PRO CARE HEALTH PLAN, INC. –
MEDICAID
PROVIDER DIRECTORY 2007
The Pro Care
Provider Directory gives you listings of Primary Care Physicians (PCP),
Specialists, Pharmacies, Hospitals and other health care providers that work
with Pro Care Health Plan, Inc. These are the people who can take care of you
when you are sick or work to keep you from getting sick. All Specialty and
Ancillary services must have a referral or prior authorization from your PCP or
Pro Care. If you have questions call us at 313-267-0300 (local) or
1-877-255-3055 (toll free).
Pro Care Health
Plan, Inc. – Medicaid
WELCOME LETTER
Dear New Member:
Welcome to Pro Care Health Plan. We look
forward to giving you the highest quality of care and service available.
The first step toward managing your health
care is selecting a Primary Care Physician (PCP). This will be the doctor that
you want to see for all your health care. PCP’s are doctors in the following
areas:
•
Family
or General Practice,
•
Internal
Medicine, Pediatrics, and/or
•
Obstetrics/Gynecology
If you haven’t selected a PCP through
Michigan ENROLLS, please call us at 313-267-0300 (local) or 1-877-255-3055
(toll free) and we will help you.
On the inside front and back covers, we
have a Quick Reference List of questions that you may have. It should help to
answer basic questions.
If you want a Certificate of Coverage, we
can mail it to you. You may also look at it on our website www.procarehp.com.
If you have any questions, please call us at 313-267-0300 (local) or
1-877-255-3055 (toll free).
Sincerely,
Member Services Division
Pro Care Health Plan
What Every Pro Care
Member Should Know – Quick Reference
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If You . . .
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Then . . .
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Have any questions
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Call us at 313-267-0300 (local) or 1-877-255-3055
(toll free)
|
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Need to choose a PCP
|
Call us at 313-267-0300 (local) or 1-877-255-3055
(toll free) for help. We can send you a copy of the Provider
Directory or you can go to our website www.procarehp.com.
The Provider Directory lists:
•
Names
of PCPs, Specialists, Hospitals and Ancillary providers (such as drug stores,
medical suppliers, home health care)
•
Addresses
•
Days
and hours open
•
Phone
numbers
•
Language
spoken
•
Any hospital affiliation
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Need to see a OB/GYN
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•
You may see an OB/GYN for annual well-woman examinations
and routine OB/GYN care without a referral from their PCP
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Need to request a change in my PCP
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Call us at 313-267-0300
(local) or 1-877-255-3055 (toll free). Remember:
•
Your assignment to a new PCP will be effective on the
first day of the following month if requested by the 15th of the
current month
•
You should verify the effective date of change with us
when you request the change
•
While the change is being made, you should continue to
see your current PCP
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|
Need to make an appointment
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•
Call your PCP’s office during regular business hours to
set up an appointment
•
Tell them that you are a Pro Care member
•
Tell them why you need to see your PCP
•
Call your PCP early in the morning for an appointment for
same day
•
Have your mihealth and Pro Care ID card available when
you call your PCP
•
Leave a message if your reach their answering machine
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Need to see a Specialist
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Ask your PCP for a referral. Your PCP will give it to
the specialist.
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Need a referral or authorization
|
Please remember:
•
You
must need the medical care
•
Your
PCP must approve your visit to a specialist or other provider
•
You
must have a referral from your PCP
•
A
referral from your PCP is also necessary for all follow-up care after
emergency treatment
•
Your
PCP will arrange for a second opinion if it is needed
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|
Are out of town and get sick or hurt
|
•
If
it is an emergency, you may go to the nearest hospital without a referral
•
Call
your PCP for a referral for all other out of area medical care needs
•
Call us at 1-313-267-0300 (local) or 1-877-255-3055
(toll free) if your PCP is not available
|
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Have an emergency (it’s so serious or life threatening
that delay might cause death or permanent harm)
|
•
Go
to the nearest emergency room or call 9-1-1
•
You
do not have to call us or your PCP
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Need transportation
|
•
Call 9-1-1 if you have a true medical emergency
•
If you need non-emergency transportation such as a ride
to get to your doctor’s appointment, please call us at 1-313-267-0300
(local) or 1-877-255-3055 (toll free). We will need:
o
to ask you some questions
o time
to schedule your ride
|
|
If You . . .
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Then . . .
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Need a prescription filled
|
•
Call us at 313-267-0300 (local) or 1-877-255-3055
(toll free) if you:
•
Have any questions about your drug coverage or
•
Need to know the Pharmacy nearest to you
•
Want a copy of the:
§ Drug
List (formulary) or
§ Provider
Directory
|
|
Need a list of providers for eye care
|
o Visit
any of the locations in the Provider Directory to get your vision services
and check-ups
o Call
us at 1-313-267-0300 (local) or 1-877-255-3055
(toll free). We cover routine eye tests, lenses and frames. You
can:
§ Visit
any of the locations in the Provider Directory to get your vision services
and check-ups
|
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Need Mental Health Care
|
•
Talk to your PCP or call us at 1-313-267-0300
(local) or 1-877-255-3055 (toll free). We cover up to
20 visits per year for outpatient mental health services
•
Go to the nearest emergency room if you have a mental
health emergency
|
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Think you are pregnant
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·
Call your PCP right away and have a pregnancy test
·
When you are sure you are going to have a baby:
•
Your PCP can help you choose a maternity care provider
•
It is important for the health of your baby to see your
maternity care provider as early as possible. Don’t delay!
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Have a baby
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•
Call your DHS caseworker to sign up your newborn baby in
the Medicaid program and have your baby enrolled with us
•
Get a new ID card for your baby
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Need to report changes in your family size, name, address
or telephone #
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Report the changes by
calling us at 313-267-0300 (local) or 1-877-255-3055
(toll free):
•
Changes in your family size must also be
reported to DHS and to us
|
|
Need to file a grievance or appeal
|
Call us at 313-267-0300 (local) or 1-877-255-3055
(toll free) or file a complaint directly with the
State of Michigan within 90 days of denial, reduction or termination of a
service.
|
|
Suspect Fraud and Abuse
|
Call us at 313-267-0300 (local) or 1-877-255-3055
(toll free). You may also report fraud and abuse directly to the State
of Michigan at:
Program Investigation Section
Capitol Commons Center Building
400 S. Pine Street, 6th Floor
Lansing, MI 48909
Toll Free: 1-866-428-0005
|
|
Want a family member or friend to ask Pro Care for your
personal health information
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You must give us written permission
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Need to look something up on the Website
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Go to our website www.procarehp.com
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Had your ID card stolen
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Call us immediately at 313-267-0300 or 1-877-255-3055
(toll free)
|
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Need help or have questions (diabetes, to quit smoking,
asthma)
|
Call us at 313-267-0300 or 1-877-255-3055
(toll free) and we will provide help
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PRO CARE HEALTH PLAN,
INC. – MEDICAID
PRIMARY CARE
PHYSICIANS (PCP) BY COUNTY
MACOMB COUNTY
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PHYSICIAN NAME
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ADDRESS
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PHONE #.
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OFFICE HOURS
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SPECIALITY
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LANUGAGES SPOKEN
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HOSPITAL AFFILIATION
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FAMILY PRACTICE
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Harris, Roger DO
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39880 Van Dyke #202
Sterling Heights MI 48313
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586-264-7930
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Mon, Thurs
8:30am to 5pm
Wed, 2:00pm to 5pm Sat, 8:30am to 12 noon
|
Family Practice
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English
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Madison Community Hospital, Oakland General
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Idrees, Eddie MD
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20966 Dequindre Rd. Warren MI 48091
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586-283-8777
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Mon, Wed, Fri
9am to 4:30 pm
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Family Practice
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English, Spanish
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Madison Community, Kern , Greater Detroit
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PEDIATRICS
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Rasheed, Abdur MD
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37300 Dequindre # 202
Sterling Heights MI 48310
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586-939-6899
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Mon – Fri 9am to 4pm
Sat 12pm to 2pm
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Pediatrics
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English, Ukrainian, Panjabi
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St John Macomb, HFHS Main
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Rasheed, Zehra MD
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37300 Dequindre # 202
Sterling Heights MI 48310
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586-939-6899
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Mon – Fri 9am to 4pm
Sat 12pm to 2pm
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Pediatrics
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English, Ukrainian, Panjabi
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St John Macomb, HFHS Main
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Provider
Directory October 2007
PRO CARE HEALTH PLAN,
INC. – MEDICAID
PRIMARY CARE
PHYSICIANS (BY COUNTY)
OAKLAND COUNTY
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PHYSICIAN NAME
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ADDRESS
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PHONE #.
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OFFICE HOURS
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SPECIALITY
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LANUGAGES SPOKEN
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HOSPITAL AFFILIATION
|
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FAMILY PRACTICE
|
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Asher, Chitra A MD
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29600 Wixom Rd.
Wixom MI 48393
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248-668-1900
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Mon – Fri 6am to 10pm
Sat and Sun 8am to 8pm
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Family Practice
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English
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Botsford, Garden City
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Khaneja-Sharrow, Rita MD
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29600 Wixom Rd.
Wixom MI 48393
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248-668-1900
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Mon – Fri 6am to 10pm
Sat and Sun 8am to 8pm
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Family Practice
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English
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Botsford
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GENERAL PRACTICE
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Schwartz, Louis W DO
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29600 Wixom Rd.
Wixom MI 48393
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248-668-1900
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Mon – Fri 6am to 10pm
Sat and Sun 8am to 8pm
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Family Practice
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English
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Detroit Receiving, Harper
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INTERNAL MEDICINE
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Ansar-Ghazi, Samina MD
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33110 W 12 Mile
Farmington MI 48334
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248-489-9070
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Mon – Tues 9am to 5pm
Thurs – Sat 9am to 5pm
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Internal Medicine
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English, Ukrainian
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Huron Valley
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Arriola, Lourdes
W MD
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30852 W. 10 Mile
Farmington MI 48336
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248-477-0112
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Mon. 9:30am to 6pm
Wed. 9:00am to 6pm
Thur. 1pm to 6pm
Fri. 9am to 5pm
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Internal Medicine
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English, Taglog, Spanish
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Detroit Riverview
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INTERNAL MEDICINE
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|
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Dubin, Howard L DO
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27483 Dequindre
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248-548-9860
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Mon – Fri 8:30am to 4:30pm
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Internal Medicine
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English
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Detroit Receiving, Harper
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Madison Hts. MI 48071
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Greenspan, Elliot DO
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29600 Wixom Rd.
Wixom MI 48393
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248-668-1900
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Mon – Fri 9am to 5:30pm
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Internal Medicine
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English
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Botsford, Garden City
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Gullapalli, Sarada MD
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20307 W. 12 Mile Rd.
Southfield MI 48034
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248-352-9400
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Mon – Fri 9:30am to 5pm
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Internal Medicine
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English, Telugu
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St Mary Mercy Livonia
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Porter, Angela MD
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20905 Greenfield Rd.
Southfield MI 48075
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248-557-0507
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Mon – Fri 9am to 5pm
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Internal Medicine
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English
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Sinai Grace
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White, Oronde MD
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29556 Southfield MI 48076
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248-663-6582
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Mon-Fri 9am-5pm
Sat 9am-2pm
Sun 12pm-4pm
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Internal Medicine
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English
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Sinai Grace
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OB/GYN
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Anderson, William G. DO
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27209 Lahser Ste 226
Southfield MI 48034
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248-353-0220
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Mon, Wed – Fri 9am to 5pm
Tues 9am to 6pm
|
GYN
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English
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Detroit Receiving
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PRO CARE HEALTH PLAN,
INC. – MEDICAID
PRIMARY CARE
PHYSICIANS (BY COUNTY)
WAYNE COUNTY
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|
PHYSICIAN NAME
|
ADDRESS
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PHONE #.
|
OFFICE HOURS
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SPECIALITY
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LANUGAGES SPOKEN
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HOSPITAL AFFILIATION
|
|
FAMILY PRACTICE
|
|
Abellana, Eduardo C MD
|
11180 Gratiot
Detroit MI 48213
|
313-372-7111
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Mon – Fri 9am to 5pm
|
Family Practice
|
English
|
Detroit Riverview, Oakwood Main
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|
Aguirre, Antonio A MD
|
1475 Ford Av
Wyandotte MI 48192
|
734-284-8686
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Mon – Fri 9am to 5pm
|
Family Practice
|
English, Taglog
|
Oakwood Main
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|
Ambrosia, Angela E MD
|
2500 Hamlin ct
Inkster MI 48141
|
313-561-5100
|
Mon, Tues, Thurs,
Fri 9am to 6pm
Wed. 11:30am to 8pm
|
Family Practice
|
English
|
Oakwood Main, Annapolis
|
|
Aprahamian, David A DO
|
20548 Fenkell
Detroit MI 48223
|
313-255-3333
|
Mon – Fri 8am to 5pm
Wed 9am to 1pm
|
Family Practice
|
English
|
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Betts, Margaret L MD
|
6001 W Outer Dr # 114
Detroit MI 48235
|
313-345-8880
|
Mon 9am to 8pm
Fri 9am to 5pm
Sat 10am to 2:30pm
|
Internal Medicine
|
English
|
Sinai Grace
|
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Brown, Richard M DO
|
12871 E. Jefferson
Detroit MI 48215
|
313-821-3900
|
Mon, Tues, Fri 9am to 5pm
|
Family Practice
|
English
|
Detroit Riverview
|
|
Brown, Richard M DO
|
8305 Grand River
|
313-894-1900
|
Mon – Fri 9am to 5pm
|
Family Practice
|
English
|
Detroit Riverview
|
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Detroit MI 48204
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Bryant, Everett V MD
|
4241 Maple Rd. Ste 200D
Dearborn MI 48126
|
313-584-1945
|
Mon – Fri 8am to 4pm
|
General Practice
|
English
|
Detroit Riverview
|
|
Bussey Riley, Annie M MD
|
2051 W. Grand Blvd.
Detroit MI 48208
|
313-894-4244
|
Mon, Tue, Wed
9am to 1pm
|
Family Practice
|
English
|
Detroit Riverview, HFH Wyandotte
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|
Bussey Riley, Annie M MD
|
20901 W. 7 Mile Rd.
Detroit MI 48219
|
313-532-2000
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Mon, Wed, Fri
9am to 5pm
|
Family Practice
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