| How do I choose a PCP and where can I get physician information? |
If you have questions regarding a PCP in the Saint Francis Hospital network you can contact the Saint Francis referral line at (918) 494-5463. If you are looking for a PCP in the St. John Hospital network you can contact the St. John’s PulseLine at (918) 744-0123. For Springer Clinc physicians please contact the referral line at (918) 499-4444.
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| How do I change my PCP? |
If you decide to change your PCP, you may choose another PCP in the same physician network by calling Member Services at 1-800-777-4890. If you call by the 15th of the month, the change will become effective the first day of the month following your request.
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| What is the difference between “formulary” and “non-formulary” drugs? |
A formulary is a listing of preferred drug. Non-formulary drugs are not on the preferred list of drugs. There are three types of formulary drugs:
- formulary - generic drugs that are covered at the lowest co-payment on your plan,
- formulary-name brand – there is no generic available and prescription is covered at the middle co-payment, and
- formulary brand – there is a generic available, but you choose to use the brand name drug and the prescription is covered at the highest co-payment.
Non-formulary drugs are subject to the highest co-payment and there are limitations and exclusions that could apply. Each PCPs office is equipped with a full formulary listing. Please discuss your prescription with your doctor or you can contact the Pharmacy Help Desk at 1-877-293-8628, 8 a.m. - 6 p.m., Monday through Friday.
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| What do I do in case of emergency? |
If the situation is not life, limb or organ threatening, call your PCP and he will direct your care. If your medical problem is determined to be an emergency go to the nearest emergency facility, have the facility call your PCP and he will then coordinate your care.
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| Do I have any vision benefit with CommunityCare? |
Each member is allowed one vision screening per 12-month period. The benefit includes vision and glaucoma tests and refraction for glasses. To obtain a list of providers for your area, you may call Member Services at (918) 594-5242, Monday – Friday, 8 a.m. – 5 p.m. If your optometrist finds a potential medical problem with your eyes, you will need to contact your PCP for further treatment options.
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| How do I order replacement cards? |
If the information on your cards is not correct, your card is lost or stolen, or if you have questions about your cards, please contact Members Services.
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| Who do I contact when I have questions specific to my needs? |
| Member Services: | (918) 594-5242 (Tulsa)
1-800-777-4890 (Statewide)
Monday – Friday, 8 a.m. – 5 p.m. | | Behavioral Health Services: | (918) 594-5262 (Tulsa)
1-800-774-2677 (Statewide)
Answered 24 hours a day/7 days a week | | Pharmacy Help Desk: | 1-877-293-8628
Monday – Friday, 8 a.m. – 5 p.m. |
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