|
Once
you have chosen CommunityFirst Health Plans, your next choice is
to select who will provide the majority of health care services
to you and your eligible dependents. Your primary care physican (PCP)
will be the one you call when you need medical advice, when you are sick, and
when you need preventive care such as immunizations.
Each participant may select his or her own PCP from the Community First Provider Directory.
Select a PCP who is a family or general practitioner, internist, or pediatrician.
If you have a chronic, disabling, or life-threatening condition, you may request to
use a specialty care provider (SCP) as your PCP.
Just call Member Services at (210) 358-6262 or toll-free (877) 698-7032 to make your request. Your request
must include information about the medical necessity of your request and be signed by you
and your SCP.
For your SCP to
be named as your
PCP, he or she
must meet all
of Community First's
requirements for
PCPs and be willing
to accept the
responsibility
of coordinating
all of your health
care needs.
GBP Participants:
You should ask about the contract status of the providers from whom you receive treatment, especially when you are referred by your PCP to a specialty care physician and when you receive services at a participating hospital. Some facility-based physicians or other health care practitioners, such as anesthesiologists, pathologists, and radiologists, may not be included in Community First's network and may balance bill you for amounts not paid by Community First.
Community First Health Plans will provide services
in the following Texas counties: Atascosa, Bandera,
Bexar, Comal, Guadalupe, Kendall, Medina, and
Wilson. The Service Area Map provides an illustration of the counties included in the Community First service area.
If you wish
to change your
PCP, please call
the Member Services
Department at
the phone numbers
in the
contact directory.
A representative
will be happy
to assist you.
|