChoices Overview ; PA Health & Wellness ; CHC Data Books. Our services help seniors and people with physical disabilities who are dually eligible for Medicare and Medicaid live as independently as possible in their own homes and experience an improved quality of life. Stress management program. endobj UPMC Community HealthChoices covers the same physical health benefits that are available through the Medical Assistance fee-for-service program (ACCESS) and Medical Assistance Adult Benefit Package. **UPMC Community HealthChoices participants can seek treatment through UPMC AnywhereCare. UPMC Pinnacle has partnered with the Harrisburg Area Dental Society to provide uninsured and underinsured Central Pennsylvania residents with access to urgent dental care. UPMC Community HealthChoices – MLTSS PO Box 106042 Pittsburgh, PA 15230-6042 Medicare Special Needs Plans (UPMC for Life Dual) 1-800-606-8648. To see a list of services covered by all plans, go to Physical and behavioral health benefits and Long-term services and supports. Copyright document.write(new Date().getFullYear());. Refer to Summary of Benefits for additional vision benefit information. You must have a prescription from a participating provider. This service provides assistance to help you maintain your Medical Assistance eligibility, so you do not lose access to your Medical Assistance benefits. Using the five geographic HealthChoices zones, implementation phases are: January 2018 - Phase 1 (Southwest) January 2019 - Phase 2 (Southeast) January 2020 - Phase 3 (Lehigh/Capital, Northwest, Northeast) Please refer to the Pennsylvania Department of Human Services (DHS) Community HealthChoices … UPMC Community HealthChoices, as one of three state-wide Managed Care Organizations for the Commonwealth’s Community HealthChoices (CHC) program, offers coverage for medical care and Long-term Services and Supports (LTSS) to its Members (also called “Participants”). A network of more than 50 volunteer dentists assists Dauphin County patients who have urgent dental needs but no dental … If you are a patient and have … stream %���� Community HealthChoices (CHC) provides physical health benefits as well as long-term services and supports to eligible individuals. UPMC Community HealthChoices . As part of Keystone First CHC, you receive the following dental benefits: Exams. (This service exceeds the $4000 lifetime maximum benefit provided by the Office of Long-Term Living's waiver program.) Echoing Pittsburgh’s groundbreaking 1960s-1970s initiative that provided emergency management service (EMS) … Provider Manual, etc. Health Details: UPMC Health Plan for Skilled Nursing Services and are interested in applying. Managed Care Organizations presentations. EVS EXAMPLE #1 — continued Status: Medicaid Service Type: 1-Medical Care 4-Diagnostic X-Ray 30-Health Benefit Plan Coverage 33-Chiropractic 35-Dental Care 47-Hospital 48-Hospital - Inpatient 50-Hospital - Outpatient 86-Emergency Services 88-Pharmacy 98-Professional (Physician) Visit - Office A6-Psychotherapy AL-Vision … What is Community HealthChoices? Health coaches can also help you manage symptoms and provide treatment options for heart disease, asthma, COPD, low back pain, diabetes, or depression. 2 0 obj Health Details: Contact Information 1-888-876-2756 8 a.m. to 8 p.m. – Monday through Friday ...A. UPMC Health Plan developed UPMC Dental Advantage to offer a single source for all your health insurance ... claim to UPMC Dental Advantage with the original treatment plan (initial placement date and months of upmc health plans for individuals Community Homepage Health Education Advisory Committee (HEAC) Participant Advisory Committee (PAC) Home > Participants > Participant Handbook. UPMC Community HealthChoices . Keystone First. A prescription from a participating provider is required. UPMC & Health Plan Launch ‘Freedom House 2.0’ ambulance. Community Care Behavioral Health. Community Care is a proud part of the UPMC Insurance Services Division, which also includes UPMC Health Plan, WorkPartners, and UPMC for You (Medical Assistance). 1-844-626-6813 (TTY: 1-844-349-8916) www.PAHealthWellness.com. 1 0 obj If the cost of the glasses or contact lenses is more than $100, you will be responsible for any cost over the $100. Dentistry ; Book Appointment. Eligibility is based on a state determination of nursing facility clinical eligibility and a pending application with the county assistance office. upmc 1-800-979-8762 Community Care is a proud part of the UPMC Insurance Services Division, which also includes UPMC Health Plan, WorkPartners, and UPMC for You (Medical Assistance). Services you receive at home and in your community are called home and community based services (HCBS). 24/7 Phone Lines ; Email; Member Site. Yes. Our care is individualized and patient-focused to allow you to put your best face forward. Wellness programs. Providers who also hold HealthChoices contracts should pay specific attention to the UPMC Health Plan’s claims guidelines as there are different addresses. Adult vision. UPMC Community HealthChoices is your secondary Medical Assistance payer instead of the Pennsylvania Department of Human Services. clock. … SELECTING A PLAN CHC is a new program introduced in the Southwest Zone in 2018, the Southeast Zone in 2019, and is slated for implementation in the Lehigh/ … CHC Overview. While this program is not strictly for the elderly, it is very relevant for seniors, as many are dually eligible for Medicaid and Medicare and / or require a level of care consistent to that … As a participant of UPMC Community HealthChoices, you may be eligible to receive additional value-added benefits. Tod E Twichell, DDS. What is Community HealthChoices? }��ъd@+��8��V�ʊ}�jT��Ru���e�� �X<4�]_~j���)&x�& �S"�7�1$����ށ0{t�YY��_=�/˚F=D�����g����3�ǀ0#¨I�~~g�����A�����/��&&. %PDF-1.7 UPMC Dental Advantage. If you need help finding a Keystone First Community HealthChoices dentist, go to Find a Provider and select Dental. endobj <> Let’s take a look at the benefits and services CHC offers. UPMC Health Plan Provider Services U.S. Steel Tower 600 Grant Street Pittsburgh, PA 15219 Network Development UPMC Dental … UPMC Community HealthChoices - PHCA. If you’re 21 or older and have both Medicare and Medicaid, or receive long-term supports through Medicaid because you need help with everyday personal tasks, you will be covered by Com Starting in January 2020, the CHC plan you choose will become your new Medical Assistance coverage. Participant Handbook. This service provides online access to a program to help you feel more confident, overcome setbacks, and take control of your life and mood. There is a $3 copay for brand-name medications. Contact Us 24/7 Phone Lines UPMC Community HealthChoices For HealthChoices, an announcement was made about newly selected MCOs. Community HealthChoices is the Department of Human Services (DHS) Medical Assistance (Medicaid) program that allows managed care organizations (MCOs) to coordinate medical care and long-term services and supports (LTSS) for individuals who qualify for Medical Assistance and also qualify for Medicare or require a nursing facility level of care. Copays do not apply to pregnant participants. Specialties. Refer to your Medicare plan for more information on Medicare copays. <>/Metadata 3409 0 R/ViewerPreferences 3410 0 R>> Hosted by. Are you a first time user? Pennsylvania Health & Wellness. Online Event. These include: $500 dental allowance. There are no UPMC Community HealthChoices copays for medical services and generic medications. WHAT DO I NEED TO DO? UPMC Community HealthChoices Provider Services: 1-844-860-9303. 4 0 obj endobj about 1 week ago. Nursing Facilities. The Pennsylvania Community HealthChoices (CHC) Program is a Medicaid managed care program for persons who are 21 years of age or older and are eligible for bothMedicaid (known as Medicaid Assistance in Pennsylvania) and Medicare (the federal health insurance program) or those who require a nursing home level of care. The current MCOs remain in place, and an announcement will be made at a later date concerning the newly selected MCOs. Community Care is a proud part of the UPMC Insurance Services Division, which also includes UPMC Health Plan, WorkPartners, and UPMC for You (Medical Assistance). If you are eligible for long-term services and supports (LTSS), all services available in the Office of Long-Term Living’s home and community based physical disability waiver programs are covered by UPMC Community HealthChoices. This service offers an allowance of up to $5,000 to assist participants who are transitioning from a nursing … Service Coordination. Community HealthChoices (CHC) is the Department of Human Services’ (DHS) Medical Assistance (Medicaid) program that allows managed care organizations (MCOs) to coordinate medical care and long-term services and supports (LTSS) for individuals who qualify for Medical Assistance and also qualify for Medicare or require a nursing facility level of care. LTSS can be provided in a nursing facility or in your home and community. Home and Community-Based Services. $100 vision allowance and glasses fitting each year. The Department of Human Services (DHS) is committed to increasing opportunities for older Pennsylvanians and individuals with physical disabilities to remain in their homes. Upmc Community Healthchoices Formulary Choose the community formulary listings for specific physical disabilities to management process, and manage your medicaid This service offers an allowance of up to $5,000 to assist participants who are transitioning from a nursing facility to the community. Extended coverage of personal assistance services. Select. UPMC Community HealthChoices is a Managed Care Plan for Community HealthChoices. 2018 Provider Summit Presentations. Added benefits. Specialized medical equipment and supplies, Health status measuring and monitoring telecare services, Activity and sensor monitoring telecare service, Medication dispensing and monitoring telecare service, CHC Translation Services and Nondiscrimination Notice (PDF). 3 0 obj Provider Contact Addresses. Accepting New Patients. CHC will only change how you receive your Medical Assistance coverage. This allowance can be used towards certain dental procedures after a benefit limit has been reached. Long-term nursing facility care is also covered. Provider Alerts include important updates for providers. Please note the following changes: the BIN will be 020545; the PCN will be RXA373; and the GRP will be RXGMCPA01. Adult dental. E.g., dental, vision, non- emergency medical transportation, over-the-counter medication, long term services and supports 7. 8. In doing so, you attest to your organization’s compliance with the Third-Party Compliance Program requirements. }8~����|ʦp(�&G&��_�#ԏ���-^�-�Y��l��?��|^̲;]�'QP��ɑ�%\��N�F6��]�zx�����A[z�sz�LCcviv��� �g�WC�TԿ! As of June 1 st, PA Health and Wellness will be switching our claims processor for Community HeathChoices and participants will get a new ID card by mail. Hospitals and Physical Health. Phone services. 1 dental exam and 1 cleaning, per provider/group, every 180 days (6 months). <> CY 2018 Data Book for Community HealthChoices; CY 2019 … UPMC Community HealthChoices CH2C CH2F CH2S CH2J CH2N. Contact Us. At the UPMC Presbyterian Dental Center, our experienced team provides general preventive and follow-up dental care, and specialized procedures to help you keep smiling with confidence. This service will provide personal assistance services to eligible participants who cannot perform activities of daily living and are at risk of entering a nursing facility. If you are dually eligible for Medicare and Medical Assistance (Medicaid), your Medicare benefits are not changed or affected by UPMC Community HealthChoices. Overview. Community Care is a proud part of the UPMC Insurance Services Division, which also includes UPMC Health Plan, WorkPartners, and UPMC for You (Medical Assistance). Other benefits. For the purposes of this attestation, an authorized representative is an individual who has responsibility, directly or indirectly, for all employees, contracted personnel, and delegated vendors who provide administrative and/or healt… Wednesday, November 18, 2020 at 12:00 PM – 1:00 PM EST. When you become enrolled in CHC, you will choose one of three CHC plans: AmeriHealth Caritas, PA Health & Wellness, and UPMC Community HealthChoices. This service provides one-on-one coaching to help you eat healthier, lose weight, reduce stress, and quit smoking. UPMC … If the procedure cost exceeds $500, you will be responsible for any cost over the $500. 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