BadgerCare Plus - Care4Kids · qauv lossis xav tau kev pab txog kev siv peb cov kev pab, thov tiv toj Chaw Pab Cuam Tswvcuab ntawm 1-800-482-8010. Children’s Community Health Plan

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Tshaj Ntawv Sau

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Children’s Community Health Plan tsis muaj kev sib cais raws li qhov xiam oos qhab txog muab cov kev saib xyuas, cov kev pab lossis kev kho mob rau. Yog tias koj xav tau cov ntawv luam tawm uas tau muab txhais, ua lwm yam qauv lossis xav tau kev pab txog kev siv peb cov kev pab, thov tiv toj Chaw Pab Cuam Tswvcuab ntawm 1-800-482-8010. Children’s Community Health Plan PO Box 56099 Madison, WI 53705 www.childrenscommunityhealthplan.org Cov kev pab cuam txhais lus Cov kev pab cuam txhais lus tau muaj pub dawb rau koj. Hu rau 1-800-482-8010. Yog tias koj yog neeg tsis hnov lus zoo, hu rau Wisconsin Lub Chaw Pab Hu Xovtooj ntawm 7-1-1. Children’s Community Health Plan (CCHP) muab cov kev pab cuam txhais lus rau cov tswvcuab uas tsis paub lus Askiv zoo (LEP), lossis cov neeg uas dig muag thiab tsis hnov lus zoo, tsis paub hais lus zoo, lossis tsis pom kev zoo yam tsis tau them nqi rau tus tswvcuab thaum lub sij hawm kho mob, thiab kom paub tseeb tias qhov kev ntsuas muaj txiaj ntsig zoo rau cov kev pab kho mob hla


cov kev sib txuas lus muaj txiaj ntsig zoo. Cov kev pab txhais lus muaj hauv kev hu xovtooj nrog Lub Chaw Pab Cuam Tswvcuab, txog cov kev tiv toj nrog CCHP cov kev pab Tswj Hwm Kab Mob thiab Tswj Hwm Kev Kho Mob, thiab thoob plaws cov txheej txheem sau ntawv tsis txaus siab thiab ntawv foob. Nws yog tsab cai ntawm CCHP kom siv cov cuab yeej pab txhais lus muaj txiaj ntsig zoo. Koj Tus Menyuam Cov Cai Yog Ib Tug Pej Xeem Care4Kids muab cov kev pab them nyiaj rau txhua tus tswvcuab muaj cai hais txog cov txuas ntxiv no: • Hnub Nyoog • Cev Nqaij Daim Tawv • Kev Xiam Oos Qhab • Lub tebchaws yug • Haiv neeg • Pojniam Txivneej

Txhua cov kev pab them nyiaj rau cov kev kho mob tsim nyog muaj thiab tau muab ib yam nkaus rau txhua tus tswvcuab. Txhua tus neeg lossis cov koom haum ua haujlwm nrog Care4Kids uas hais txog lossis qhia rau kom muab cov kev pab yuav tsum ua li no hauv tib qho rau txhua tus tswvcuab.


Cov cai txog kev yeem ntawm tus kheej rho npe Tus menyuam niamtxiv/tus saib xyuas raug cai muaj cai yeem ntawm tus kheej rho npe lawv tus menyuam ntawm qhov Care4Kids tau txhua lub sij hawm rau ib qho laj thawj twg. Hnub tim ntawm qhov kev rho npe yuav tsum yog hnub kawg ntawm lub hli uas tau sau ntawv thov rho npe tawm. Yog tias koj xav thov rho pe koj tus menyuam tawm ntawm Care4Kids, thov tiv toj rau Care4Kids Tus kws rau npe nkag tshwj xeeb ntawm 1-800-291-2002.


Cov npawb xovtooj tseem ceeb Lub Chaw Pab Cuam Tswvcuab ............. 1-800-482-8010 Monday – Thursday: 7:30 teev sawv ntxov txog 5 teev tsaus ntuj Friday: 8 teev sawv ntxov txog 4:30 teev tsaus ntuj Lub Chaw Pab Cuam Cov Neeg Yuav Khoom Tuaj Yeem Pab Koj tau li cas? • Xaiv lossis hloov pauv thawj tus kws kho mob • Cov kev pab cuam txhais lus • Cov lus nug txog cov nyiaj pab • Taug kev tawm ntawm thaj chaw • Cov kev pab cuam kho mob hlwb, quav dej cawv

lossis lwm yam yeeb tshuaj Care 4 Kids Pab Pawg Khiav Haujlwm Pab Kho Mob 1-855-371-8104 Cov Tswvcuab Tsis Hnov Lus Zoo – Hu Rau Wisconsin Tus Npawb Pab Hu Xovtooj ....................................... 7-1-1 Xwm txheej kub ntxhov – Hu tau 24 teev hauv ib hnub, xya hnub hauv ib lim tiam .......................... 1-877-257-5861 Yog tias muaj mob hnyav, hu rau 911.


CCHP Tus Npawb Hu Kws Tu Neeg Mob (hu tau 24/7) –1-877-257-5861 Kev ntsuas qhov muag yog tias hu tuaj ntawm 414 tus npawb thaj chaw ....................................... 1-414-462-2500 Kev kuaj qhov muag yog tias hu sab nrauv 414 tus npawb thaj chaw ................................................... 1-800-822-7228 Qhov kev pab teem caij kho hniav ............. 1-877-389-9870 Kev pab cuam caij tsheb mus los .............. 1-866-907-1493 Tus kws rau npe nkag tshwj xeeb .............. 1-800-291-2002 Lub Xeev Qhov Kev Pab Ombudsman ..... 1-800-760-0001 Cov Kev Pab Cuam Kuaj Mob - 24 tau txais cov ntawv hauv 24 teev ............................................. 1-877-227-1142 Nias rau qhov kev xaiv #2 txhawm rau sau ntawv txog koj daim ntawv thov cov kev pab. Cov lus sau tseg rau hauv xovtooj, fev thiab muab xa hauv email tom qab sij hawm lawj haujlwm yuav tau teb rau hnub ua haujlwm txuas ntxiv tom ntej. Cov ntawv sau uas xa tom qab ib tag hmo hnub Monday – Friday yuav muab sa rov qab nyob hauv tib hnub.


Thawj tus kws kho mob Nov yog ib qho tseem ceeb kom hu rau koj tus menyuam thawj tus kws kho mob (PCP) ua ntej thaum lawv xav tau kev pab. Tus kws kho mob no yuav tuav tswj txhua yam ntawm koj tus menyuam li kev noj qab haus huv. Yog tias koj tus menyuam tsis yog tus neeg mob saib xyuas tas li ntawm tus kws kho mob uas koj xaiv, nws yog ib qho zoo tshaj plaws kom teem caij ntsib sai npaum li sai tau. Koj tus menyuam tus PCP tuaj yeem pab koj xaiv seb koj tus menyuam puas yuav tsum tau mus ntsib lwm tus kws kho mob lossis kws kho mob tshwj xeeb thiab, yog tias tsim nyog, sau ib tsab ntawv xa mus. Nco ntsoov tias koj yuav tsum tau txais kev tso cai los ntawm koj tus menyuam tus PCP ua ntej mus ntsib lwm tus kws kho mob. Koj tuaj yeem xaiv koj tus menyuam tus PCP ntawm cov kws kho mob uas lees txais cov neeg mob tshiab raws li ntaus cim hauv cov npe kws kho mob. Koj tuaj yeem xaiv koj tus menyuam thawj tus kws kho mob los ntawm cov kws kho mob uas muaj no. Ntxiv rau qhov kev xaiv koj tus menyuam thawj tus kws kho mob, pojniam kuj tseem yuav tau txais tus kws kho mob tshwj xeeb uas yog pojniam xws li OB/GYN lossis cov pab yug menyuam yam tsis tas yuav xa mus.


Care4Kids cov kws kho mob yog cov mob siab rau txog qhov xav tau raws kab lis kev cai. Txhawm rau xaiv thawj tus kws kho mob lossis txhawm rau hloov pauv cov kws kho mob, hu rau Chaw Pab Cuam Tswvcuab ntawm 1-800-482-8010 lossis Pab Pawg Dhia Dej Num Saib Xyuas Kev Kho Mob ntawm 1-855-371-8104. Kev hloov koj tus menyuam tus kws kho mob Yog tias koj tsis txaus siab nrog tus kws kho mob uas koj tus menyuam mus ntsib, koj tuaj yeem hloov lwm tus kws kho mob tau txhua lub sij hawm. Hu rau Chaw pab cuam tswvcuab ntawm 1-800-482-8010 lossis Pab Pawg Saib Xyuas Kev Kho Mob ntawm 1-855-371-8104. Kev tsis tuaj ntsib raws qhov teem caij Nws yog ib qho tseem ceeb uas koj yuav tau ua raws li koj tus menyuam txhua qhov teem caij ntsib. Yog tias koj tsis muaj peev xwm ua raws qhov teem caij ntsib, hu rau kws kho mob lub chaw haujlwm sai npaum li sai tau. Kev tau txais lub tswv yim kho mob thib ob Yog tias koj tus menyuam li niam txiv/tus neeg saib xyuas raug cai thiab tsis pom zoo nrog koj tus menyuam tus kws kho mob cov lus qhia kho mob, koj tuaj yeem tau txais lub tswv yim kho mob thib ob. Tiv toj rau koj tus menyuam tus kws kho mob lossis Pab Pawg Ua Haujlwm Saib Xyuas


Kev Kho Mob ntawm 1-855-371-8104 kom paub ntau ntxiv. Kev xa mus kho Koj tus menyuam thawj tus kws kho mob pab koj dhia dej num txhua yam ntawm koj tus menyuam li kev noj qab haus huv raws li qhov xav tau. Yog tias koj tus menyuam yuav tsum mus cuag kws kho mob tshwj xeeb, tus kws kho tus cwj pwm lossis mus rau hauv tsev kho mob, koj thawj tus kws kho mob tuaj yeem pab koj nrhiav ib tug ntawm peb cov kws kho mob tshwj xeeb lossis cov tsev khomob koom tes nrog. CCHP yuav tsum kom peb cov tswvcuab siv cov kws kho mob nyob hauv cov koom tes nrog yog tias qhov kev pab yog yam uas raug pab them nyiaj. Yog tias peb tsis muaj tus kws kho mob uas tuaj yeem pab koj nrog rau kev pab them nyiaj, ces kuj yuav txiav txim siab tso cai rau mus cuag kws kho mob sab nraud cov koom tes nrog. Txhawm rau pab nrhiav thawj tus kws kho mob, tus kws khomob tshwj xeeb, hu rau Chaw Pab Cuam Tswvcuab ntawm 1-800-482-8010 lossis Pab Pawg Dhia Dej Num Kho Mob ntawm 1-855-371-8104. Koj kuj tseem tuaj yeem mus nrhiav cov npe kws kho mob lossis mus rau hauv peb tus website www.childrenscommunityhealthplan.org thiab nias rau ntawm qhov sau tias “Find a Doc”. Koj yuav tsum tau txais


kev tso cai tshwj xeeb mus cuag lwm tus kws kho mob uas tsis yog CCHP cov kws kho mob. Kev kho mob xwm txheej kub ntxhov Thov ua tib zoo nyeem cov nqi lus no. Peb xav kom koj kawm paub txog yam yuav tsum tau ua hauv qhov xwm txheej kub ntxhov ua ntej nws yuav tshwm sim. Kev kho mob xwm txheej kub ntxhov yog yam kev kho mob uas xav tau kiag tam sim. Qhov no vim yog muaj qhov kev raug mob lossis mob hnyav sai sai. Muaj qee yam piv txwv txuas ntxiv no: • Tsis nco qab (tsis meej pem) • Pob txha lov hnyav • Mob heev • Ntshav tawm ntau tsis xwm yeem • Pom lub plawv dhia tsis xwm yeem • Txhaj tshuaj ntau dhau • Ua tsis taus pa • Pom muaj mob hlab ntshav txhaws • Tsis nco qab lawm • Raug kub hnyiab hnyav • Tsis nco qab lawm • Kuaj pom cov kuab lom • Kev qaug dab peg lossis rov qab tsis meej pem dua


Kawm paub txog yuav ua li cas ua ntej yuav tshwm sim muaj mob xwm txheej kub ntxhov Yog tias koj tus menyuam xav tau kev pab kho mob xwm txheej kub ntxhov, ces mus rau Care4Kids tus kws kho mob kom pab. Yog tias koj tus menyuam tus mob tsis tuaj yeem nyob tos tau, mus rau tus kws kho mob uas nyob ze tshaj plaws (tsev kho mob, kws kho mob lossis chaw kuaj mob). Hu rau 911 lossis koj lub chaw haujlwm tub ceev xwm lossis lub chaw haujlwm tua hluav taws hauv cheeb tsam kom muab cov kev pab xwm txheej kub ntxhov yog tias qhov xwm txheej kub ntxhov ntawv yog ib qho hnyav thiab koj tsis tuaj yeem tau txais kev pab los ntawm tus kws kho mob nyob ze tshaj. Kev pab kho mob los ntawm tus kws kho mob uas tsis yog-Care4Kids tus kws kho mob Yog tias koj tus menyuam yuav tsum mus hauv tsev kho mob lossis tus kws kho mob uas tsis yog -Care4Kids tus kws kho mob, hu rau Tus Neeg Dhia Dej Num Saib Xyuas Kev Kho Mob ntawm 1-855-371-8104 sai npaum li sai tau thiab qhia rau peb txog yam uas tshwm sim. Nov yog ib qho tseem ceeb yog li peb thiaj tuaj yeem tau txais kev tshuaj xyuas kho mob.


Nco ntsoov: Lub tsev kho mob cov chav pw kho mob xwm txheej kub ntxhov yog txhawm rau cov uas yog mob xwm txheej kub ntxhov tiag xwb. Yog tias koj tus menyuam muaj mob xwm txheej kub ntxhov tiag, hu rau koj tus menyuam thawj tus kws kho mob lossis peb tus npawb saib xyuas neeg mob hu tau 24 teev, CCHP hauv Xovtooj ntawm 1-877-257-5861. Yog tias koj tsis paub tias koj tus menyuam tus mob lossis qhov kev raug mob puas yog mob xwm txheej kub ntxhov, hu rau koj tus menyuam thawj tus kws kho mob lossis peb tus npawb kws saib xyuas neeg mob hu tau 24 teev CCHP hauv Xovtooj. Peb yuav qhia rau koj seb yuav mus cuag kev saib xyuas qhov twg. Nov yog tus npawb hu dawb. Kev kho mob maj ceev Kev kho mob maj ceev yog yam kev kho mob uas koj tus menyuam xav tau sai dua li yam kev kho mob raws kev teev caij nyoog ntsib kws kho mob, tab sis nws kuj tsis yog mob xwm txheej kub ntxhov. Muaj qee yam piv txwv raws li hauv qab no: • Doog ntshav • Pob txha lov me • Nqaij raug txiav me ntsis • Yuav luag txhua yam pob txha tawg • Yuav luag txhua yam kev siv tshuaj huam


• Ntshav tawm yam uas tsis hnov mob qhov twg • Qis pob txha lossis ntxee leeg • Koj tus menyuam yuav tsum tau txais kev kho mob

maj ceev los ntawm Care4Kids cov kws kho mob tshwj tsis yog koj twb xub tau txais kev tso cai kom mus cuag tus kws kho mob uas tsis yog Care4Kids tus kws kho mob. Tsis txhob coj koj tus menyuam mus hauv chav kho mob xwm txheej kub ntxhov yog tias muaj tus mob kho maj ceev tshwj tsis yog koj tau txais kev tso cai los ntawm Care4Kids ua ntej.

Yog tias koj xav tau kev pab kho mob maj ceev hu rau koj thawj tus kws kho mob lub chaw kuaj mob lossis CCHP hauv Xovtooj, peb tus npawb kws saib xyuas neeg mob hu tau 24 teev ntawm 1-877-257-5861. Koj yuav tsum tau txais kev pab kho mob maj ceev los ntawm CCHP cov kws kho mob tshwj tsis yog koj tau txais kev tso cai los ntawm peb kom mus ntsib lwm tus kws kho mob. CCHP ntawm Tus Npawb Kws Saib Xyuas Neeg Mob Koj tus menyuam thawj tus kws kho mob ib txwm raug nug kom teb cov lus nug txog kev kho mob rau koj. Koj kuj tseem tuaj yeem hu rau CHP hauv Xovtooj, peb tus npawb kws saib xyuas neeg mob. Peb muaj cov kws saib xyuas neeg mob ua haujlwm 24 teev hauv ib hnub, xya hnub hauv ib lim tiam los pab teb koj cov lus nug. Hu tau yooj


yim rau 1-877-257-5861. Nov yog tus npawb hu dawb xwb. Thaum twg kuv yuav tsum tau siv CCHP ntawm Kev Hu Xovtooj?? • Ua ntej coj koj tus menyuam mus hauv chav kho mob

xwm txheej kub ntxhov • Ua txhua cov lus nug txog kev kho mob lossis cov kev

txhawj xeeb • Yog tias koj tus menyuam muaj mob ua npaws • Yog tias koj tus menyuam lub pob qej taw qis • Yog tias koj xav tau kev pab xaiv seb yuav mus nrhiav

kev pab qhov twg • Yog tias koj tus menyuam muaj cov tawv nqaij voos

lossis khaus • Yog tias koj tus menyuam muaj qhov raug txhuam

lossis nqaij to • Txhua zaus koj muaj lus nug txog yuav nrhiav chaw

pab nyob qhov twg Vim li cas kuv thiaj yuav tau siv CCHP ntawm Kev Hu Xovtooj?? • Tus kws saib xyuas neeg mob tuaj yeem pab koj kom

tau txais kev saib xyuas uas haum rau koj tus menyuam.


• Lawv tuaj yeem qhia koj txog cov kev kho mob kom tuav tswj koj tus menyuam li kev noj qab haus huv.

Leej twg yuav yog tus teb kuv cov lus nug txog kev noj qab haus huv? • Tus kws kho mob uas tau txais kev cob qhia yuav los

teb koj txhua lo lus nug txog kev kho mob. • Lawv yuav hais kom koj piav qhia cov tsos mob lossis

cov teebmeem uas tus menyuam muaj. • Lawv yuav pab koj xaiv seb yuav tau txais yam kev

kho mob zoo tshaj plaws rau koj tus menyuam li cas. • Lawv tuaj yeem pab kom koj nkag siab txog yuav mus

cuag tau kev kho mob ntawm Care4Kids li cas. • Yog tias tsim nyog, lawv yuav xa koj mus rau tus kws

sab laj MD. Kev kho mob thaum koj tus menyuam tsis nyob hauv tsev Tsis nyob hauv tsev txhais tau tias tawm mus sab nraud nrug deb ntawm thaj chaw muab kev pab kho mob li 50 mais. Ua raws li cov cai no yog tias koj tau menyuam xav tau kev pab kho mob tab sis nyob deb dhau ntawm tsev uas yuav mus ntsib tau nws thawj tus kws kho mob lossis lub chaw kuaj mob. Yog qhov kev kho mob xwm txheej kub ntxhov tiag, mus rau lub tsev kho mob uas nyob ze tshaj plaws, lub chaw kho mob lossis kws kho mob maj


ceev. Hu rau Care4Kids ntawm 1-855-371-8104 sai npaum li sai tau uas koj yuav hu qhia peb tias muaj dab tsi tshwm sim. Txog cov kev kho mob raws kev teem caij thaum nyob deb tsev, koj yuav tsum tau txais kev tso cai ua ntej los ntawm peb mam li mus cuag lwm tus kws kho mob, chaw kuaj mob, tsev kho mob. Hu rau Care4Kids ntawm 1-855-371-8104 kom tso cai rau mus cuag lwm tus kws kho mob, chaw kuaj mob lossis tsev kho mob. Kev pab kho mob thaum lub sij hawm cev xeeb tub thiab thaum yug menyuam Yog tias koj tus menyuam lub cev xeeb tub, thov qhia rau Care4Kids thiab lub chaw haujlwm tuav tswj koj cov nyiaj khwv tau los (IM) paub sai sai yog li koj thiaj tau txais cov kev pab saib xyuas ntxiv raws li qhov nws xav tau. Koj tus menyuam yuav tsum mus hauv lub tsev kho mob uas yog Care4Kids cov chaw kho mob koom tes nrog los saib xyuas nws tus menyuam. Txhawm rau nrhiav ib lub tsev kho ob hauv Care4Kids cov kws kho mob koom tes nrog, thov mus saib hauv www.childrenscommunityhealthplan.org thiab nias rau qhov “Find a Doc”. tham nrog nws tus kws kho mob Care4Kids kom paub tseeb tias koj nkag siab txog lub tsev kho mob twg nws yuav tau mus cuag thaum lub sij hawm yug nws tus menyuam. Tsis txhob mus yug menyuam sab nraud thaj chaw tshwj tsis yog koj tau txais kev tso cai los ntawm


Care4Kids. Koj tus kws kho mob Care4Kids pab txog nws li keeb kwm thiab yog tus kws kho mob pab tau nws zoo tshaj plaws. Tsis tas li ntawv xwb, tham nrog koj tus menyuam tus kws kho mob yog tias nws npaj yuav tawm mus ncig sab nraud thaum lub hli kawg uas yuav yug menyuam. Peb xav kom nws muaj kev nyab xeeb thaum yug menyuam thiab yug menyuam tau zoo; yog li ntawd, nws yuav tsis yog ib lub sij hawm zoo rau nws mus ncig. Qhov Kev Pab Leej Niam Noj Qab Nyob Zoo, Tus Menyuam Noj Qab Nyob Zoo CCHP xav kom koj tus menyuam muaj kev noj qab nyob zoo thaum cev xeeb tub thiab tus menyuam noj qab nyob zoo thiab muaj qhov kev pab uas hu tias Leej Niam Noj Qab Nyob Zoo, Menyuam Noj Qab Nyob Zoo uas muaj pub dawb rau txhua tus tswvcuab. Nws yogi b txoj haujlwm uas pab cov pojniam muaj menyuam kom tau txais kev pab txhawb thiab cov kev pab uas xav tau kom tus menyuam muaj kev noj qab nyob zoo. Cov kev pab tau muab los ntawm cov neeg ua haujlwm pab txhawb lossis cov kws saib xyuas neeg mob uas muaj keeb kwm tshwj xeeb rau qhov muab cov kev pab rau cov niam muaj menyuam thiab cov tsev neeg. Peb muab cov kev pab no ntawm koj tsev, qhov chaw raws koj siab nyiam lossis lossis hauv xovtooj. Lwm cov kev pab suav nrog kev pab pub mis menyuam thiab kev sib koom tes saib xyuas


menyuam. Peb yuav mua lus zoo siab muab cov ntaub ntawv ntau ntxiv rau koj thiab teem caij ntsib tshuaj xyuas koj tus menyuam nrog ib ntawm peb cov neeg saib xyuas haujlwm. Peb yuav xa ib daim npav khoom plig raug tus nqi $10 rau koj thaum koj qhia rau peb paub tias koj tus menyuam cev xeeb tub. Hu rau peb ntawm 1-877-227-1142 thiab xaiv qhov kev xaiv 3. Kev Tswj Hwm Tus Mob Kho Nyuaj Kev Tswj Hwm Tus Mob Kho Nyuaj (CCM) yog ib qho txheej txheem kev sib koom tes uas yog ntsuam xyuas, npaj, nqis tes ua, sib koom tes, tshuaj xyuas thiab ntsuas cov kev xaiv thiab cov kev pab uas haum raws li qhov xav tau ntawm tus neeg ntawv tus mob uas kho nyuaj. CCHP qhov kev pab CCM mob siab rau txog peb cov kev pheej hmoo siab tshaj plaws. Cov qauv xaiv tus neeg muaj cai tau txais muaj xws li:

• Cov tswv cuab uas muaj Mob Ntsws (Cystic Fibrosis) uas tau mus kho mob xwm txheej kub ntxhov yam tsawg kawg ib zaug lossis mus hauv tsev kho mob hauv 6 lub hli dhau los

• Cov tswvcuab uas muaj Ntau Txoj Hlab Ntshav Txhaws uas tau muaj mob hnyav thiab tsim kev puas tsuaj


• Cov tswvcuab uas muaj yam mob txawv (polypharmacy) uas siv tshuaj kho 20 lossis ntau dua coj los kho

• Cov tswvcuab uas tau raug mob hnyav rau lub cev nyob hauv sij hawm 3 lub hlis dhau los uas tau mus pw kho hauv tsev kho mob ntau tshaj 6 hnub thiab lossis cov uas raug xa musk ho rau theem uas saib xyuas uas yog kev tiv thaiv

• Cov tswvcuab uas Muaj Cov Cell Kab Mob Sickle uas tau mus peb 2 lossis ntau zaus dua hauv tsev kho mob nyob hauv 12 hlis dhau los

• Cov tswvcuab uas tus txha nqaj qaum raug mob nyob hauv 3 lub hlis dhau los

• Cov tswvcuab uas muaj tus mob hlab ntshav txhawb hauv 3 lub hlis dhau los uas ua rau muaj mob hnyav

• Lwm yam xwm txheej kev kho mob hnyav yuav saib raws qhov tsim nyog

Cov kev pab muaj xws li:

• Cov kev ntsuam xyuas muaj txiaj ntsig zoo • Sib xyaw lub hom phiaj thiab kev npaj kho mob • Kev sib koom tes kho mob thiab pab cuam • Muab kev qhia paub txog tus mob lossis yam kab

mob, suav nrog kev tuav tswj tus kheej • Kev sib koom tes hauv zej zog thiab cov chaw pab


Kev Tswj Hwm Kab Mob Kev Tswj Hwm Mob Hawb Pob CCHP siv cov lus qhia txog kev kuaj mob los pab txhawb rau peb cov tswvcuab thiab/lossis lawv ov neeg saib xyuas nrog rau muab cov cuab yeej tuav tswj thiab cov hauv kev kawm paub hla peb Qhov Kev Pab Tswj Hwm Tus Kab Mob Hawb Pob (Asthma Disease Management (DM)). Peb sib koom tes hauv pab pawg kho mob uas muaj cov txuj ci los muab kev qhia paub, txhawb kev tswj hwm tus kheej thiab sib tiv toj nrog cov chaw pab. Peb lub hom phiaj yog txhawb tus tswvcuab rab peev xwm los tuav tswj nws tus ob thiab kho kom tus mob zoo thiab muaj lub neej zoo. CCHP kuj tseem txaus siab los muab cov chaw pab no rau peb ov kws kho mob thiab cov koom tes nrog hauv zej zog. Koj thiab koj tus(cov) menyuam tuaj yeem koom nrog hauv Qhov Kev Pab Kho Mob Hawb Pob DM. Qhov kev pab yog pub dawb thiab yeem ntawm tus kheej. Koj tus(cov) menyuam tau rau npe nkag ib leeg yog tias:

• Lawv yog tus tswvcuab tam sim no • Lawv muaj hnub nyoog li ntawm 6 thiab 17 xyoo • Lawv tau muaj lossis tab tom muaj mob hawb pob

Cov txiaj ntsig ntawm qhov kev pab no muaj xws li:

• Cov ntawv tshaj xov hauv txhua 3 hlis


• Mus Siv Tau CCHP Qhov Kev Hu Xovtooj Kev Noj Qab Nyob Zoo

• Cov cuab yeej siv thiab cov chaw pab kho mob hawb pob

• Kev pab txhawb los ntawm kws saib xyuas neeg mob thiab cov neeg ua haujlwm kho mob

• Mus Cuag Tau Cov Kev Pab Hauv Lub Zej Zog Kev Tswj Hwm Kev Ntxhov Siab CCHP siv lub chaw kuaj mob cov lus qhia los pab txhawb rau peb cov tswvcuab thiab/lossis lawv cov neeg saib xyuas nrog rau cov cuab yeej tuav tswj thiab cov hauv kev qhia paub hla peb Qhov Kev Pab Tswj Hwm Mob Ntxhov Siab (DM). Peb muaj ib pab pawg koom ua haujlwm uas yuav los muab kev qhia paub, pab txhawb kev tswj tus kheej thiab kev tiv toj nrog cov chaw pab cuam. Peb lub hom phiaj yog txhawb cov tswvcuab rab peev xwm los tuav tswj lawv tus mob thiab txhim kho tag nrho cov kev kho mob thiab kev ua neej muaj txiaj ntsig zoo. CCHP kuj tseem txaus siab los muab cov chaw pab no rau peb cov chaw kho mob thiab cov koom tes nrog hauv zej zog. Thaum yog ib tug tswvcuab, koj muaj peev xwm koom nrog hauv Qhov Kev Pab Kho Ntxhov Siab DM. Qhov kev pab yog pub dawb thiab yeem ntawm tus kheej. Koj yuav raug rau npe nkag ib leeg yog tias …


• Koj yog tus tswvcuab tam sim no; • Koj muaj hnub nyoog 18 xyoo lossis laus dua; thiab • Koj tau muaj lossis tab tom muaj kev ntxhov siab.

Benefits of the program include:

• Cov ntawv tshaj xov hauv txhua 3 hlis • Mus Siv Tau CCHP Qhov Kev Hu Xovtooj Kev Noj

Qab Nyob Zoo • Cov cuab yeej kho ntxhov siab thiab cov chaw pab • Kev pab txhawb los ntawm kws saib xyuas neeg

mob thiab cov neeg ua haujlwm kho mob • Mus Cuag Tau Cov Kev Pab Hauv Lub Zej Zog

Thaum twg koj yuav raug sau nqi rau cov kev pab Nyob hauv Care4Kids, koj tsis tas yuav tau them nyiaj rau koj tus menyuam cov kev pab uas raug pab them. Txhawb rau pab kom koj paub tseeb tias koj tsis raug sau nqi rau koj tus menyuam cov kev pab, koj tus menyuam yuav tsum mus ntsib Care4Kids tus kws kho mob koom tes nrog. Tsuas yog muaj ib qho kev zam rau qhov xwm txheej kub ntxhov. Yog tias koj yeej yeem ntawm tus kheej them cov nqi thiab sau ib qho kev npaj them nyiaj nrog koj tus menyuam tus kws kho mob, koj nug txog cov kev pab uas tsis-pab them. Cov kws kho mob yuav sau nqi ntawm koj raws li qhov lawv ib txwm sau thiab ntxiv rau cov nqi kho mob uas tsis tau txais kev pab them.


Yog tias koj tau txais ib daim ntawv sau nqi rau cov kev pab uas tsis pom zoo nrog, thov hu rau Chaw pab cuam tswvcuab ntawm 1-800-482-8010. Yog tias koj tus menyuam taug kev sab nraud ntawm Wisconsin thiab xav tau kev pab kho mob xwm txheej kub ntxhov, cov kws kho mob tuaj yeem kho nws thiab xa cov ntawv sau nyiaj rau Care4Kids. Care4Kids tsis pab them nqi rau ib qho kev pab, suav nrog kev kho mob xwm txheej kub ntxhov, uas kho sab nraud Tebchaws Asmeskas, Canada, thiab Mexico. Yog tias koj tus menyuam xav tau kev pab kho mob xwm txheej kub ntxhov thaum nyob hauv Canada thiab Mexico, Care4Kids yuav pab them rau cov kev pab yog tias tus kws kho mob lossis lub tsev kho mob lub txhab nyiaj txiag yog nyob hauv tebchaws Asmeskas xwb. Lwm yam kev pab yuav raug pab them los ntawm Care4Kids qhov kev tso cai yog tias lub tsev kho mob muaj Tebchaws Asmeskas lub txhab nyiaj txiag. Thov hu rau Care4Kids yog tias koj tus menyuam tau txais ib qho kev kho mob xwm txheej kub ntxhov sab nraud Tebchaws Asmeskas. Yog tias koj tau txais ib daim ntawv sau nqi kho mob, hu rau peb Lub Chaw Haujlwm Pab Cuam Neeg Mob ntawm


1-800-482-8010 sai sai. Cov ntawv thov yuav tsum muab xa rau:

Children’s Community Health Plan P.O. Box 56099 Madison, WI 53705


Cov kev pab tau pab them nyiaj los ntawm Care4Kids Care4Kids ua lub luag haujlwm los muab txhua cov kev pab kho mob tsim nyog Medicaid pab them rau cov kev pab. Cov Kev Pab Care4Kids Kev Pab Them

Nyiaj

Kho hniav Pab them tag nrho

Cov khoom siv kho mob uas siv tas pov tseg (DMS)

Pab them tag nrho

Cov khoom siv kho mob uas rov coj los siv dua ib ntus

Pab them tag nrho

Chav kho mob xwm txheej kub ntxhov

Pab them tag nrho

Kev tshuaj xyuas mob rau menyuam

Pab them tag nrho ntawm Cov Nqi Tshuaj Xyuas Mob thiab lwm cov kev pab rau cov neeg uas hnub nyoog qis dua 21 xyoos

Kev pab kho kom hnov lus Pab them tag nrho


Cov Kev Pab Care4Kids Kev Pab Them Nyiaj

Kev pab kho mob hauv tsev Pab them nqi tag nrho rau cov nqi saib xyuas tus kheej, kho mob hauv tsev thiab kev saib xyuas tus kheej

Neeg mob pw hauv tsev kho mob

Pab them tag nrho

Kev kho mob hlwb thiab kho quav tshuaj

Pab them tag nrho

Kev kho mob hauv tsev Pab them tag nrho

Neeg mob tsis pw hauv tsev kho mob uas tsis yog chav kho mob xwm txheej kub ntxhov

Pab them tag nrho

Kev kho lub cev, kev kho ua haujlwm thiab kho hais lus-kom hais tau lus (SLP)

Pab them tag nrho

Kws kho mob, kho nrog cev, X-ray thiab tshuaj xyuas ntshav

Pab them tag nrho

Kev kho mob menyuam yaus Pab them tag nrho



Cov tshuaj muaj ntawv yuav tshuaj (Cov txiaj ntsig tshuaj muaj ntawv yuav tshuaj tau muab thiab tuav tswj los ntawm Xeev Wisconsin, tsis yog Care4Kids.)

Cov nyiaj pab tshuaj muaj ntawv yuav tshuaj nrog rau cov kev pab them nyiaj ntawm cov tshuaj muaj ntawv yuav tshuaj, cov tshuaj muaj saub npe thiab qee cov tshuaj tsis muaj ntawv yuav tshuaj

Kev kho muaj menyuam Pab them tag nrho, tsis suav cov kev ua kom tsis muaj menyuam, kev ua tus saib xyuas menyuam thiab kev yeem ntawm tus kheej rov qab ua thim qhov ua kom tsis muaj menyuam



Kev caij tsheb mus los –Tsheb Thauj Neeg Mob, Tsheb Thauj Kho Mob Tshwj Xeeb, Tsheb Thauj Li Niaj Hnub

Pab them tag nrho cov nqi tsheb mus thiab los kho mob xwm txheej kub ntxhov thiab tsis yog-xwm txheej kub ntxhov ntawm tus kws kho mob rau cov kev pab uas tau pab them nyiaj. Cov nqi caij tsheb mus los tau npaj hla tus kws kho mob uas tau ua ntawv cog lus nrog ntawm Xeev Wisconsin, tsis yog Care4Kids

Kho kom pom kev Pab them tag nrho suav nrog cov pab cov tsom iav

Kev pab cuam hauv chaw muag tshuaj Tus kws kho mob yuav muab ib tsab ntawv sau piav qhia rau koj txog cov tshuaj kho mob rau koj tus menyuam. Koj tuaj yeem tau txais ib daim ntawv xaj yuav tshuaj ntxiv ntawm lub chaw muag tshuaj uas yog tus kws kho mob rau BadgerCare Plus. Nco ntsoov qhia koj tus menyuam daim npav ID ForwardHealth rau tus kws muag tshuaj thaum koj mus nqa cov tshuaj muaj ntawv xaj yuav tshuaj.


Cov txiaj ntsig hauv lub chaw muag tshuaj tau pab them los ntawm Xeev Wisconsin, tsis yog Care4Kids. Yog tias koj xav tau kev pab ntxiv tshuaj rau daim ntawv yuav tshuaj, tiv toj Lub Chaw pab cuam tswvcuab ntawm 1-800-362-3002. Koj yuav muaj qhov txwv rau cov tshuaj uas pab them nyiaj. Kev pab kho hniav Care4Kids pab them rau txhua yam kev pab kho hniav. Koj yuav tsum coj koj tus menyuam mus rau Care4Kids tus kws kho hniav. Saib Cov Npe Kws Kho Hniav lossis hu rau peb Pab Pawg Dhia Haujlwm Kho Hniav ntawm 1-855-371-8104 kom pab nrhiav chaw thiab teem sij hawm muaj ntsib. Thaum yog ib tug tswv cuab ntawm Care4Kids, koj tus menyuam muaj cai teem caij mus kho hniav raws caij nyoog nyob hauv sij hawm 90 hnub txij li hnub koj sau ntawv lossis hu xovtooj tuaj thov rau Pab Pawg Dhia Haujlwm Saib Xyuas Kev Kho Mob. Kev pab kho hniav xwm txheej kub ntxhov Thaum yog ib tug tswvcuab ntawm Care4Kids, koj tus menyuam muaj cai kom tau txais kev kho mob rau cov kev kho hniav xwm txheej kub ntxhov hauv sij hawm 24 teev raws li koj thov. Qhov kev kho hniav xwm txheej kub ntxhov yog ib qho kev pab kho hniav sai sai uas yuav tsum tau kho qhov mob hnyiav, hniav o, ua npaws, kis


mob lossis raug mob rau cov kaus hniav. Yog tias yuav tas los koj tus menyuam tau mus kho mob hniav xwm txheej kub ntxhov: Yog tias koj twb muaj ib tus kws kho hniav uas yog nyob hauv Care4Kids:

• Hu rau ntawm tus kws kho hniav lub chaw haujlwm. • Pom tau tias tus menyuam muaj qhov mob hniav

xwm txheej kub ntxhov. • Qhia rau tus kws kho mob cov neeg ua haujlwm txog

yam teebmeem yog dab tsi tiag. Qhov no yuav yog qee yam xws li mob rau hauv tus hniav lossis ua rau ntsej muag o.

• Hu rau Pab Pawg Dhia Haujlwm Saib Xyuas Kev Kho Mob yog tias koj xav tau kev pab kom tau txais kev caij tsheb mus thiab los ntawm koj qhov teem caij kho hniav.

Yog tias koj tsis muaj ib tus kws kho hniav rau tus menyuam uas yog nyob hauv Care4Kids:

• Hu rau peb Lub Chaw Pab Cuam Kho Cov Neeg Mob Hniav ntawm 1-877-389-9870. Qhia rau peb tias koj tus menyuam muaj qhov mob hniav xwm txheej kub ntxhov. Peb tuaj yeem pab kom koj tau txais kev pab kho hniav.


• Qhia rau peb yog tias koj xav tau kev pab kom tau caij tsheb mus thiab los ntawm kws kho hniav lub chaw haujlwm.

Cov Lus Qhia Kev Kho Hniav

• Nrhiav tus kws kho hniav thiab teem caij ntsib nrog tus kws kho hniav ntawv. Tus neeg ua haujlwm kho hniav ntawv yuav yog qhov chaw uas koj tus menyuam tau txais txhua yam kev pab kho hniav.

• Tus menyuam qhov mus ntsib kws kho hniav thawj zaug yuav tsum yog thaum lawv muaj hnub nyoog ib xyoos.

• Koj yuav tsum teem sij hawm mus ntsib kws kho hniav txhua rau lub hli.

• Tsis txhob noj cov khoom muaj piam thaj ntau tshwj xeeb yog thaum yuav mus pw.

• Tsis muaj lub kho ntxais (sippy cups) rau tus menyuam.

• Noj cov khoom noj muaj txiaj ntsig thiab cov khoom noj txaum ncauj.

• Tiv thaiv koj tus menyuam cov kaus hniav nrog cov pob looj tiv thaiv hniav thaum ua cov kis las.


Cov kev pab kho mob hlwb thiab kho quav yeeb tshuaj Care4Kids muab cov kev pab kho mob hlwb thiab kho quav tshuaj (tshuaj thiab dej cawv) rau txhua tus menyuam yaus uas rau npe hauv Care4Kids. Yog tias koj tus menyuam xav tau cov kev pab no, thov tiv toj rau thawj tus kws kho mob, Pab Pawg Dhia Dej Num Kho ob, lossis lub chaw pab cuam tswvcuab raws li qhov tsim nyog. Yog tias koj tus menyuam mob hnyav, tiv toj rau lub chaw haujlwm pab kho mob hnyav hauv koj lub nroog: • Nroog Kenosha: 262-657-7188 lossis 1-800-236-7188

(24 teev hauv ib hnub) • Nroog Milwaukee: 414-257-7222 (24 teev hauv ib

hnub) • Nroog Ozaukee: 262-377-2673 (24 teev hauv ib

hnub) • Nroog Racine: 262-638-6741 (9 teev sawv ntxov txog

5 teev tsaus ntuj) • Nroog Washington: 262-365-6565 (24 teev hauv ib

hnub) • Nroog Waukesha: 262-548-7666 (8 teev sawv ntxov

txog 4:30 teev tsaus ntuj Hnub Monday txog Friday) Tom qab lawj haujlwm hu rau 211 lossis 414-455-1736 lossis 1-800-211-3380.


Yog tias koj muaj ib tus kws kho hniav nyob hauv Care4Kids cov koom tes nrog koj tuaj yeem mus rau tus kws kho hniav ntawv thiab koj tsis tas yuav tsum hu rau peb ua ntej koj teem caij ntsib. Yog tias koj xav tau kev pab nrhiav ib tus kws kho hniav hu rau peb lub chaw pab cuam tswvcuab ntawm 1-800-482-8010. Yog tias koj xav tau kev pab sai sai hu rau CCHP ntawm Tus Xovtooj hu kws saib xyuas neeg mob ntawm 1-877-257-5861, uas yog qhib 24 teev hauv ib hnub thiab xya hnub hauv ib lim tiam. Yog tias koj muaj mob xwm txheej kub ntxhov, hu rau 911 lossis mus rau chav kho mob xwm txheej kub ntxhov uas nyob ze tshaj plaws lossis lub chaw kho coj tus cwj pwm lossis tsev kho cov neeg quav tshuaj. Txhua cov kev pab muab los ntawm Care4Kids yuav tsis pub qhia lwm tus paub. Cov kev pab npaj tsis pub muaj menyuam Peb muab cov kev pab npaj tsis pub muaj menyuam uas tsis pub lwm tus neeg paub rau txhua tus tswvcuab, suav nrog cov menyuam yaus. Yog tias koj xaiv tsis tham nrog koj tus menyuam thawj tus kws kho mob txog kev npaj tsis pub muaj menyuam, hu rau peb Pab Pawg Dhia Dej Num Kho Mob ntawm 1-855-371-8104. Peb yuav pab koj tus menyuam xaiv Care4Kids tus kws kho mob uas pab npaj qhov tsis pub muaj menyuam uas tsis yog lawv thawj tus kws kho mob. Peb txhawb kom koj tus menyuam tau txais


qhov kev pab npaj tsis pub muaj menyuam los ntawm Care4Kids tus kws kho mob yog li ntawv peb thiaj dhia haujlwm saib xyuas kev kho mob tau zoo dua. Txawm li cas los xij, koj tus menyuam kuj tuaj yeem mus ntsib kws kho mob npaj tsis pub muaj menyuam rau lub chaw kuaj mob uas yuav les txais lawv li npav ID ForwardHealth, txawm tias lub chaw kuaj mob tsis yog ib feem ntawm Care4Kids. Kev Pab Kho Qhov Muag Care4Kids muab cov kev pab kho qhov muag, suav nrog tsom iav; txawm li cas los xij, muaj qee yam kev txwv los siv rau. Kom paub cov ntaub ntawv ntau ntxiv, hu rau Pab Pawg Dhia Haujlwm Kho Mob ntawm 1-855-371-8104 lossis hu rau 414-462-2500 txhawm rau teem sij hawm ntsib. Cov Kev Pab Kho Mob Hlwb Cov kev pab kho tus cwj pwm tau pab them raws li Wisconsin Medicaid. Koj yuav tau txais cov kev pab them nqi kho mob hlwb los ntawm Medicaid-cov kws kho mob rau npe nkag uas yuav lees txais koj li npav ID ForwardHealth. Txhawm rau nrhiav Medicaid-cov kws kho mob rau npe nkag:

• Mus rau “www.forwardhealth.wi.gov”


• Nias rau qhov txuas nrog Cov Tswvcuab lossis qhov icon hauv tshooj nruab nrab ntawm nplooj ntawv.

• Txav mus rau hauv qab thiab nias rau kab ntawv Chaw Pab Cuam Tswvcuab (Resources).

• Nias rau ntawm qhov txuas nrog “Find a Provider”. • Hauv Qab Qhov Program, xaiv BadgerCare Plus.

Lossis, koj tuaj yeem hu rau ForwardHealth Lub Chaw Pab Cuam Tswvcuab ntawm 1-800-362-3002. Kev Kuaj Mob (HealthCheck) HealthCheck yog ib qho kev pab uas pab them nyiaj txhua yam rau kev mus kuaj mob, suav nrog cov teebmeem mob uas pom thaum mus kuaj, rau cov tswvcuab uas muaj hnub nyoog qis dua 21 xyoo. Cov kev kuaj mob no yog ib qho tseem ceeb heev rau cov menyuam yaus li kev noj qab haus huv. Koj tus kws kho mob xav kom koj tus menyuam tuaj ntsib tas li txhawm rau kuaj mob, tsis yog thaum muaj mob mam tuaj ntsib xwb. Qhov HealthCheck qhov kev pab kho mob muaj 3 lub hom phiaj:

• Txhawm rau nrhiav thiab kho cov teebmeem mob rau cov menyuam hnub nyoog qis dua 21 xyoo;


• Txhawm rau qhia koj paub txog cov kev pab khomob tshwj xeeb rau cov menyuam hnub nyoog qis dua 21 xyoo no; thiab

• Txhawm rau ua kom cov menyuam hnub nyoog qis dua 21 xyoo kom muaj cai rau qee yam kev pab kho mob uas tsis tau txais kev pab them.

Qhov kev kuaj mob HealthCheck muaj xws li:

• Kev txhaj tshuaj tiv thaiv (txhaj) haum raws lub hnub nyoog

• Kev ntsuam xyuas lub cev • Kev kuaj xyuas kev loj hlob thiab/lossis kuaj mob

hlwb • Kev kuaj qhov hnov lus • Kev kuaj hniav thiab pib xa mus rau kws kho hniav

pib txij thaum muaj hnub nyoog 1 xyoos • Kev ntsuam xyuas ntshav thiab zis (suav nrog kev

kuaj cov kuab tooj hlau thaum lub hnub nyoog haum) • Kev kuaj qhov muag

Care4Kids muab cov kev ntsuas HealthCheck thaum txhawb rau cov kev teem caij ntsib ua ntu zus tau qhia los ntawm American Academy of Pediatrics (AAP) rau cov menyuam yaus uas saib xyuas tawm sab nrauv lub tsev. Koj tus menyuam yuav tau txais Cov Kev Ntsuas HealthCheck:


• Txhua lub hli rau cov muaj hnub nyoog rau hli nqis los

• Txhua 3 hlis rau cov menyuam muaj hnub nyoog txij 6 hli mus txog 2 xyoos

• Ob zaug hauv ib xyoo rau cov menyuam muaj hnub nyoog 2 xyoo nce mus

Txhawm rau teem caij qhov kev ntsuas HealthCheck lossis kom paub cov ntaub ntawv ntau ntxiv, hu rau Pab Pawg Ua Haujlwm Saib Xyuas Kev Kho Mob ntawm 1-855-371-8104. Yog tias koj xav caij tsheb mus los rau qhov teem caij HealthCheck, thov hu rau Lub Chaw Haujlwm Saib Xyuas Kev Kho Mob (DHS) kev caij tsheb mus lost sis yog-kho mob xwm txheej kub ntxhov (NEMT) tus thawj saib xyuas ntawm 1-866-907-1493 (lossis TTY 1-800-855-2880) kom teem sij hawm caij tsheb. Cov Kev Pab Caij Tsheb Mus Los Kev caij tsheb mus los tsis yog-kho mob xwm txheej kub ntxhov (NEMT) muaj hla DHS NEMT tus thawj saib xyuas. NEMT tus thawj coj npaj thiab them nyiaj rau cov nqi caij tsheb mus txhawm rau pab them cov nqi caij tsheb mus los rau cov tswvcuab uas tsis tuaj yeem nrhiav lwm txoj hauv kev caij tsheb.


Kev caij tsheb mus los tsis yog-kho mob xwm txheej kub ntxhov tuaj yeem suav nrog cov kev caij tsheb uas siv:

• Tsoomfwv cov tsheb npav, xws li cov npav hauv nroog

• Cov tsheb thauj neeg mob tsis yog-xwm txheej kub ntxhov

• Cov tsheb thauj neeg mob tshwj xeeb • Lwm yam tsheb thauj neeg mob, raws li tus

tswvcuab qhov kev kho mob thiab kev caij tsheb mus los uas xav tau

Tsis tas li ntawv xwb, yog tias koj siv koj lub tsheb caij mus thiab los ntawm koj tus menyuam cov kev kho mob uas raug pab them, koj yuav muaj cai rau kev thov thim nyiaj rov qab. Koj yuav tsum teem sij hawm caij tsheb yam tsawg kawg ob hnub ua haujlwm ua ntej koj tus menyuam qhov teem caij ntsib. Koj tuaj yeem teem sij hawm caij tsheb mus los uas yog hu rau NEMT tus thawj coj ntawm 1-866-907-1493 (or TTY 1-800-855-2880), Monday txog Friday, txij 7 teev sawv ntxov txog 6 teev tsaus ntuj. Koj kuj tseem tuaj yeem teem sij hawm caij tsheb teem sij hawm kho mob maj


ceev. Qhov kev caij tsheb mus thiab los ntawm qhov teem caij maj ceev yuav tau muab hauv 3 teev lossis tsawg dua. Tsheb thauj neeg mob Care4Kids pab them cov nqi tsheb thauj neeg mob mus los rau cov kev kho mob xwm txheej kub ntxhov. Peb kuj tseem yuav pab them rau cov nqi kho mob no rau lwm lub sij hawm, tab sis koj yuav tsum muaj qhov kev tso cai rau tag nrho cov nqi tsheb thauj neeg mob mus los uas tsis yog-kho mob xwm txheej kub ntxhov. Hu rau Chaw Pabcuam Neeg Mob ntawm 1-800-482-8010 kom tso cai. Ib txwm hu rau 911 hauv qhov kev pab kho mob xwm txheej kub ntxhov. Daim Ntawv Tso Cai Ua Ntej, Yog Tseem Muaj Sia lossis Daim Ntawv Tso Cai Rau Cai rau Kev Kho Mob Tus menyuam niam thiab txiv/tus neeg saib xyuas raug cai muaj cai los txiav txim txog tus menyuam cov kev kho mob. Niam txiv/tus neeg saib xyuas raug cai muaj cai lees txais lossis tsis lees txais kev kho mob lossis kev phais mob rau tus menyuam. Niam txiv/tus neeg saib xyuas raug cai kuj tseem muaj cai los npaj thiab qhia paub txog hom kev kho mob uas tus menyuam yuav tau txais yav tom ntej yog tias nws tsis tuaj yeem hais qhia txog yam uas nws xav tau lawm. Niam txiv/tus neeg saib xyuas raug cai tuaj yeem qhia rau tus menyuam tus kws kho mob


paub txog nws txoj kev xav uas yog sau kom tiav daim ntawv yog tseem muaj sia nyob lossis daim ntawv cog lus ua ntej raug cai rau kev kho mob. Tiv toj rau koj tus menyuam tus kws kho mob kom paub cov ntaub ntawv ntau ntxiv. Cov kws kho mob uas tsis nyob hauv tsev tsis muaj cai los tso cai rau ib qho kev pab kho mob lossis sau ib daim ntawv foos yog tseem muaj sia nyob rau tus menyuam. Yog tias koj yog tus menyuam niam txiv/tus neeg saib xyuas raug cai koj muaj cai sau daim ntawv foob rau Lub Chaw Haujlwm Pab Cuam Kho Mob – Qhov Kev Txiav Txim Txog Pab Kas Phais Muaj Txiaj Ntsig Zoo, yog tias tsis ua raws li koj tus menyuam daim ntawv sau qhia ua ntej, yog tseem muaj sia nyob lossis daim ntawv tso cai raug cai. Koj kuj tuaj yeem thov kom pab sau daim ntawv foob. Cov cai txog cov ntawv kho mob sau tseg Koj lossis koj tus menyuam muaj cai thov kom luam tus menyuam cov ntawv kho mob uas tau sau tseg ntawm cov kws kho mob. Peb tuaj yeem pab koj kom tau txais cov ntawv luam ntawm cov ntawv sau tseg no. Hu rau Chaw Pab Cuam Cov Neeg Mob ntawm 1-800-482-8010 kom pab. Thov nco tseg tias: Koj yuav tau them nqi rau kev luam cov ntawv kho mob sau tseg. Koj kuj tseem yuav tau kho cov ntaub ntawv uas sau tsis raug hauv cov ntaub


ntawv kho mob yog tias cov kws kho mob pom zoo rau kho. Tau txais kev pab thaum koj muaj lus nug lossis muaj teebmeem • Care4Kids Tus Neeg Pab Txhawb Tswvcuab

Care4Kids muaj Tus Neeg Pab Txhawb Tswvcuab los pab koj kom tau txais cov kev kho mob uas xav tau rau koj tus menyuam. Koj yuav tsum tiv toj rau koj Tus Neeg Pab Txhawb Tswvcuab kom pab koj txog cov lus nug txog yuav ua li cas thiaj tau txais kev kho mob rau koj tus menyuam thiab daws cov teebmeem uas koj tus menyuam yuav tau txais kev kho mob los ntawm Care4Kids. Koj tuaj yeem hu rau Tus Neeg Pab Txhawb Tswvcuab ntawm 1-855-371-8104.

• Xeev Wisconsin Qhov Kev Pab Ombuds Lub xeev tau tsim qhov Ombuds (cov neeg uas muab kev ncaj ncees, saib xyuas tsis pub lwm tus paub thiab cov kev pab cuam raug cai) leej twg thiaj tuaj yeem pab koj txog cov lus nug lossis cov teebmeem muas koj muaj. Qhov Ombuds tuaj yeem qhia rau koj txog yuav ua li cas thiaj tau txais kev kho mob rau koj tus menyuam uas xav tau los ntawm Care4Kids. Qhov Ombuds kuj tseem tuaj yeem pab koj daws cov teebmeem lossis cov kev tsis txaus siab uas koj yuav


muaj txog qhov kev pab Care4Kids. Hu rau 1-800-760-0001 thiab thov tham nrog tus Ombuds.

• Pab kas phais muaj txiaj ntsig zoo Care4Kids lub hom phiaj yog los muab cov kev pab kho mob kom muaj txiaj ntsig zoo, muaj kev koom tes thiab mus cuag tau yooj yim. Lub Chaw Haujlwm Saib Xyuas Pab Cas Phais Muaj Txiaj Ntsig Zoo yuav los saib xyuas peb cov kev npaj. Peb ua li no txhawm rau kom paub tseeb tias peb ua tau raws li koj qhov kev kho mob uas xav tau. Peb yuav thov cov lus pom los ntawm koj hauv cov kev ntsuam xyuas cuam tshuam txog koj li kev txaus siab nrog cov kev pab kho mob thiab cov kev pab uas tus menyuam tau txais. Peb ib txwm ua haujlwm los txhim kho peb cov kev pab rau koj. Qhov pab kas phais muaj txiaj ntsig zoo kuj tseem suav nrog kev npaj, pib ua thiab tshuaj xyuas kom paub tseeb tias koj muaj kev nyab xeeb thiab ua tau raws li yam kev kho mob uas koj xav tau. Qhov piv txwv ib qho ntawm peeb cov kev pab yog xa cov ntawv tshaj xov ceebtoom rau cov niam txiv lossis cov neeg saib xyuas kom txhua tus menyuam tau txais kev pab kuaj mob HealthCheck. Peb ntseeg tias kev muaj cov kev pab zoo li no yuav pab tau koj. Lawv ceebtoom rau koj txog cov kev pab uas tuaj


yeem ua rau koj tus menyuam muaj kev noj qab nyob zoo. Lub Chaw Ntsuas Pab Kas Phais Muaj Txiaj Ntsig Zoo yuav tshuaj xyuas cov kev pab no. Peb kuj tseem yuav tos txais cov lus qhia rau cov haujlwm tshiab.

Tiv toj nrog peb! Txuas ntxiv tiv toj nrog cov Menyuam Yaus Qhov Kev Npaj Kho Mob Hauv Zej Zog. Thov ntsib peb tus website ntawm www.childrenscommunityhealthplan.org kom pom cov ntaub ntawv uas hloov pauv tshiab tshaj plaws thiab cov chaw pab. Cov Lus Tsis Txaus Siab thiab Cov Ntawv Foob Daim ntawv foob tsis txaus siab yog cov ntsiab lus feem ntau uas tau siv los piav qhia seb koj puas txaus siab nrog koj tus menyuam qhov kev npaj kho mob lossis tus kws kho mob. Daim ntawv tsis txaus siab yuav yog hais ntawm ncauj lossis sau thiab tej zaum yuav suav nrog:

• Mus cuag tau kev saib xyuas cov teebmeem – xws li koj tsis tuaj yeem tau txais yam kev pab, kev kho mob lossis cov tshuaj kho mob uas koj tus menyuam xav tau

• Koj tus menyuam qhov kev npaj tsis kam lees muab cov kev pab thiab hais tias nws tsis yog kev kho mob tsim nyog


• Koj tus menyuam yuav tsum tau tos ntev dhau rau qhov teem caij ntsib

• Koj tus menyuam tau txais kev kho mob tsis zoo lossis raug hais lus saib tsis taus

• Koj tus menyuam lub pab kas phais npaj kho mob tsis them koj cov nqi kho mob xwm txheej kub ntxhov

• Koj tau txais ib daim ntawv sau nyiaj uas koj ntseeg tias koj yuav tsum tsis tau them

Daim ntawv foob tsis txaus siab yog hais ntawm ncauj lossis sau ntawv qhia txog yam kev tsis txaus siab nrog qhov kev txiav txim siab uas Care4Kids muab rau koj thaum koj muaj kev tsis txaus siab, lossis thaum koj tsis txaus siab nro Care4Kids qhov kev txiav txim tsis kam lees lossis txwv kev tso cai lossis cov nyiaj pab ntawm cov kev kho mob uas tau thov. Koj lossis koj tus neeg raug tso cai sawv cev tuaj yeem sau ib daim ntawv foob nyob hauv sij hawm 45 hnub txij li hnub peb qhov kev txiav txim txog ib qho twg. Cov teebmeem no yuav suav nrog, tab sis tsis tas rau:

• Kev ua zoo ntawm kev saib xyuas lossis cov kev pab uas tau muab rau

• Kev hais lus nyaum los ntawm tus kws kho mob lossis tus neeg ua haujlwm


• Tsis hawm txog koj tus menyuam cov cai ua tib tus tswvcuab

• Hom lossis them kev saib xyuas • Kev txiav, ncua tseg lossis tshem tawm cov kev pab

tau tso cai yav dhau los • Kev pab kho hniav, hauv tag nrho lossis ib feem,

ntawm qhov kev them nyiaj rau cov kev pab

Peb xav paub tias yog koj muaj kev tsis txaus siab lossis xav sau ntawv foob qhov kev txiav txim txog koj cov kev saib xyuas lossis cov kev kho mob uas koj tus menyuam tau txais los ntawm Care4Kids. Hu rau Care4Kids HMO Tus Neeg Pab Txhawb Tswvcuab ntawm 1-800-482-8010 yog tias koj muaj kev tsis txaus siab lossis sau ntawv foob lossis sau ntawv rau peb ntawm:

Care4Kids Txog rau: Complaint/Appeal Department PO Box 1997, MS6280 Milwaukee, WI 53201-1997

Yog tias koj yog tus menyuam niam txiv/tus neeg saib xyuas raug cai thiab koj xav tham nrog ib tus neeg nyob sab nraud ntawm Tus Menyuam Lub Chaw Npaj Kho Mob Hauv Zej Zog, hu rau HMO tus kws tshwj xeeb rau npe nkag ntawm 1-800-291-2002. Tus kws rau npe nkag tshwj


xeeb yuav muaj peev xwm los pab koj daws qhov teebmeem. Koj kuj tseem tuaj yeem sau ib tsab ntawv raug cai lossis daim ntawv foob mus rau Care4Kids lossis rau hauv Wisconsin Managed Care Program. Qhov chaw nyob thiab npawb xovtooj tiv toj lub xeev qhov kev pab HMO yog:

Care4Kids, Medicaid Managed Care Ombuds PO Box 6470 Madison, WI 53716-0470 1-800-760-0001

Yog tias koj daim ntawv foob tsis txaus siab yuav tsum tau nqis tes ua sai sai vim tias yog kho mob qeeb yuav ua rau muaj kev pheej hmoo siab rau koj tus menyuam li kev noj qab haus huv, hu rau Care4Kids Lub Chaw Pab Cuam Tswvcuab sai npaum sai tau ntawm 1-800-482-8010. Peb tsis tuaj yeem kho mob rau koj tus menyuam sib txawv li lwm tus tswvcuab vim qhov koj sau ntawv tsis txaus siab lossis ntawv foob. Koj tus menyuam cov txiaj ntsig kev kho mob yuav tsis muaj qhov cuam tshuam txog. Koj muaj cai sau ntawv foob mus rau Xeev Wisconsin Feem Haujlwm Saib Xyuas Cov Ntawv Foob thiab Saib Xyuas Kev Ncaj Ncees rau daim ntawv thov saib xyuas


kev ncaj ncees yog koj ntseeg tias koj tus menyuam cov nyiaj pab raug tsis kam lees, txwv, txiav tawm, ua qeeb lossis tso tseg yam tsis ncaj ncees ntawm Care4Kids. Daim ntawv foob yuav tsum tau sau tsis pub dhau 45 hnub tom qab hnub uas tau nqis tes daim ntawv txiav txim. Yog tias koj sau ntawv foob rau qhov no rau Feem Haujlwm Saib Xyuas Kev Ncaj Ncees thiab Ntawv Foob ua ntej hnub uas siv tau, koj tus menyuam yuav txuas ntxiv tau txais cov kev pab. Koj yuav tsum tau them cov nqi saib xyuas yog tias kev txiav txim siab los ntawm kev saib xyuas dua tsis raug raws koj siab xav. Yog tias koj xav sau daim ntawv thov saib xyuas kev ncaj ncees, xa ib tsab ntawv thov mus rau:

Department of Administration Division of Hearings and Appeals PO Box 7875 Madison, WI 53707-7875

Qhov kev saib xyuas kev ncaj ncees yuav tau teev tseg hauv lub nroog uas koj nyob. Koj tus menyuam muaj cai mus koom nrog ntawm lub rooj saib xyuas kev ncaj ncees. Yog tias koj tus menyuam xav tau kev paj pab tshwj xeeb txog kev xiam oos qhab lossis txhais lus Askiv, hu rau 1-608-266-3096 (suab lus) lossis (608) 264-9853 (tsis hnov lus zoo). Yog tias koj xav tau kev pab sau ib daim ntawv thov rau kev tsis hnov lus zoo, hu rau Wisconsin Managed


Care Ombudsman ntawm 1-800-760-0001 lossis HMO tus kws tshwj xeeb rau npe nkag ntawm 1-800-291-2002. Cov Ntawv Lees Txais Menyuam Yaus Qhov Kev Npaj Kho Mob Hauv Zej Zog xav kom nws cov tswvcuab tau txais cov kev pab kho mob uas zoo tshaj plaws thaum lawv xav tau nws. Kom ua tau li no, peb siv cov txheej txheem tso cai ua ntej, uas yog ib feem ntawm peb qhov kev pab Tswj Hwm Kev Siv (UM). UM qhov kev txiav txim yog ua raws li qhov tsim nyog ntawm kev kho mob thiab kev pab cuam xwb, thiab cov kev pab them uas tseem tshuav. Care4Kids tsis muaj cov nyiaj npaj tshwj xeeb nrog peb cov kws kho mob uas tuaj yeem muaj kev cuam tshuam txog kev siv daim ntawv xa mus thiab lwm cov kev pab uas menyuam yaus yuav xav tau. Koj muaj cai thov yog tias peb muaj kev npaj nyiaj tshwj xeeb nrog peb cov kws kho mob lub cev uas tuaj yeem cuam tshuam txog kev siv cov ntawv xa mus thiab lwm cov kev pab uas koj tus menyuam yuav xav tau. Txhawm rau kom tau txais cov ntaub ntawv no, hu rau Chaw pab cuam tswvcuab ntawm 1-800-482-8010 thiab thov cov ntaub ntawv hais txog peb cov kev npaj them nyiaj rau kws kho lub cev.


Kev paub txog cov kws kho mob li ntawv keeb kwm kev paub Koj thiab koj tus menyuam muaj cai tau txais cov ntaub ntawv hais txog peb cov kws kho mob uas suav nrog tus kws kho mob li kev kawm paub, daim ntawv pov thawj thiab cov ntawv lees paub dua. Kom tau txais cov ntaub ntawv no, hu rau Chaw Pab Cuam Cov Neeg Mob ntawm 1-800-482-8010. Koj Cov Cai Ua Tswvcuab Koj tus menyuam muaj cai kom:

• Thov ib tus kws pab txhais lus thiab tau txais ib tus kws pab txhais lus pub rau koj thiab koj tus menyuam thaum lub sij hawm muaj ib qho kev kho mob uas Care4Kids pab them

• Tau txais cov ntaub ntawv tau muab hauv tswvcuab phau ntawv qhia no ua lwm hom lus lossis lwm yam qauv

• Tau txais cov kev pab kho mob ib yam li cov kev pab uas tau muab raws li tsoomfwv thiab lub xeev tsab kev cai lij choj. Txhua cov kev pab tau pab nyiaj yuav tsum muaj thiab mus cuag tau rau koj tus menyuam. Thaum yog kev kho mob tsim nyog, cov kev pab yuav tsum muaj 24 teev hauv ib hnub, xya hnub hauv ib lim tiam.


• Tau txais cov ntaub ntawv hais txog cov kev xaiv kho mob suav nrog cov cai kom thov txoj kev xaiv thib ob hais txog cov nqi lossis cov kev pab them nyiaj

• Koom nrog cov kws kho mob hauv kev txiav txim txog koj tus menyuam li kev kho mob hais txog ntawm tus nqi lossis cov kev pab them nyiaj

• Tau txais kev kho mob nrog kev saib taus thiab hawm. Koj tus menyuam muaj cai kom saib xyuas tus kheej ntiag tug txog lawv li kev kho mob

• Tsis pub kom muaj ib qho kev raug kuav cia lossis raug cais los siv ua kev quab yuam, tuav tswj, yooj yim, lossis kev tsis ua haujlwm zoo

• Tau txais cov ntaub ntawv hais txog Care4Kids nws cov kev pab, cov kws kho mob thaib cov chaw khomob thiab tswvcuab cov cai thiab cov luag haujlwm.

• Cov lus yws tsis txaus siab lossis lus foob nrog Care4Kids lossis cov kev pab uas nws muab rau

• Muab cov lus taw qhia ntsig txog Care4Kids tsab cai tswvcuab cov cai thaib cov luag haujlwm

• Qhov kev sib tham tshiab ntawm cov kev xaiv qhov tsim nyog lossis kev kho mob tsim nyog rau koj tus menyuam tus mob, hais txog cov nqi lossis cov kev pab them nyiaj


Koj muaj lub luag haujlwm kom: • Nkag siab txog koj tus menyuam li teebmeem kev

noj qab haus huv thiab koom ua cov hom phiaj txhim kho kev kho mob

• Qhia rau koj tus menyuam tus kws kho mob lossis Care4Kids txog yam uas lawv yuav tsum tau paub txog kev kho koj tus mob

• Ua raws li qhov kev npaj kho mob thiab cov lus qhia uas tau pom zoo raws li koj thiab koj tus menyuam tus kws kho mob

Ceebtoom Txog Kev Siv Tus Kheej Ntiag Tug Qhov kev ceebtoom no piav qhia txog yuav ua li cas thiaj tiv thaiv tau cov ntaub ntaub ntawv kho mob txog peb cov tswvcuab uas yuav tau siv thiab nthuav tawm thiab yuav ua li cas cov tswvcuab thiaj tuaj yeem tau txais kev mus saib tau cov ntaub ntawv kho mob uas tau txais kev tiv thaiv no. Thov ua tib zoo tshuaj xyuas tsab ntawv ceebtoom no. Children’s Community Health Plan Care4Kids tau cog lus yuav tiv thaiv koj tus menyuam tus kheej ntiag tug. Tsab ntawv ceebtoom no piav qhia txog Children’s Community Health Plan Li Kev Siv Tus Kheej Ntiag Tug, cov luag haujlwm raug cai thiab koj tus menyuam cov cai cuam tshuam txog lawv tus kheej cov ntaub ntawv kho mob.


Peb pov hwm cov cai hloov pauv peb cov kev siv tus kheej ntiag tug thiab cov ntsiab lus ntawm tsab Ntawv Coobtoom Tus Kheej Ntiag Tug no raws li tau tso cai los ntawm kev cai lij choj. Thaum peb ua qhov kev hloov pauv tseem ceeb hauv peb cov kev siv tus kheej ntiag tug, peb yuav hloov tsab ntawv ceebtoom no thiab xa tsab ntawv ceebtoom no rau peb cov tswvcuab lossis muab nws tso rau hauv peb tus website ntawm www.childrenscommunityhealthplan.org. Cov ntsiab lus “tus kheej cov ntaub ntawv kho mob” hauv tsab ntawv ceebtoom no suav nrog tus kheej txhua cov ntaub ntawv uas tau sau lossis tau txais los ntawm qhov kev npaj kho mob uas cuam tshuam txog peb cov tswvcuab li kev kho mob mob lub cev lossis mob hlwb lossis cov mob , cov kev kho mob lossis kev them nyiaj rau cov kev pab kho mob uas tau txais los ntawm peb cov tswvcuab. Cov luag haujlwm tus kheej ntiag tug Children’s Community Health Plan yuav tsum ua raws kev cai lij choj kom:

• Paub tseeb tias tus kheej cov ntaub ntawv kho mob tau muab khaws cia tsis pub lwm tus paub


• Muab Tsab Ntawv Ceebtoom Txog Kev Siv Tus Kheej Ntiag Tug rau niam txiv/tus neeg saib xyuas raug cai

• Ua raws li cov ntsiab lus ntawm Tsab Ntawv Ceebtoom Txog Kev Siv Tus Kheej Ntiag Tug

Peb yuav siv thiab nthuav tawm koj tus menyuam cov ntaub ntawv kho mob:

• Rau niam txiv/tus neeg saib xyuas raug cai, ib tus neeg twg uas koom nrog hauv koj tus menyuam li kev kho mob, lossis kom xaiv ib tus phooj ywg lossis ib tus neeg hauv tsev neeg txog koj tus menyuam tus mob, lawv cov kev rau npe nkag rau hauv lub tsev kho mob lossis kev ploj tuag

• Rau Tus Thawj Saib Xyuas ntawm Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv thiab Pab Cuam Tib Neeg

• Rau tsoomfwv cov chaw haujlwm hauv qhov xwm txheej muas muaj mob hnyav lossis saib xyuas kev nyab xeeb

• Kom tso cai hais txog kev ua phem, kev tsis saib xyuas lossis kev ua phem hauv tsev

• Ua raws li lub tsev hais plaub daim ntawv xaj, daim ntawv tso cai lossis koom nrog kev tshawb fawb

• Rau lub hom phiaj ua raws li kev cai lij choj


• Rau lub hom phiaj kev tshawb fawb yog tias qhov kev tshawb fawb haum raws li txhua cov cai tus kheej ntiag tug uas xav tau

• Txog lub luag haujlwm tswj hwm tshwj xeeb xws li tub rog, cov kev nyab xeeb hauv tebchaws thiab cov haujlwm kev txawj ntse

• Txog tus kws xoo hluav taws xob lossis tus kws ntsuam xyuas mob lossis tus thawj saib xyuas ntees tuag

• Rau kev xaj yuav khoom, kev nyiaj txiag lossis kev hloov cov khoom hauv nrog cev, qhov muag lossis khoom hauv lub cev

• Kom ua raws li tus neeg ua haujlwm cov kev ua haujlwm lossis cov kev cai lij choj uas sib xws

• Txog cov chaw haujlwm saib xyuas kev kho mob txhawm rau tshuaj xyuas, tshawb nrhiav qhov tseeb, tshuaj ntsuam xyuas thiab kev tso cai tsim nyog rau tsoomfwv tshuaj xyuas cov kab ke kho mob thiab cov kev pab kho mob

Peb muaj cai kom siv thiab nthuav tawm koj tus menyuam cov ntaub ntawv kho mob ntiag tug txhawm rau them nyiaj rau cov nqi kho mob thiab pab cov kev ua haujlwm:

• Txog tus kws kho mob, lub tsev kho mob lossis lwm lub chaw kho mob, uas thov tog koj tus menyuam


cov ntaub ntawv kho mob uas tau txais kev tiv thaiv txhawm rau kom nws tau txais cov kev pab kho mob

• Txhawm rau them rau cov kev thov pab them nyiaj rau cov kev pab kho mob uas raug pab them rau koj tus menyuam los ntawm cov kws kho mob, cov tsev kho mob lossis lwm lub chaw kho mob

• Txhawm rau kev ua haujlwm ntawm Children’s Community Health Plan xws li kev nqis tes ua koj tus menyuam qhov kev rau npe, ua raws li niam txiv/tus neeg saib xyuas raug cais qhov xav tau, teb raws li koj daim ntawv thov cov kev pab rau koj tus menyuam, kev koom tes kho mob rau koj tus menyuam, kev hais daws qhov tsis sib haum xeeb thaib cov haujlwm uas txhawm rau kev tuav tswj kev kho mob, saib xyuas kev kho mob kom zoo, kev kuaj xyuas thiab tshuaj ntsuam xyuas cov kws tshaj lij kho mob

• Txhawm rau tiv toj niam txiv/tus neeg saib xyuas raug cai cov ntaub ntawv cuam tshuam txog cov txiaj ntsig thiab cov kev pab lossis cov kev xaiv kho mob uas yuav ua rau nws muaj kev txaus siab

Cov kev pab kho mob uas tuaj yeem muab rau Children’s Community Health Plan los ntawm lwm cov koom haum tau paub tias “cov chaw saib xyuas haujlwm.” Piv txwv li, lub chaw tuav tswj thib peb yuav los saib xyuas txog koj


tus menyuam daim ntawv thov yog li tuaj yeem them raws li kev thov. Lawv cov ntaub ntawv tiv thaiv kev kho ob yuav tau muab rau lub chaw lag luam cuam tshuam yog li them tau raws li qhov kev thov. Txhua cov chaw lag luam cuam tshuam yuav tsum muaj los ntawm Children’s Community Health Plan kom kos npe rau daim ntawv pom zoo txog kev nyab xeeb rau koj tus menyuam cov ntaub ntawv kho mob uas tau txais kev tiv thaiv.. Txhua lwm cov kev siv lossis nthuav tawm koj tus menyuam cov ntaub ntawv kho mob uas tau txais kev tiv thaiv yuav tsum kom niam txiv/tus neeg saib xyuas raug cai sau ib tsab ntawv tso cai ua ntej yuav siv lossis nthuav tawm cov ntaub ntawv kho mob uas tau txais kev tiv thaiv. Niam txiv/tus neeg saib xyuas raug cai tuaj yeem thim kev tso cai tau txhua lub sij hawm uas yog sau ib tsab ntawv ceebtoom rau. Txhua cov ntaub ntawv kho mob uas tau txais kev tiv thaiv uas yav tas los tau siv lossis nthuav tawm raws li daim ntawv tau tso cai ua ntej yuav tsis tuaj yeem thim tau lossis hloov pauv tau. Koj tus menyuam cov cai Txuas ntxiv no yog koj tus menyuam cov cai nrog kev hawm kom tiv thaiv cov ntaub ntawv kho mob uas tau txais kev tiv thaiv:


• Tshuaj xyuas thiab luam tawm. Niam txiv/tus neeg saib xyuas muaj cai tshuaj xyuas thiab luam tawm nws tus menyuam cov ntaub ntawv kho mob uas tau txais kev tiv thaiv. Kom ua raws li cov kev tshuaj xyuas lossis kev thov luam tawm, niam txiv/tus neeg saib xyuas yuav tsum xa ib daim ntawv thov mus rau Lub Chaw Tswj Hwm Kev Npaj Kho Mob ntawm qhov chaw nyob uas muaj nyob ntu kawg ntawm Tsab Ntawv Ceebtoom Kev Siv Tus Kheej Ntiag Tug No. Nws yuav raug sau nqi yam tsim nyog rau cov nqi luam ntaub ntawv. Hauv qhov kev txwv rau cov xwm txheej, koj yuav raug tsis kam lees cov hauv kev rau kev tshuaj xyuas thiab luam tus menyuam cov ntaub ntawv kho mob uas tau txais kev tiv thaiv. Feem ntau, yog tias tsis kam lees mus saib tau tus menyuam cov ntaub ntawv kho mob uas tau txais kev tiv thaiv, niam txiv/tus neeg saib xyuas yuav thov kom tshuaj xyuas qhov tsis kam lees.

• Kev thov kom hloov kho. Niam txiv/tus neeg saib

xyuas raug cai muaj cai thov kom muaj lub caij nyoog los hloov kho ib cov ntaub ntawv kho mob uas tau txais kev tiv thaiv uas nws xav tias sau tsis raug lossis sau tsis tag. Txhawm rau thov kom muaj lub caij nyoog los hloov kho tus menyuam cov ntaub ntawv kho mob uas tau txais kev tiv thaiv, daim ntawv thov


yuav tsum muab xa mus rau Lub Chaw Tswj Hwm Kev Npaj Kho Mob ntawm qhov chaw nyob muaj nyob ntu kawg ntawm Tsab Ntawv Ceebtoom Kev Siv Tus Kheej Ntiag Tug. Tsab ntawv thov no muaj cov laj thawj uas nws xav tias cov ntaub ntawv kho mob uas tau txais kev tiv thaiv tsis raug lossis sau tsis tag. Daim ntawv thov kom hloov kho tus menyuam cov ntaub ntawv kho mob uas tau txais kev tiv thaiv yuav raug tsis kam lees xws li qhov aus cov ntaub ntawv kho mob uas tau txais kev tiv thaiv yog: o Sau raug thiab sau tag lawm o Tsi yog sau los ntawm Children’s Community

Health Plan o Tsis muaj nyob hauv cov ntaub ntawv kho mob

uas tau txais kev tiv thaiv uas yog Children’s Community Health Plan ua tus khaws lossis muab rau

o Tsis yog cov ntaub ntawv kho mob uas tau txais kev tiv thaiv uas niam txiv/tus neeg saib xyuas raug cai muaj cai los tshuaj xyuas

• Kev thov cov npe ntawm cov chaw uas nthauv

tawm rau. Niam txiv/tus neeg saib xyuas raug cai muaj cai kom tau txais cov npe qhov chaw uas Children’s Community Health Plan tau nthuav tawm cov ntaub ntawv rau cov kev npaj kho mmob uas tau


ua rau lwm tus, zam rau cov kev nthuav tawm uas tsim nyog rau kev kho mob, kev them nyiaj, kev ua haujlwm kho mob lossis kev nthuav tawm tau ua rau nws tus menyuam lossis lwm yam kev nthuav tawm. Txhawm rau thov cov npe uas nthuav tawm no, niam txiv/tus neeg siab xyuas raug cai yuav tsum xa ib daim ntawv thov rau tus neeg tswj hwm qhov kev npaj ntawm qhov chaw nyob uas muaj nyob ntu kawg ntawm Tsab Ntawv Ceebtoom Kev Siv Tus Kheej Ntiag Tug, Tsab ntawv thov yuav tsum teev tseg ncua sij hawm, yuav yuav ntev dua rau xyoo ua ntej hnub uas thov tuaj thiab yuav tsis thov ib co ntaub ntawv uas nthuav tawm ua ntej Lub Kaum Ob Hlis 1, 2005. Yog tias niam txiv/tus neeg saib xyuas raug cai thov cov npe nthuav tawm ntau tshaj li ib zaug hauv 12 lub hli, peb yuavyuav sau nqi yam tsim nyog, tus nqi yog ua raws li cov uas teev rau hauv cov ntawv thov no.

• Kev thov kom txwv. Niam txiv/tus neeg saib xyuas

raug cai muaj cai thov kom txwv cov ntaub ntawv kho mob uas tau txais kev tiv thaiv nthuav tawm txog tus menyuam li kev kho mob, kev them nyiaj lossis kev ua haujlwm kho mob. Children’s Community Health Plan tsis tas yuavyuav tsum tau pom zoo raws li daim ntawv thov. Txhawm rau thov cov kev txwv, niam txiv/tus neeg saib xyuas raug cai yuav tsum xa ib


daim ntawv thov mus rau Tus Neeg Tswj Hwm Qhov Kev Npaj ntawm qhov chaw nyob uas muaj nyob ntu kawg ntawm Tsab Ntawv Ceebtoom Kev Siv Tus Kheej Ntiag Tug. Nws yuav tsum suav nrog daim ntawv thov: o Cov ntaub ntawv rau kev txwv o Seb yog nws xav kom txwv kev siv lossis nthuav

tawm cov ntaub ntawv kho mob uas tau txais kev tiv thaiv los yog tag nrho ob qho

o Rau tus neeg uas nws xav kom txwv tsis txhob muab rau

• Kev thov kom muaj kev sib txuas lus tsis pub lwm

tus neeg paub. Niam txiv/tus neeg saib xyuas raug cai muaj cai thov Children’s Community Health Plan kom tham txog nws cov teebmeem kho mob hauv ib txoj hau kev twg lossis hauv ib thaj chaw tshwj xeeb. Txhawm rau thov kom sib tham lus tsis pub lwm tus neeg paub, xa daim ntawv thov tuaj rau hauv Tus Neeg Tswj Hwm Qhov Kev Npaj ntawm qhov chaw nyob muaj nyob ntu kawg ntawm Tsab Ntawv Ceebtoom Kev Siv Tus Kheej Ntiag Tug. Daim ntawv thov yuav tsum qhia meej txog yuav sib tham li cas/lossis yuav sib tham tsis pub lwm tus neeg paub nyob rau qhov chaw twg. Peb yuav mob siab rau ua txhua yam kom tau raws li txhua daim ntawv thov sib


tham lus tsis pub lwm tus neeg paub uas muaj laj thawj.

• Daim ntawv luam ntawm Tsab Ntawv Ceebtoom

Kev Siv Tus Kheej Ntiag Tug. Tus neeg mob ntawm Children’s Community Health Plan tuaj yeem thov ib daim ntawv theej ntawm tsab ntawv ceebtoom no tau txhua lub sij hawm. Niam txiv/tus neeg saib xyuas raug cai yuav thov ib daim ntawv thov kom muab daim ntawv theej ntawm tsab ntawv ceebtoom no uas yog sau ntawv mus rau Tus Tswj Hwm Qhov Kev Npaj ntawm qhov chaw nyob uas muaj nyob ntu kawg ntawm Tsab Ntawv Ceebtoom Kev Siv Tus Kheej Ntiag Tug.

Kev tsis txaus siab Yog tias niam txiv/tus neeg saib xyuas raug cai ntseeg tias nws tus menyuam cov cai ntiag tug raws li tsab cai no tau raug yuam, nws tuaj yeem sau ntawv foob kev tsis txaus siab nrog Children’s Community Health Plan tus neeg ua haujlwm saib xyuas tus kheej ntiag tus ntawm qhov chaw nyob muaj npe hauv qab no. Lwm txoj hauv kev, nws tuaj yeem xa daim ntawv tsis txaus siab mus rau Tus Tuav Haujlwm ntawm Tebchaws Asmeskas Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv thiab Pab Cuam Tib Neeg. Niam txiv, cov neeg saib xyuas raug cai lossis tus


menyuam yuav tsis raug nplua nyiaj lossis raug ua pauj rau qhov sau ntawv foob tsis txaus siab. Tus neeg ua haujlwm tswj hwm qhov kev npaj thiab tus kheej ntiag tug cov ntaub ntawv tiv toj yog:

Tus Tuav Tswj Qhov Kev Npaj (Plan Administrator) Lwm Thawj Tswj Hwm Children’s Community Health Plan PO Box 1997 Milwaukee, WI 53201 1-414-266-6328

Tus Saib Xyuas Tus Kheej Ntiag Tug (Privacy Officer) Tus Thawj Saib Xyuas Ntawv Tsis Txaus Siab (Director of Corporate Compliance) Children’s Community Health Plan PO Box 1997 Milwaukee, WI 53201 1-414-266-2215

Cov lus yuav tau paub • Mus cuag tau – Ib tus neeg rab peev xwm kom tau

txais kev kho mob • Kev sau qhia ua ntej –Ib daim ntawv uas piav qhia

txog tus neeg txoj kev nyiam txog kev kho mob thaum nws tsis muaj rab peev xwm hais tau ntawm nws tus kheej lawm

• Xwm txheej kub ntxhov –Ib qho mob uas tuaj yeem puas tsuaj rau lub neej txoj sia uas yog los ntawm kev


raug mob, muaj mob lossis mob hlwb uas tshwm sim sai thiab yuav tsum tau kho kom sai sai

• Lub koom haum tuav tswj kev kho mob (HMO) –Ib lub koom haum uas los txiav txim txog yuav siv kev pab kho mob li cas, thiab tus nqi kho mob thiab cov kev ntsuas yuav ua li cas thiaj kho mob tau zoo rau tus tswvcuab

• Tswj hwm kev kho mob –Qhov kab ke ntawm kev kho mob uas txhawb rau kev siv thiab tus nqi kho mob thiab ntsuas kev kho mob tau zoo

• Mob hlwb – Yam mob uas muaj kev cuam tshuam txog mob hlwb thiab txoj kev xaiv

• Tus saib xyuas yug menyuam –Tus kws kho mob uas pab saib xyuas cov pojniam ua ntej yug menyuam thiab thaum tus menyuam yug, tshwj xeeb ntawm tseev lossis lwm qhov chaw uas tsis yog nyob hauv tsev kho mob

• Kws kho mob pojniam cev xeeb tub (OB/GYN) –Ib tus kws kho mob uas muaj kev paub tshwj xeeb txog kev yug menyuam, kev saib xyuas thiab kho mob rau cov pojniam uas yug menyuam, saib xyuas kev noj qab haus huv thiab kho mob rau cov pojniam

• Daim ntawv tso cai raug cai –Ib daim ntawv raug cai muab rau ib tus neeg (lub chaw haujlwm) kom muaj lub hwj chim los sawv cev rau koj. Lub chaw haujlwm


yuav txiav txim siab kho mob kom tsim nyog rau koj thaum koj tsis tuaj yeem tham lus tau

• Kev pab kho mob thaum pib –Kev pab kho mob uas tau mob los ntawm cov kws kho mob hu tias cov kws kho mob tshwj xeeb, suav nrog tsev neeg cov kws kho mob, cov kws siv tshuaj kho mob thiab cov kws kho menyuam yaus

• Thawj tus kws kho mob – Tus kws kho mob uas khiav txhua yam haujlwm pab cuam kev kho mob

• Kev tso cai ua nej – Ib daim ntawv tso cai tau txais los ntawm tus kws kho mob rau tus tswvcuab komm tau txais kev pab kho mob

• Kws kho mob –Ib tus neeg lossis ib pab pawg ntawm cov kws kho mob uas muab kev pab kho mob ntawm lub tsev kho mob lossis lub chaw kuaj mob

• Kev kho mob maj ceev –Ib qho kev raug mob lossis muaj mob uas yuav tsum tau kho sai sai tab sis kuj tsis yog mob hnyav txaus uas yuav mus kho hauv chav kho mob xwm txheej kub ntxhov

Koj tuaj yeem pab tiv thaiv kev tsis ncaj nees hauv kev kho mob! Kev tsis ncaj ncees hauv kev kho mob nyiag cov nyiaj ntawn cov kev pab kho mob thiab tseg cov nyiaj tsawg dua rau qhov uas kho mob tiag.


Nov yog qee txoj hau kev uas koj tuaj yeem pab nres tsis pub muaj qhov ua txhaum: • Tsis txhob muab koj tus menyuam Daim Npav ID

ForwardHealth rau ib tus neeg twg dhau ntawm tus kws kho mob, lub chaw kuaj mob lossis tsev kho mob, thiab tsuas yog muab thaum lawv tau txais kev kho mob xwb

• Tsis txhob muab koj tus menyuam daim npav ForwardHealth rau ib tus neeg twg qiv

• Tsis txhob kos npe rau daim ntawv foos uas tsis sau dab tsi rau

• Ceev faj txog kev muab koj tus menyuam tus npawb Social Security

• Tshuaj xyuas koj cov ntawv txog cov nqi kho mob uas koj tus menyuam tsis tau txais

Yog koj pom tias muaj qhov ua tsis ncaj, thov hais qhia kiag tam sim. Koj qhov hais qhia yuav khaws cia tsis pub lwm tus neeg paub. Txhawm rau hais qhia kev tsis mob siab rau, ua txhaum thiab tub sab, suav sau cov ntaub ntawv kom ntau npaum ntau tau uas koj tuaj yeem ua. Thaum hais qhia rau tus kws kho mob (kws kho mob, kws kho hniav, tsev kho mob, thiab lwm tus) muab cov ntaub ntawv komm ntau npaum li ntau tau raws li hauv qab no: • Lub npe, chaw nyob thiab npawb xovtooj ntawm tus

kws kho mob


• Tus npawb Medicaid ntawm tus kws kho mob thiab thaj chaw, yog tias muaj

• Hom kws kho mob (kws kho mob, kws kho hniav, tsev kho mob, chaw muag tshuaj, thiab lwm tus)

• Lub npe thiab cov neeg uas ua ua pov thawj uas tuaj yeem pab tshawb nrhiav qhov tseeb

• Hnub tim thaum koj kuaj pom qhov kev ua tub sab tshwm sim.

• Sau cov ntsiab lus qhia txog qhov uas tshwm sim Thaum hais qhia txog tus neeg qhua (tus neeg uas tau txais cov txiaj ntsig), muab cov ntaub ntawv txuas ntxiv no: • Tus neeg lub npe • Tus neeg hnub yug, tus npawb social security lossis

tus npawb cov ntaub ntawv yog tias muaj • Lub nroog uas tus neeg ntawv nyob • Cov ntsiab lus qhia txog qhov kev tub sab lossis ua

txhaum Koj tuaj yeem sau ntawv foob kev ua tub sab yam tsis qhia koj lub npe uas yog xa ntawv rau:

Attn: Director of Corporate Compliance Children’s Community Health Plan PO Box 1997, MS 6280 Milwaukee, WI 53201-1997


Koj kuj tuaj yeem hu rau peb ntawm 414-266-2215 lossis tus npawb hu dawb 1-877-659-5200. Koj kuj tuaj yeem tiv toj rau Wisconsin’s Medicaid Fraud Unit ntawm:

Lub Chaw Haujlwm Saib Xyuas Medicaid Kev Ua Tub Sab thiab Ua Txhaum Tiv toj: Medicaid Fraud Control Unit Department of Justice 17 W. Main Street PO Box 7857 Madison, WI 53707

Children’s Community Health Plan (CCHP) complies with all applicable civil rights laws and does not discrim-inate on the basis of race, color, national origin, sex, age, disability, or other legally protected status, in its administration of the plan, including enrollment and benefit determinations.

CCHP provides appropriate auxiliary aids and services, including qualified interpreters for individuals with disabilities and who have language services needs and information in alternate formats, free of charge and in a timely manner, when such aids and services are necessary to ensure an equal opportunity to participate to individuals with disabilities.

Any person who believes someone has been subjected to discrimination on the basis of race, color, nation-al origin, sex, age or disability may file a grievance in person, by mail, fax or email. The grievance must be filed with 60 days of the person filing the grievance becomes aware of the alleged discriminatory action. It is against the law for CCHP to retaliate against anyone who files a grievance, or who participates in the inves-tigation of a grievance. Members can request CCHP’s grievance procedure by contacting the Section 1557 Coordinator:

Director, Corporate ComplianceMail Station C760P.O. Box 1997Milwaukee, WI 53201-1997Telephone: (414) 266-2215TDD-TTY (for the hearing impaired): (414) 266-2465Fax: (414) [email protected]

Members must submit their complaints in writing with their name, address, the problem or action alleged to be discriminatory and the remedy or relief sought. Members can also file a complaint of discrimination elec-tronically through the Office for Civil Rights Complaint Portal, which is available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail at:

U.S. Department of Health and Human Services 200 Independence Avenue SW Room 509FHHH Building Washington, D.C. 20201

Complaint forms are available at:http://www.hhs.gov/ocr/office/file/index.html

Discrimination is against the law.

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HINDI: यदि आपके ,या आप द्वारा सहायता ककए जा रहे ककसी व्यक्तत क ेChildren’s Community Health Plan के बारे में प्रश्न हैं ,तो आपके पास अपनी भाषा में मुफ्त में सहायता और सूचना प्राप्त करने का अधिकार है। ककसी िुभाषषए से बात करने के लिए 1-855-371-8104.पर कॉि करें। TTY: 7-1-1.

PENNSYLVANIA DUTCH: Wann du hoscht en Froog, odder ebber, wu du helfscht, hot en Froog baut Children’s Community Health Plan, hoscht du es Recht fer Hilf un Information in deinre eegne Schprooch griege, un die Hilf koschtet nix. Wann du mit me Interpreter schwetze witt, kannscht du 1-855-371-8104 uffrufe. TTY: 7-1-1.

LAOTIAN: ້າທ່ານ, ຫ ຼືຄົນທ ່ທ່ານກໍາລັງຊ່ວຍເຫ ຼືອ, ມ ຄໍາຖາມກ່ຽວກັບ Children’s Community Health Plan, ທ່ານມ ສິດທ ່ຈະໄດ້ຮັບການຊ່ວຍເຫ ຼືອແລະຂໍ້ມູນຂ່າວສານທ ່ເປັນພາສາຂອງທ່ານບໍ່ມ ຄ່າໃຊ້ຈ່າຍ. ການໂອ້ລົມກັບນາຍພາສາ, ໃຫ້ໂທຫາ 1-855-371-8104. TTY: 7-1-1.

KOREAN: 만약 귀하 또는 귀하가 돕고 있는 어떤 사람이 Children’s Community Health Plan 에 관해서 질문이 있다면 귀하는 그러한 도움과 정보를 귀하의 언어로 비용 부담없이 얻을 수 있는 권리가 있습니다. 그렇게 통역사와 얘기하기 위해서는 1-855-371-8104 로 전화하십시오. TTY: 7-1-1.

RUSSIAN: Если у вас или лица, которому вы помогаете, имеются вопросы по поводу Children’s Community Health Plan то вы имеете право на бесплатное получение помощи и информации на вашем языке. Для разговора с переводчиком позвоните по телефону 1-855-371-8104. TTY: 7-1-1.

BURMESE: Children’s Community Health Plan နွင့္ပတ္သက္၍ သင္ သို႔မဟုတ္ သင္အကူအညီေပးေနသူတစ္ဦးတြင္ ေမးျမန္းစရာမ်ား ရွိမည္ဆိုပါက၊ အကူအညီနွင့္ သတင္းအခ်က္အလက္မ်ားကို အခမဲ့့ သင္ရယူပိုင္ခြင့္ ရွိပါသည္။ စကားျပန္ဆိုသူ တစ္ဦးထံသို႔စကားေျပာဆိုရန္၊ 1-855-371-8104. တြင္ ဖုန္းေခၚဆိုပါ။ TTY: 7-1-1.

SOMALI: Haddii adiga iyo qof aad caawinaysaa su’aalo qabaan ku saabsan Children’s Community Health Plan, waxaad leedahay xaqa aad caawimo ku hesho iyo macluumaadka luqaddaada iyaddoon kharash kugu fadhiyin. Lahadal turjubaan wac 1-855-371-8104. TTY: 7-1-1.

If you or someone you’re helping has questions about Children’s Community Health Plan, you have the right to get help and information in your language at no cost. To talk to an interpreter, call 1-855-371-8104. If you are hearing impaired, call the Wisconsin Relay at 7-1-1.

Auxiliary Aids and ServicesChildren’s Community Health Plan (CCHP) provides free aids and services to people with disabilities to communicate effectively with us including qualified interpreters (including sign language) and written information in other languages and formats (large print, audio, accessible electronic formats,). To request, call CCHP at 414-266-3490.

ATTENTION: If you speak English, language assistance services are available to you free of charge. Call 1-855-371-8104 (TTY: 7-1-1)

ATENCIÓN: Si habla español, los servicios de asistencia de idiomas están disponibles sin cargo, llame al 1-855-371-8104 (TTY: 7-1-1)

CEEB TOOM: Yog koj hais lus Hmoob, kev pab rau lwm yam lus muaj rau koj dawb xwb. 1-855-371-8104 (TTY: 7-1-1)

注意: 如果您说中文，您可获得免费的语言协助服务。请致电 1-855-371-8104 (TTY: 7-1-1)

ВНИМАНИЕ: Если Вы говорите по-русски, Вам будут бесплатно предоставлены услуги переводчика. Позвоните по номеру: 1-855-371-8104 (TTY: 7-1-1)

ေက်းဇူးျပဳ၍ နားဆင္ပါ - သင္သည္ ျမန္မာစကားေျပာသူျဖစ္ပါက၊ သင့္အတြက္ အခမဲ့ျဖင့္ ဘာသာစကားကူညီေရး ၀န္ေဆာင္မႈမ်ား ရရွိနိုင္သည္။ 1-855-371-8104 (TTY: 7-1-1)တြင္ ဖုန္းေခၚဆိုပါ။

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Children’s Community Health PlanPO Box 56099Madison, WI 53705childrenscommunityhealthplan.org

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BadgerCare Plus - Care4Kids · qauv lossis xav tau kev pab txog kev siv peb cov kev pab, thov tiv toj Chaw Pab Cuam Tswvcuab ntawm 1-800-482-8010. Children’s Community Health Plan