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About Siletz tribal newspaper. (Siletz, Oregon) 1997-1997 | View Entire Issue (July 1, 1997)
Page 4~~Siletz Tribal Newspaper CLINIC NEWS CONTRACT HEALTH SERVICES by Tamara Morrow, CHS Technician II Just a reminder to tribal members who receive "Contract Health Services". Please remember to give the Vendors (Doctors offices) all the information they need to send the bills to us. We have had a few bills go to collections because no coverage information was given at the time services were rendered. Vendors will send a follow up request for added information if they don’t have an insurance company to bill. Please fill in the added information on bill and send it back (if you did not in the doctor’s office)or send us the bill, so it does not go to collections; ! ■ Reasons why a bill cpuld go into collection: (1) . Correct information was not given to Vendor (Doctor office). (2) . It was a support service from hospital for same date such as: x-ray, lab, anesthesiologist etc. and that office did not receive patients coverage information. ’.(3). The Vendor did not bill Contract Health. ' ■ t (4) . Patient did not get prior authorization from Contract Health Services.. „ (5) . Corvallis Clinic will not bill Contract Health if patient has Primary Insurance so patient is responsible for getting bill to Contract Health office. RRMRMB'ER. You must call Contract Health Services within 24 hours after you have been to a Doctor if you haven’t received prior authorization from Contract Health Services. You m ust call Contract HealthServices within 72 hours after you have received help in an emergency room. Failure to do this may make you ineligible for Contract Health Services. You can send bills to: Contract Health Services PO Box 549 Siletz Oregon 97380 , ■■ j CONTRACT HEALTH SERVICES For Tribal members 25 miles or more from tribal clinic by Tamara Morrow, CHS Technician II MEDICAL: You may see any medical doctor as long as they are not a specialist. I f your regular medical doctor wants to refer you to a specialist, you need a referral for the gatekeeping review, which meets every Wednesday morning at 8:30a.m., ail request need to be received in CHS office no later than Tuesday 4:30p.m., chart notes with the doctor’s request should be included such as, if physical therapy how many visits etc.... . EYE - CARE: Contract Health will pay $175.00 for Glasses /Contacts every two (2) years and up to $75.00 repair every two (2) years. I f you are a student or elder (55 or older) you are eligible every year. Eye exams are paid 100%. You must: see a regular eye doctor and not a specialist; EYE - CAKE ELDERS OUT OF SERVICE AREA: If you are an elder (55 or older) and do not live in the following counties in Oregon: Lincoln, Tillamook, Marion, Polk, Yamhill, Linn, Lane, Benton, Multnomah, Washington, and Clackamas, then you are eligible-to receive a one time-JiiisiLspnly:.eye exam and. up to $175.QQ fQt„^as^es^ ThiLfi^anx ma-y be done by a ophthalmologist, since patients. Please send receipjs^to: C ontract Healih Services, PO Box 549, Siletz Oregco 97380. I f you have services rendered and have paid for the services ll is an,authorization number from us prior to your appointment and We will pay the vendor. This is being done due to carry over monies, so can end without notice. DENTAL: You may see any dentist as long as they axe not a specialist: Some procedure codes are not covered and you will be required to go to an Indian Clinic, so we will need a treatment plan sent to us after your first initial visit Any questions please feel free to call Contract Health Servicesat:!-800-628-5720 or 541-444-1236. ER GATEKEEPING SERVICE DISCONTINUED Effective August 1 5 ,1 9 9 7 Siletz Tribal Health, Contract Health Services program will no longer sponsor the after hours emergency telephone gatekeeper service. Siletz Community Health Clinic providers will not be available for emeigency medical consultation during evenings or weekends. Contract Health Services patients are encouraged to call your local urgent care center or hospital emergency room if you need advice or assistance. Please remember to call CHS within 72 hours of an emergency room visit. Bills for services which have not been reported may be denied payment. . ( Medical appropriateness of emergency room visits will continue to be reviewed before payment. Therefore it is advisable that patients w ho rely on contract health services for payment of medical expenses carefully assess the urgency of the problem or condition. Statistically, the majority of ER visits are determined inappropriate because treatment should have been sought from a primary care provider. . , To pre-authorize treatment, or to report an emergency room visit call: CHS (541) 4 4 4 -1 2 3 6 or (800) 6 2 8 -5 7 2 0 . To schedule a primary care visit call: Siletz Community Health Clinic (541) 4 4 4 -1 0 3 0 or (800) 648-0449- Tooth Talk T hou g ht ’ s on bad breath By Linda Kreutzer Have you ever wondered what causes had breath? It’s GERMSI Better known as bacteria. Why do they smell? The odor from bacteria is really the odor from the waste products of the bacteria Germs eat?grow, multiply and get rid of waste, just like any other living thing. How can w e control bacteria? By controlling plaque. Plaque is the sticky, whitish deposit left behind on our teeth after eating sugar. The more sugar w e eat, the more plaque our mouth’s produce. Plaque is made o f bacteria or GERMS. How do w e control plaque? By eating less sugar. Drinking less pop with sugar. Good brushing and flossing are very important in keeping plaque buildup to a minimum. Plaque is alpt like battery acid. It’s strong enough to eat into our teeth, causing decay, and make our gums bleed. It’s GERMS that do all o f that destruction! AND THEY STINKI Brushing ri especially important in the morning. Morning mouth is caused by the buildup of plaque during the night. There has been no food or drink or movement of the tongue to help clean your teeth. Have you ever wondered w hy morning breath smells like, wefl.....poop? Because it is! It’s the germs going to the bathroom all n ig h t. Not a pleasant thing to think about. Optomery News: How often do I need my eyes examined? In general the following guidlines are used. All children should have a vision exam before starting school whether it is head start of kindergarten. If they are wearing glasses then a yearly eye exam is recomended and for students not wearing glasses an exam is indicated every two to four years. The schqol usually sponsers a vision screening but this does not take the place o f a comprehensive eye exam. Adults should haye a vision exam every two to three years routinley and more often if they have diabetes or an other health condition that may effect the eyes. Patients with glaucoma are seen more often as well as those with hypertension. Patients over age 60 are seen yearly for an exam. To sched ule an eye exam call the Siletz clinic at 4 4 4 -1 0 3 0 . (
