Provider relationships are very important to consumers and network status is part of their decision making process.

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Provider Search Ancillary Benefit Providers September 2017 Provider relationships are very important to consumers and network status is part of their decision making process.

1 Provider Search Ancillary Benefit Providers September 2017 Provider relationships are very important to consumers and network status is part of their decision making process. The purpose of this user guide is to help you accurately look up in-network providers for ancillary benefits. There are many different types of providers and networks can be complex. This job aid will provide you with the knowledge you need to set correct expectations with consumers. Note: A separate user guide is available for medical provider look up. Use that guide to look up providers for the Medicare coverage portion of the plan. For example, some chiropractic care is covered by Medicare; that treatment requires a provider listed in Rally. Table of Contents Accessing Online Provider Search Tools for Ancillary Benefits... 2 Mental Health Providers... 2 Dental... 5 Vision... 7 Hearing Chiropractic and Acupuncture Services Acronym Description Acronym Description CMS Centers for Medicare & Medicaid Services NPPO National Preferred Provider Organization DSNP Dual Special Need Plan OON Out-of-Network EOC Evidence of Coverage PA Prior Authorization FFS Fee-for-Service PCP Primary Care Physician HMO Health Maintenance Organization PSP Provider Specific Plan INN In-network PDP Prescription Drug Plan MA Medicare Advantage PFFS Private Fee-for-Service MA-PD Medicare Advantage Prescription Drug VAIS Value Added Information and Services

Accessing Online Provider Search Tools for Ancillary Benefits From the Jarvis home page, click on the Enrollment Tab on the top toolbar and select Provider Search.

2 Accessing Online Provider Search Tools for Ancillary Benefits From the Jarvis home page, click on the Enrollment Tab on the top toolbar and select Provider Search. For ancillary benefit providers, click on the links at the bottom of the page (Mental Health Providers, Vision Providers, Dental Providers, Hearing Providers). Mental Health Providers Note: Substance Use providers are also found under Mental Health Click on the Mental Health Providers link located under the Ancillary Provider Searches section Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 2

A separate window will open and defaults to the Find a Provider page. To find a provider, make sure Find a Provider is selected. Enter Zip Code or City and State. Click Search.

3 A separate window will open and defaults to the Find a Provider page. To find a provider, make sure Find a Provider is selected. Enter Zip Code or City and State. Click Search. A list of providers will appear. You can further refine your search using the options in the left hand panel. Be sure you refine to Medicare coverage type so that you are just getting the providers for Medicare lines of business Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 3

Telemental Health Along with other aspects of telemedicine, Telemental Health is predicted to grow rapidly over the next few years with more customers and health care consumers requesting the

4 If needed, you can create a PDF of your search. Scroll to the bottom of the page to find the Create PDF of this page link. You may also search for mental health facilities, search by a name, or search for telemental health. Telemental Health Along with other aspects of telemedicine, Telemental Health is predicted to grow rapidly over the next few years with more customers and health care consumers requesting the technology. CMS rules dictate that consumers who may use Telemental Health services must be referred by a physician and must reside in a rural area where mental health care providers and facilities are not available. Choosing what cases are appropriate for Telemental Health versus traditional face-to-face treatment is ultimately at the discretion of the referring and/or treating clinician. Each provider must determine what services can be safely and effectively delivered based on the unique clinical needs of the individual patient and patient location when services are delivered Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 4

5 Dental Click on the Dental Providers link located under the Ancillary Provider Searches section. Select a network and the type of search. The National Medicare Advantage Network is the nationwide network used by most Individual Medicare Advantage plans (including the Dental Platinum Rider) unless you have selected a plan with a special network. If you have a Dual Special Needs Plan, select the National UnitedHealthcare Dual Complete Network. If you have a Dual Special Needs plan member in AZ, FL or TN, select a state specific network. If you have a DHMO plan (CA, CO or NY/NJ), select a state specific DHMO network. If you are in Florida, there are three different networks, depending on plans. Select FL Solstice Plus Plan Options Network for all members in FL, except: FL Full Dual Special Needs Plan Network is for members who belong to DSNP plans H , H , R or R National Medicare Advantage Networks is for members in H , H , and H Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 5

Complete the appropriate search criteria fields and click Search. The search results will be displayed. 9.11.

6 Complete the appropriate search criteria fields and click Search. The search results will be displayed Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 6

Vision For plans that use UnitedHealthcare Vision [UHC Vision] as the contracted vendor. Each Welcome Kit contains a provider directory that lists in-network providers for the plan.

7 Vision For plans that use UnitedHealthcare Vision [UHC Vision] as the contracted vendor. Each Welcome Kit contains a provider directory that lists in-network providers for the plan. In most cases, a member will see an optometrist for a routine eye exam. Please reference the EOC to verify who the vendor or network is for Routine Vision services not all plans use UnitedHealthcare Vision (UHC Vision). See Best Practices section of this guide for more information. Reminder: UHC Vision acquired the Spectera network years ago; in the provider community sometimes the name is interchanged but they are UHC Vision. For plans that include Routine Vision through UHC Vision, you will find those providers in the vision section of the printed provider directory. Click on the Vision Providers link located under the Ancillary Provider Searches section Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 7

Members should register on www.myuhcvision.com.

8 Members should register on If the member tries a quick provider search when they are not logged into their account, they will see all of UHC Vision providers, including those that are part of UHC Vision s Commercial network and do not service Medicare Advantage plans. As of May 2016, Costco is now part of the UHC Vision network. For plans that offer vision benefits, but are not provided through a vendor like UHC Vision, members can access routine vision exams from network optometrists/ophthalmologists indicated in the specialist section of the provider directory. If the member has a routine vision eyewear benefit that is not provided through a vendor like UHC Vision, then the benefit may be available from any provider (fee-for-service) and members can submit the bill to UnitedHealthcare for payment. Please verify in the EOC who the provider of the service is. You can verify Medicare participating providers in the UHC Vision network by using the dummy member ID s below. Please do not give these dummy ID s out to members. Using these ID s will eliminate all non-medicare participating providers. Reminder: Please be very careful when entering in the passwords. For security purposes, passwords are case sensitive. The password will lock after 3 missed attempts. These ID s can be used by multiple people at the same time. Portal Username medicareuser1 medicareuser2 medicareuser3 medicareuser4 medicareuser5 Portal Password Medicare#12345 Medicare#12345 Medicare#12345 Medicare#12345 Medicare#12345 Very Important: If you do a general search without using the dummy ID, then your search will bring up all UHC Vision providers for the ZIP code. It is not limited to the UHC Vision Medicare Network. To begin a search: Enter a dummy User name and Password (provided above) and click Log In Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 8

9 Click on Find a Provider. Enter the member's address or a specific provider s name. Click Search Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 9

Pay attention to the service notes. For example, this provider is a Full Service Provider, meaning that a member can see this Provider for both exam and materials.

10 The search results will appear. For additional information about the provider, click on Details. The details screen will show you Specialties, Service Notes, Office hours, other info, such as languages and handicap accessibility. Pay attention to the service notes. For example, this provider is a Full Service Provider, meaning that a member can see this Provider for both exam and materials. But if it says Exam Only, it means a member can see this provider for an exam, but not for glasses or contacts Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 10

corresponding plan year or click on the tab for the corresponding year.

11 Hearing Click on the Hearing Providers link located under the Ancillary Provider Searches section. Once the document opens, select the corresponding plan year you need: From the Index tab / Quick Links section, choose the corresponding plan year or click on the tab for the corresponding year. Complete the following steps to return plan-specific information: Enter the state and plan number Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 11

12 Once the plan selection information has been entered, the tables will populate with information specific to that plan. Use the Hearing Aid Contact Information section to determine the specific phone number and/or website required to look up a participating provider Chiropractic and Acupuncture Services Please check plan EOCs to verify if your plans have a routine chiropractic or acupuncture benefit. Not all plans in all the states listed below have the benefit. Copayments and the number of visits vary by plan. Routine chiropractic and/or acupuncture visits: Do not require a referral Are covered for the relief of pain, neuromusculoskeletal disorders and nausea. Covered services do not include chiropractic or acupuncture treatment for weight loss, sexual dysfunction, mental conditions such as depression, smoking cessation, drug or alcohol addiction or any other conditions not related to the relief of pain. Note: Routine chiropractic visits should not be confused with the Medicare-required covered Subluxation Chiropractic benefit. The Subluxation Chiropractic benefit is limited to specific diagnoses and may require a referral from a primary care physician. Please refer to the plan EOC for more information. For the Oxford Plan H provided through the Oxford Network and can be verified in the Provider Directory or by calling the Customer Service number: Note: If you are looking for a provider for Medicare-covered Chiropractic care, use the Medical Provider Search tool on Rally. There is a User Guide available. To get plan details, you may go to uhcmedicaresolutions.com where you will find the EOC and Summary of Benefits Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 12

OptumHealth Physical Health of California For plans in California, click on the Chiropractic/Acupuncture Providers: California link under the Ancillary Provider Searches section.

13 OptumHealth Physical Health of California For plans in California, click on the Chiropractic/Acupuncture Providers: California link under the Ancillary Provider Searches section. Click on Provider Locator Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 13

Enter in the Specialty, State and select UnitedHealthcare Medicare Solutions West (or further narrow by City, Zip Code, Provider's Name, or Clinic's Name). Click Submit.

14 Enter in the Specialty, State and select UnitedHealthcare Medicare Solutions West (or further narrow by City, Zip Code, Provider's Name, or Clinic's Name). Click Submit. System Response: Scroll down to see the results that list the provider s name, address, phone number, and the plans in which they participate (which we specified in our search). At the bottom of the screen, click the Back to Provider Locator button to begin a new search Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 14

OptumHealth Physical Health: Arizona, Hawaii, Nevada, New York, Oregon, Washington For plans in Arizona, Hawaii, Nevada, New York, Oregon and Washington, click on the Chiropractic/Acupuncture

15 OptumHealth Physical Health: Arizona, Hawaii, Nevada, New York, Oregon, Washington For plans in Arizona, Hawaii, Nevada, New York, Oregon and Washington, click on the Chiropractic/Acupuncture Providers link under the Ancillary Provider Searches section. Enter in the Specialty and State (or further narrow by City, Zip Code, Provider's Last Name, or Clinic's Name). Click Submit Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 15

16 System Response: Results will appear listing the provider s name, address, phone number, and the plans in which they participate. For these states, you will look for UnitedHealthcare Medicare Solutions or UnitedHealthcare Dual Complete plans. Plans that cover routine chiropractic and acupuncture services: UnitedHealthcare Medicare Solutions (West) UnitedHealthcare Medicare Solutions (OR) UnitedHealthcare Dual Complete (WA) UnitedHealthcare Dual Complete (AZ) UnitedHealthcare Dual Complete (HI) At the bottom of the screen, click the Back to Provider Locator button to begin a new search Confidential property of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Page 16

2016 Guide to Understanding Your Benefits

2016 Guide to Understanding Your Benefits Additional information about covered benefits available from Health Net Healthy Heart (HMO) Plan Yolo County, CA Lisa Pasillas-Le, Health Net We re part of your