Effective July 1, 2006, Harmony Healthcare will be managing the Culinary Care Assistance Program. 

 There are NO changes to the Culinary mental health benefits.  The program will continue to provide ongoing services to your Culinary patients:

• Family Assistance Services – up to five (5) free visits with a counselor
• Substance Abuse treatment – two (2) courses of treatment for alcohol, drug and gambling addiction
• Mental Health benefits – include inpatient care and outpatient counseling

There are some other changes to the program: 

• You and your patients will now be able to make calls for a family member or other loved one in need of care.
• There is a new phone number for access to mental health providers -  (702) 251-8000.
• Many of the same providers are in the Harmony’s provider network.  There is also the option of using the two Harmony mental health clinics if your patients prefer. 
• Harmony Healthcare provides a ‘rapid response’ program to ensure that Culinary patients are seen quickly during a crisis.

 For information on pre-authorization for your Culinary patients, please contact Harmony’s “Provider Relations Department” at (702)251-8000.  For any patients who will need medications or need to utilize the mental health benefit for counseling, please contact the Harmony Healthcare Provider Relations Department for an authorization form, or visit their website at http://culinary.harmonyhc.com.

Beginning 7/1/06, Culinary patients should be referred to Harmony Healthcare for counseling services and other mental health treatment.  Care provided outside of the Harmony Healthcare network will not be covered.

 Should you have any questions, please contact the Fund Customer Service Office at (702) 733-9938.

Culinary Welcomes Catalyst

The Culinary Health Fund is pleased to announce that Catalyst will become our Pharmacy Benefit Manager effective June 1, 2006. There are no changes to the Culinary prescription benefits.  Below is a summary of the changes effective June 1.

• Culinary Medical/Prescription Card – we are issuing new cards to our participants replacing any other Culinary Health Fund cards.  To protect patient privacy, the new cards do not list Social Security Numbers.  Eligible dependents are also not listed on the new card.  To verify eligibility, call our Customer Service office at (702) 733-9938 or click here.  Remember that possession of the card does not guarantee eligibility for benefits. 
• Drug Prior Authorization – Catalyst Rx will be the drug prior authorization provider. 

• More Pharmacies in the Network – More pharmacies have been added to the Culinary network.  To see a list of all the new pharmacies in Las Vegas and in other states, click here or you can go to the Catalyst website by clicking here.
• New Mail Order Provider – Culinary’s mail order service will be administered by PharmaCare Direct.  Your patients using maintenance drugs can benefit to this service by getting 2-months supply of drugs for one copayment.  You may be required to write new scripts for your Culinary patients as they transition to PharmaCare mail order service. 
• More Drugs added – no drugs have been removed from the Culinary formulary, but some drugs have been added. Click here to print a list of the most common prescribed generics and Tier 2 drugs.  Visit the Catalyst Rx website for a complete list of the Culinary formulary by clicking here.

If you have additional questions, please contact the Fund Customer Service office at (702) 733-9938 or Catalyst at 1-866-611-5960.

Generic Form of Oxycontin

The generic form of Oxycontin (Oxycodone Extended Release) is now available in all doses.  As you know, generics are safe, effective, and FDA approved.  They just cost less than brand name drugs. 

Once a generic is available, the Fund will cover the generic only.  If you prescribe Oxycontin, the pharmacy should fill the generic automatically.  If you require the brand name because of your patients' preference, your Culinary patients will be responsible for the difference in cost between the generic version and the brand name.  In the case of Oxycontin, this can be several hundred dollars.

The generic has been marketed before we could communicate this issue to your Culinary patients.  Any assistance you can provide in explaining this issue to your Culinary patients using Oxycontin will be appreciated. 

If you have any questions, please call our Customer Service office at (702) 733-9938.

As of December 1, 2005, Southwest Medical Associates 24-hour Urgent Care Clinic on Rancho Drive is part of the Culinary provider network.  This is a 24-hour Urgent Care Clinic where Culinary participants will have a $35 copay. 

Southwest Medical Associates

888 S. Rancho Drive

Las Vegas, NV  89106

(702) 877-8600

Please remember:  Only the above SMA location is PPO for Culinary participants.

The Fund is continuously working to enhance our website.  Just remember that some of the FAQs are only a click away.

From your requests, here are the recent enhancements to our website:

• Claim Status Enhancements:

- Original receipt date

- Check number

- Pending reasons

• Provider Directory

-PDF version of the current Provider Directory

REMEMBER - the website is secure and confidential.  Available information includes:

• Your patient eligibility
• Claim status
• Plan copayments and benefits
• Provider Manual and Provider Directory
• Forms and Documents

For assistance, please contact our Customer Service office at (702) 733-9938 or send an email to webmaster@culinaryhealthfund.org.

LabCorp on Russell Rd. - Temporary Closure

Due to road construction, the LabCorp Patient Service Center, on Russell Road will be temporarily closed and will reopen on March 1.

For other locations, please call our Customer Service office (702-733-9938) or click here for a complete list.

We apologize for any inconvenience this may cause your office.  If you have any questions, please contact our Customer Service office at 733-9938 for assistance.