October 8, 2014 RE: Important Provider Network Change in North Brevard Dear Valued Member: We hope that this letter finds you well. At Health First Health Plans we are committed to providing access to the highest quality health and wellness care and services. We work very hard to ensure that, through your health insurance plan, you are able to receive the medical care you need to support your optimum health and quality of life. We trust you have experienced our commitment to your well-being in the time you have been a member of Health First Health Plans. As you may know, Parrish Medical Center executives decided to end their participation agreement with Health First Health Plans & Insurance long before the contract was due to expire. We are extremely disappointed with their decision to disrupt patient care after our longstanding mutually beneficial relationship. This letter is the first step in the process to help you navigate through this transition to other participating physicians and facilities. Important Information: North Brevard Medical Support Physicians: Network participation will end December 7, 2014. Parrish Medical Center: Network participation will end March 7, 2015, however Parrish Medical Center may decline to accept non-emergency patients as of December 7, 2014. Parrish Fitness Center: Network participation will end January 14, 2015, although your membership may continue through the end of the month. At Parrish Medical Center s executive s discretion, these entities could decline for nonemergent care after December 7, 2014. What you should know: Emergencies: In an emergency, you always have access to the closest emergency room. You can continue to receive emergency care in any hospital, regardless of the facility s participation status. Elective hospital care: For elective hospital care, we are pleased to tell you that additional choices are now available. In addition to Health First hospitals including Viera Hospital and Cape Canaveral Hospital, you also have access to a number of other facilities throughout the state. See the enclosed list of Participating Hospitals for details. Physician care: You still have access to many physicians under your plan, including Primary Care Physicians located in Titusville on the enclosed list. Our network continues to expand and now includes more than 3,000 providers, including many new additions through our partnership with Florida Hospital. If you are in active treatment with a provider whose contract is ending, you will be able to continue your care for a period of time. The enclosed Frequently Asked Questions will explain these rights.
Lab services: For lab work, you have access to Quest s draw station located at Quest Diagnostics, 3233 Garden Street, Unit 13,. For members who wish to make appointments, please call (888) 277-8772 or go online www.questdiagnostics.com. Radiology services: Health First s Cape Canaveral Hospital, 701 W. Cocoa Beach Causeway, Cocoa Beach, FL 32932 Health First s Diagnostic Center, 255 Borman Drive, Merritt Island, FL 32953 Health First s Diagnostic Center, 270 Sykes Creek, Suite 100, Merritt Island, FL 32953 Health First s Viera Hospital Medical Office Building, 8745 N. Wickham Rd, Melbourne, FL 32940 We sincerely regret that this change has occurred, and thank you for your patience during the transition. Please be assured you will continue to have access to high-quality care under your plan, and that we are here to help. Over the coming weeks you may receive a phone call from a Health First Health Plans & Insurance associate. The purpose of this call is to answer any questions you may have and assist you with transitioning your care to an in-network provider. If you have any additional questions please call us at (855) 372-4029 or visit us online at www.myhfhp.org. Sincerely, Ed Griese President & CEO Health First Health Plans Health First offers health care coverage options through two companies. Health First Health Plans, Inc. offers Medicare Advantage and Group HMO and POS (point of service) health plans. Health First Insurance, Inc. offers Group and Individual PPO insurance, including Exchange policies. Health First Health Plans and Insurance does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.
Frequently Asked Questions about the Provider Network Change When will Parrish Medical Center s affiliated provider s contracts end? North Brevard Medical Support Physicians: Network participation will end December 7, 2014. Parrish Medical Center: Network participation will end March 7, 2015, however Parrish Medical Center may decline to accept non-emergency patients as of December 7, 2014. Parrish Fitness Center: Network participation will end January 14, 2015. At Parrish Medical Center s executive s discretion, these entities could decline for nonemergent care after December 7, 2014. What if I need emergency care or I am taken by ambulance to Parrish Medical Center? Emergency services will be covered under the in-network benefits of your plan. If you are admitted to the hospital from the emergency room, your stay will be covered at the in-network benefit level of your plan until you are stable and ready to be transferred to a participating facility. What if I am admitted to Parrish Medical Center before December 7, 2014, but stay longer? Hospital services you receive will be covered at the in-network level until you are discharged. What if I am in active treatment with a provider who will no longer be participating? If you are in active treatment (including maternity care) with a provider when their contract ends, you may continue your care with authorization in advance. Authorized care will be covered under your in-network benefits for up to six months until your care is completed. To request authorization, have your provider submit an authorization request to us 30 days before their network participation ends. What if I have been approved for services at Parrish Medical Center after December 7, 2014? For elective services, please work with your physician to schedule your procedure at a participating facility if possible. If not possible, your physician may submit an authorization request for consideration. What if my doctor only admits patients to Parrish Medical Center? If your doctor will remain in our network, you can keep your doctor. If you need hospital care, he or she will coordinate your admission to a participating hospital, where you will be cared for by a qualified on-staff physician.
What if I have a plan with out-of-network benefits? If you have a Point of Service (POS) plan with out-of-network coverage, benefits are available for any covered service received from a non-contracted provider as described in your benefit materials. Which providers are included in this change? North Brevard Medical Support (NBMS) medical group physicians Anthony J. Allotta, DO (Sports Medicine) Christina M. Caito, DO (OB/GYN) Daniel E. Mora-Rivera, MD (Family Medicine) Daniela Rusovici, MD (Neurology) Denis A. Perez, MD (OB/GYN) Erica O'Bryan, MD (Pediatrics) Eugene H. Go, MD (Endocrinology) Jonathan J. Lubitz, DPM (Podiatry) Julie Lynn Flick, MD (Family Medicine) Julio Merrell Pagan, MD (Internal Medicine) Kantilal H. Bhalani, MD (OB/GYN) Manuel R. Quintana, MD (OB/GYN) Maria Oconer, MD (Internal Medicine) Michael J. Magee, MD (Orthopedic Surgery) Pamela S. Tronetti, DO (Geriatric Medicine) Patricia A. Alexander, MD (Internal Medicine) Patrick R. Sonser, MD (Physical Medicine & Rehab) Rhu-Jade M. Raguindin, MD (Internal Medicine) Sandra C. Ogata, MD (Family Medicine) Simon Symeonides, MD (Infectious Diseases) Tanya Itani Taival, DO (Obstetrics & Gynecology) Victor R. Boodhoo, MD (Family Medicine) Vidya N. Hate, MD (OB/GYN) Wendy L. Worsley, MD (Family Medicine)
Titusville Providers Internal Medicine Douglas Anderson, MD 500 N. Washington Ave, Ste 208 321-267-6100 Jeram P. Chapla, MD Radha Medical, 1027 Garden St. 321-383-3332 Rasiklal N. Delvadia, MD 2185 A Cheney Hwy 321-269-9800 Nabil S. Itani, DO, 875 Century Medical Dr. 321-268-8787 Miguel A. Medina MD 4420 S. Hopkins Ave. 321-264-8644 Ashok Shah, MD, 3808 S. Hopkins Ave. 321-268-2005 Family Practice Deborah M. Malone, DO Royal Oaks Medical Center Amber W. Surber, MD Royal Oaks Medical Center Maria Torres, MD, LLC 766 Country Club Dr. 321-264-1052 Rodolfo A. Torres, MD Royal Oaks Medical Center Pediatrics Douglas G. Barimo, MD 1653 Jess Parrish Ct. Ravi G. Raman, MD 1653 Jess Parrish Ct, Ayesha I. Rashid, MD 1653 Jess Parrish Ct, Charlene F. Vargas, MD 1653 Jess Parrish Ct,
PRIMARY CARE ALSO AVAILABLE AT: Brevard Health Alliance A Federally Qualified Health Center 500 N. Washington Ave, Suite 105 321-264-5496 Urgent Care Centers Chiron Urgent Care 603 N. Washington Ave., Suite 101 321-268-5008 Medfast Urgent Care-Port St. John 5005 Port St. John Pkwy Port St. John, FL 32927 321-633-6820 Medfast Urgent Care-Titusville 3045 Columbia Blvd., Suite 108A 321-821-4955 Royal Oaks Medical Center-Port St. John 7227 N. US Hwy 1 Port St. John, FL 32927 321-637-1595 Royal Oaks Medical Center-Titusville Participating Hospitals and Rehab Facilities BREVARD COUNTY Health First's Cape Canaveral Hospital 701 W. Cocoa Beach Cswy Cocoa Beach, FL 32931 321-799-7111 Health First's Holmes Regional Medical Center 1350 S. Hickory Street Melbourne, FL 32901 321-434-7000 Health First's Palm Bay Hospital 1425 Malabar Rd NE Palm Bay, FL 32907 321-434-8000 Health First's Viera Hospital 8745 N. Wickham Rd Melbourne, FL 32940 321-434-9000 Kindred Hospital Melbourne 765 W. Nasa Blvd. Melbourne, FL 32901 321-733-5725
OUTTIENT REHABILITATION FACILITIES Advanced Rehab Center 4401 S. Hopkins Ave, Suite 105-106 321-383-0889 Cora Rehabilitation Clinics 712 Cheney Hwy 321-269-8155 OSCEOLA