UnitedHealthcare Connected® for MyCare Ohio(메디케어-메디케이드 플랜)

독감 예방 주사

인플루엔자는 심각한 질병이지만 간단한 주사로 쉽게 예방할 수 있습니다.

• 독감 예방 주사 접종에 가장 좋은 시기는 독감 시즌이 시작하기 전입니다. 귀하에게 적합한 접종 방식이 무엇인지 의사와 상담하십시오, 접종 시 세부 사항에 대한 기록을 원할 수도 있으며 매년 같은 시기에 접종을 계획할 수도 있습니다.
• 독감 예방 주사 접종은 보험 약관에 의해 보장됩니다. 예약과 관련하여 도움을 받으려면 회원 ID 카드 뒤에 있는 무료 전화번호로 전화를 하십시오. 의료 상담 직원이 매일 오전 8부터 오후 8까지 여러분을 돕기 위해 대기 중입니다.

독감 예방 주사 접종을 위해 의사를 만날 시간이 없습니까? 독감 예방주사를 접종할 수 있는 장소의 목록을 확인해 보십시오.

독감 예방주사 접종 장소

UnitedHealthcare Care Managers for Member's Unique Needs

Every UnitedHealthcare MyCare Ohio member receives a personal representative. These Care Managers are licensed professionals providing education and coordination of UnitedHealthcare Connected^® for MyCare Ohio (Medicare Medicaid Plan) benefits, tailored for each member's unique needs.

Click here to watch a video on how these Care Managers are helping current members.

UnitedHealthcare Member Advisory Council and "Connected Advisors"

UnitedHealthcare Member Advisory Council and "Connected Advisors" is an advisory council to ensure that UnitedHealthcare actively engages consumers, families, advocacy groups, and other key stakeholders as partners in the program design and delivery system.

Who is involved?

• Any members, or a member's representative, are eligible to participate.
• There are no term limits for participation.
• Representatives from member stakeholder or advocacy organizations.
• Representation reflects the diversity of the member population including: race, ethnicity, religion, sexual orientation, gender, disability (physical or mental), age, parental status, or genetic information.

They will advise and guide the UnitedHealthcare Community Plan of Ohio on:

• Clinical design and delivery
• Strategies to support members in the community
• Abuse and neglect initiatives
• Promote member-centric culture
• Provide input regarding research and best practices

How is it organized?

• One statewide council
• Three local groups of "Connected Advisors" with representation in the Northeast (Cuyahoga, Geauga, Lake, Lorain, and Medina counties); Northeast Central (Columbiana, Mahoning, and Trumbull counties); and East Central (Portage, Stark, Summit, and Wayne counties) MyCare Ohio regions.

What will they do?

• Participate in quarterly conference calls
• Receive electronic or printed newsletter(s).
• Attend three in-person, regional meetings held annually (UnitedHealthcare will provide a travel stipend at the request of a member. The amount of the stipend will follow the guidelines of the appropriate state governing rules and guidelines).
• There is no cost for participation.
• Decisions of the Member Council and Connected Advisors will be made by simple majority vote of members present.
• One member will be appointed/elected to participate in UnitedHealthcare's National Peer Ambassador program. The goal of a peer ambassador program is to elevate and empower members through meaningful dialogue, information exchange, and inclusion in the development of best practices, innovations, and delivery/design in promotion of a member-centered culture. The Community and National Peer Ambassadors connect virtually (via conference or web-based technology) to share experiences and insights regarding opportunities to better the quality of life and experience of the populations we serve. We leverage recommendations and insights shared by the Ambassadors to support improved outcomes and experiences in the promotion of a member-centered culture. The Ambassadors do not receive compensation for service in the ambassador role.

To learn more about UnitedHealthcare's Member Advisory Council and "Connected Advisors," or get involved, get information at https://member.uhc.com/communityplan or call Member Services at 1-877-542-9236 (TTY 711).

사기, 낭비 및 남용

Healthcare fraud, waste and abuse affects everyone. Combating it begins with awareness.

Fraud is committed when a dishonest provider or consumer intentionally submits, or causes someone else to submit, false or misleading information for use in determining the amount of health care benefits.

Waste is the over-utilization of services not caused by criminally negligent actions and the misuse of resources. 

Abuse is provider practices that are inconsistent with professional standards of care: medical necessity, or sound fiscal, business, or medical practices and provider or beneficiary practices that result in unnecessary costs to the healthcare program.

What is provider fraud, waste and abuse?

• Billing for services not rendered
• Upcoding (billing for more expensive services or procedures than were actually provided or performed)
• Soliciting, offering or receiving kickbacks
• Improper or sloppy billing practices
• Failure to maintain adequate records
• Routine waiver of coinsurance and deductible

What is member fraud, waste and abuse?

• Loaning or using another person's insurance card
• Forging or selling prescription drugs
• Providing false information when applying for program benefits

UnitedHealthcare Community Plan is committed to combating fraud, waste and abuse. If you suspect health care fraud, waste and abuse, you may report via the following methods:

• Ethics Hotline: 1-866-242-7727

Clinical Care Guidelines

주산기 의료

American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, Sixth Edition, Guidelines for Perinatal Care

Preventive Services Guideline

Guide to Clinical Preventive Services – US Preventive Services Task Force (USPSTF)

Agency for Healthcare Research and Quality

For a description of the UnitedHealthcare practice guidelines, please write to:

UnitedHealthcare Community Plan Quality Improvement
5900 Parkwood Place
Dublin, OH 43016