The Government Health Plan of Puerto Rico

The new Government Health Plan of Puerto Rico (GHP) offers more services and benefits. It also offers a Preferred Provider Network within the Primary Medical Group (PMG) of your choice, which you can visit freely without the need for Referrals or paying Copayments.

Under the GHP you do not need the countersignature of the PCP on the Prescriptions ordered by a Specialists or sub-specialists within the Preferred Provider Network of your PMG. You can freely choose dentists and pharmacies of your choice, among those contracted by the GHP.

In addition, you can receive mental health services within the same facility of your PMG as well as physical health services within the same facilities where you receive mental health services. The GHP offers physical and mental health integrated services, so you can receive these services in one place.

Additional information including provider guidelines and information on the structure and operations of the GHP and physician incentive plans is available to you upon request.  If you would like additional information please contact First Medical Health Plan’s Customer Service Department at 1-844-347-7800 Monday through Friday from 7:00 a.m. to 7:00 p.m.  TTY/TDD users should call 1-844-347-7805.

November: Diabetes Awareness Month

Diabetes Awareness

Provider Directory and Health Services Facilities

Provider Directory and Health Services Facilities

 

Important Information for Providers

Webinar Invitation for Zika in Puerto Rico

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On August 11, 2016 the Puerto Rico Department of Health will be conducting a webinar regarding the prevention campaign for the Zika virus. This webinar will include the collaboration of Dr. Brenda Rivera, Director of the Epidemiology Office from the Puerto Rico Department of Health and other health professionals. We encourage you to participate in this initiative. For more information, please see the invitation below. Webinar Invitation for Zika in Puerto Rico Read more

Frequently Asked Question’s ICD-10

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Frequently Asked Question’s ICD-10 Instructions: To ensure the quality of service, it is important to refer to these questions and answers when you receive a call from a Provider requesting information related to ICD-10. Questions and Answers: 1.What is the ICD-10? It is the set of codes that will replace the ICD-9. ICD-10 is the acronym for the International Classification of Diseases Tenth Edition. It consists of two (2) components: ICD-10-CM (Clinical Modification) and ICD-10-PCS (Procedures… Read more

Certifying Compliance with ICD-10

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Certifying Compliance with ICD-10 First Medical Health Plan, Inc. (FMHP) is committed to complying with the International Classification of Diseases, Tenth Edition (ICD -10) requirement and therefore has been working towards a successful implementation. As a health care provider, you must comply with Article Number 162 of Rule # 45 of the Code of Federal Regulations. Therefore you and your staff must be trained and ready for the ICD-10 coding implementation.An important part of FMHP’s… Read more

Are you ready for ICD-10?

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Are you ready for ICD-10? On October 1st, 2015, the International Classification of Diseases, Tenth Edition (ICD-10), will become the new reference point for clinical data, clinical documentation, claims processing, and the presentation of reports of public health. First Medical Health Plan, Inc. (FMHP) as the health insurance company, contracted by the Puerto Rico Health Insurance Administration (PRHIA) to administer the North, San Juan and Virtual Regions of the Government Health Plan of… Read more

Events & Activities

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Institutional Initiative - Cardiovascular Health

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Institutional Initiative - Cardiovascular HealthEl Vocero: First Medical joins International Day for Prevention of Cardiovascular Conditions San Juan - On Friday, February 6th, International Day for Prevention of Cardiovascular Conditions, First Medical Health Plan, Inc., conducted a symbolic walk along with the Hato Rey Regional Office staff during the closing acts of the Cardiovascular Health education campaign. As part of First Medical Health Plan Education & Prevention Department, was… Read more