Your Guide to Important

Health Plan Enhancements ook

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NEW

A New
Direction
 New name
 New member ID cards
 New website
 My Online ServicesSM

 New Explanation of Benefits

 New phone numbers
A publication for commercial members
CHGS2113 (04-10)
 Welcome to
Coventry Health Care of Florida
Since 2007 VISTA* has been a wholly-owned subsidiary of Coventry Health Care.
As a national diversified healthcare company, Coventry Health Care serves more
than 5 million members across the U.S.
To further embrace Coventry’s national reputation and leadership position in
the industry, we will now be known as Coventry Health Care of Florida. The new
name reflects the strength of our parent company and shows that we have a local
presence - assuring our customers that we will continue to provide the flexibility and
convenience that comes from working with a Florida-based company.

Coventry Health Care of Florida is dedicated to providing you with the best
value for your health care investment and we are pleased to offer you
enhanced benefits and service capabilities, designed to improve your overall
experience with us. For your convenience, you can learn about all of our great new
features in this publication.
If you have any questions about the
benefit and service enhancements
featured in this guide, please call the
Customer Service number on your
ID card, Monday through Friday from
8 a.m. to 6 p.m.

Welcome to
Coventry Health Care of Florida!

* VISTA companies include Vista Healthplan, Inc.

and Vista Healthplan of South Florida, Inc.

1 Your guide to important health plan enhancements

New Member ID Cards
Towards the end of May, you and each of your covered dependents will receive a new member ID
card with the Coventry Health Care of Florida name. The ID card, which will be effective June 1st, will
also contain important information that you will need to access health care services, including:
• New member ID number
• New group number
• Customer service telephone number
• New pharmacy benefit manager logo and information

Please review the card carefully and call Customer Service if corrections are needed. The phone
number is on the front of your ID Card.

Be sure to discard your old ID card and beginning June 1st, provide the new card to your
health care providers and pharmacy.

Coventry Health Care of Florida 2

 Coming June 2010 . . .
New Website!
We are pleased to announce that we’re launching a new public website. The redesigned website will
be more user-friendly, making it easier to navigate through the features and access the information
you need.

Your new online experience will begin June 1st at www.chcflorida.com.

Learn more
about My Online
Services in the
article on the
next page.

3 Your guide to important health plan enhancements

My Online Services
Effective June 1st, advanced website tools
are just a click away at

www.chcflorida.com
Beginning June 1st, you will have access to
My Online Services - our new secure member
portal! My Online Services makes it easier for
you to find, use and manage your personal health
and benefits information.

• print or request an ID card

• change your primary care physician
• view recent claims
• locate a participating provider or pharmacy
• access links to health and wellness resources

How do you register?

1) go to www.chcflorida.com
2) find My Online Services

3) click Login or Register Now

Coventry Health Care of Florida 4

 Explanation of Benefits 1 The address to which the EOB
was mailed.

2 Group Name - the payor of your medical

claim. If your company is a self-funded
In most cases, when you or a covered dependent access health care group, their name will appear here.
services, you receive an Explanation of Benefits (EOB). The EOB
3 Insured - the person who holds the
explains how your medical claims, including payments and denials, contract with the insurer.
are processed. An Explanation of Benefits is not a bill. You should
4 Patient - the person who received
always review your EOB to make sure that you received the medical services. This may be a
services for which your health plan is being billed. subscriber or a dependent.

5 ID Number - the identification for the

To help familiarize you with the format of an EOB, we have included person receiving medical services.
a sample below.
6 Claim Number - document control
number generated by Coventry Health
Care. If you need to call a member
service representative to discuss the
claim, this is an important number to
give them.

7 Provider - the provider of your medical

service. This could be an individual
practice or facility.

8 Member Responsibility - this is the

amount the member is responsible
to pay the provider.

9 Date - the date your medical services

were incurred.

10 Procedure Code/Description - the

coverage category for which the code
is classified.

11 Billed Amount - the total amount billed

to Coventry Health Care by your
physician.

12 Contractual Adjustment - reductions in

payment due to network savings,
coordination of benefits, or non-covered
services. For more information, see
number 19, Cont. Rmk/Other Rmk.

13 Approved Amount - the amount

Coventry agrees to pay the provide for
services rendered minus copays,
coinsurance or deductibles,
if applicable.

14 Less Copay

15 Less Coinsurance

16 Less Deductible

17 Less Other Amounts

18 Plan Paid - the amount paid by

your plan.

19 Cont. Rmk/Other Rmk - a Coventry

Health Care code that explains why
certain amounts were not covered.

5 Your guide to important health plan enhancements

We are here to help
If you have a question or need information, there are several ways to obtain assistance. Some of
our contact information is changing and the list below is effective June 1st. If you need assistance
before June 1st, please refer to the phone numbers listed on your current member ID card.

Via the Internet

effective June 1st
www.chcflorida.com

By Phone
Customer Service 866-847-8235
TDD Line for all members 888-444-7352
Customer service representatives are available Monday through Friday from 8 a.m. to 6 p.m.

Employees of the groups listed below should use the appropriate corresponding number:
AutoNation 866-575-1878
Broward County Government 866-575-1877
Broward Sheriff’s Office 866-575-1870
Federal Government 866-575-1882
Publix Super Markets 888-679-9148
School Board of Broward County 800-547-0852
State of Florida 866-575-1875

By Mail
Customer Service
1340 Concord Terrace
Sunrise, FL 33323

Coventry Health Care of Florida 6

1340 Concord Terrace
Sunrise, FL 33323

CHGS2113 (04-10)

Other Important Numbers

Coventry Pharmacy Customer Service
866-847-8279
Monday through Friday from 8 a.m. to 5:30 p.m.

Behavioral Health Services

Psychcare 800-221-5487
Monday through Friday from 8:30 a.m. to 5:30 p.m.

MHNet 800-835-2094
(PPO members, Broward Sheriff’s Office and
School Board of Broward County employees)
Monday through Friday from 8 a.m. to 7 p.m.

Dental - Member Services

800-848-3480
Monday through Friday from 8 a.m. to 6 p.m.