Introducing your Health Benefits team!

The Southern Ute Tribal Health Benefits team (pictured left to right), Benefits Coordinator Misha Weaver, Benefits Coordinator Elizabeth (Cindy) Gallegos, and Benefits Coordinator Erika Atencio.
Damon Toledo | The Southern Ute Drum

The Tribal Health Department along with the Tribal Council had many changes this past year to better serve the Southern Ute Indian Tribal Members. There have been staff additions and new programs implemented.

We have a wonderful staff with many years of experience in Benefits Coordination and Contract Health.

BENEFITS STAFF

Erika Atencio has worked for the Tribe for 13 years, 8 of which have been with the Tribal Health Department. She is currently works for the Department as a Benefits Coordinator and is one of the direct contacts for members and providers on medical, dental, vision and pharmacy benefits. She also provides support for patient related travel and tribal member employee premium reimbursement. She is always happy to talk with the members and address any of their questions or concerns. Erika can be reached at 970-563-4704 or extension 2211.

Elizabeth (Cindy) Gallegos has worked as a Benefits Coordinator for about 14 years in a couple of settings, the Southern Ute Health center for 7 years and the Tribal Health Department for the last 7 years. She lives in Ignacio with her son Andrew. Cindy also helps with the Contract Health Services provide through the Southern Ute Health Center. Cindy can be reached at 970-563-4813 or extension 2203.

Misha Weaver started with the Tribal Health Department in 2005. She just recently came back to the Department as a Benefits Coordinator. She is one of the other direct contacts for members and providers in regard to the medical, dental, vision and pharmacy benefits. She also provides support for patient related travel and tribal member employee premium reimbursement. Misha can be reached at 970-563-4716 or extension 2204.

IMPORTANT NEWS!

It’s been a very busy year as the Southern Ute Indian Tribe has worked through the reorganization of the Tribal Member Health Benefit Plan. The Tribe has identified several existing networks to provide Tribal Members with services that are normally not provided through the Southern Ute Health Center.

Medical coverage is with First Health Network through a third party administrator, Capitol Administrators. It is always important to remember to use your employer based coverage (Anthem BCBS, Rocky Mountain HMO, Aetna, etc.) or any other coverages (Medicare, Medicaid, CHP, etc.) first. When going to an outside of the Health Center medical provider please provide them with your other coverage cards first and then your Tribal Member Benefit card (First Health) secondary. Your secondary card will pick up any co-pays, co-insurances or deductibles.

To locate in network providers please go to the following website www.firsthealthnetwork.com. If you need to order new medical cards please contact Capitol Administrators at 1-800-331-5301.

Dental coverage is with Delta Dental Network and to locate an in network dentist to can go to their website at www.deltadentalco.com. If you need to order new dental cards please contact Delta Dental at 1-800-610-0201. If you have another Delta Dental plan through an employer please use your Tribal Member Delta Dental plan to pay for your services. You will have a greater maximum benefit allowance and you will also have no co-pays, co-insurances or deductibles as long as you use an in network provider.

Vision coverage is with Vision Service Plan (VSP). To locate in network providers please go to the following website www.vsp.com. You will not have a card for your VSP coverage and you are identifiable to the provider by your SSN #. If you have another VSP through an employer please use your Tribal Member VSP to pay for your services. You will also have no co-pays, co-insurances or deductibles as long as you use an in network provider.

Pharmacy coverage is with the Pequot Pharmaceutical Program. It is always important to remember to use your employer based coverage (Anthem BCBS, Rocky Mountain HMO, Aetna, etc.) or any other coverages (Medicare, Medicaid, CHP, etc.) first for your medications, if you have unique situations please discuss with your provider to ensure you get your medications filled in a timely fashion. When going outside of the Southern Ute Health Center Pharmacy, please provide them with your other coverage cards first and then your Tribal Member Benefit card (First Health) secondary. Your secondary card will pick up any co-pays or co-insurances.

CONTRACT HEALTH SERVICES

Medical/dental care provided at the Southern Ute Health Center is called Direct Care. The Contract Health Program is for Medical/Dental care provide outside the Health Center. If Contract Health Program is requested to pay, then a patient must meet the residency requirements, notification requirements, medical priority and use of alternate resources. An easy way to access benefit information anytime is the Colorado PEAK program. It is an online service for Coloradoans to check for Eligibility and application for Medical benefits. The Family Center of Colorado is another source available to apply for Alternate resources they can be reached at 970-385-4747 (Durango) or 970-884-4747 (Bayfield). Please remember a referral is not a guarantee of payment. If you are not sure if your referral will be covered by Contract Health, please call us for more information coordinating your health benefits.

 

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