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COVID-19 - Testing Locations
provider, and receive treatment for COVID-19 – all in one place at a Test to Treat site.
If you have a medical condition which makes you more likely to get very sick from COVID-19, you may be eligible to receive treatments. Adults and Children over the age of 12 can receive treatments, but treatment must be started as soon as possible and within 5 days of symptom onset.
Click here for more information on the COVID-19 Test to Treat Program.
Walgreens Test to Treat Program
Select Walgreens pharmacies are now dispensing oral antivirals for the treatment of COVID-19. Eligible members must have a valid prescription from their healthcare provider. Walgreens offers a variety of delivery options, like same day or free 2-day delivery. Most prescriptions are eligible for Same Day Delivery.
Click here for more information.
FREE at-home COVID-19 tests
Every home in the U.S. is eligible to order one free COVID-19 test kit, which includes four at-home tests. The tests are completely free. Click here to order your free at-home tests from USPS.
Effective 2/1/22, Medi-Cal Members can receive at-home COVID-19 tests from a Medi-Cal enrolled pharmacy. California Department of Health Care Services (DHCS) will cover up to 8 test kits per month per member. For information on which test kits are covered or if you need assistance with a prescription, please ask your Doctor or your Pharmacist.
Medi-Cal Members will be reimbursed for at-home test kits purchased between March 11, 2021, and January 31, 2022, by DHCS the cost (with a receipt) using the process outlined here.
San Bernardino County-facilitated testing sites will offer free at-home COVID-19 tests kits to people who live, work, or attend school in San Bernardino County (proof of residency or employment required). Click here to find a list of county-facilitated testing sites.
Testing
If you believe you are at risk for COVID-19, you can get COVID-19 screening and testing at the sites below.
IEHP covers provider-ordered tests, regardless of whether it’s PCR, rapid, at-home, etc. If your doctor orders the test for you, IEHP will cover the cost of the test. Your provider is required to bill IEHP directly for these tests.
IEHP does NOT reimburse Members who choose to pay for COVID tests that are not ordered by a provider.
Riverside County COVID-19 Testing Sites
Banning
Banning Family Care Center
3055 W. Ramsey, Banning
Schedule an Appointment
Beaumont
Beaumont Women's Club
306 E 6th St., Beaumont, 92223
Call (888) 634-1123
Schedule an Appointment
Borrego Health
Multiple Locations Available
Click here for information on COVID-19 sites in your area.
Cathedral City
Plaza Rio Vista Kiosk
67908 Vista Chino, Cathedral City
Schedule an Appointment
Coachella
Our Lady of Soledad
52525 Oasis Palm Ave., Coachella
Schedule an Appointment
Coachella
TODEC Legal Center COVID Testing
1560 6th St., Coachella
Schedule an Appointment
Corona
Corona Community Health Center
2813 S. Main St., Corona
Schedule an Appointment
Corona
Unicare Community Health Center
107 N. MicKinley St., Corona
Call (909) 457-3603
CVS MinuteClinic
Multiple Locations Available*
Schedule an Appointment
Hours vary by location
Desert Hot Springs
Henry V. Lozano Community Center
12800 West Arroyo, Desert Hot Springs
Schedule an Appointment
Indio
Indio Fleet Services
82775 Plaza Ave., Indio
Schedule an Appointment
Indio
Old Amistad High School
44801 Golf Center Pkwy, Indio
Schedule an Appointment
Jurupa
Avalon Park Community Center
2500 Avalon St., Jurupa
Schedule an Appointment
La Quinta
La Quinta Wellness Center
78450 Avenida La Fonda, La Quinta
Schedule an Appointment
Lake Elsinore
The Outlets at Lake Elsinore Testing
17600 Collier Ave., Suite J-195 Parking Lot, Lake Elsinore
Schedule an Appointment
Moreno Valley
Moreno Valley Family Care Center
23520 Cactus Ave., Moreno Valley
Schedule an Appointment
Moreno Valley
Cottonwood Golf Center
13671 Frederick St., Moreno Valley
Schedule an Appointment
Moreno Valley
Moreno Valley Kiosk
14075 Frederick St., Moreno Valley
M-F 10am - 6:30pm
Schedule an Appointment
Moreno Valley
Riverside University Health System Medical Center
26520 Cactus Ave., Moreno Valley
M-F 10am - 6:30pm
Schedule an Appointment
Murrieta
California Oaks Center Trailer
40565 California Oaks Rd., Murrieta
Schedule an Appointment
Palm Desert
UCR Palm Desert Campus
75080 Frank Sinatra Dr., Palm Desert
Schedule an Appointment
Palm Springs
Palm Springs Convention Center
277 N. Avenida Caballeros, Palm Springs
Schedule an Appointment
Perris
Perris' City Council Chamber
101 N D St., Perris
Schedule an Appointment
Perris
Perris Community Health Center
308 E. San Jacinto Ave., Perris
Schedule an Appointment
Perris
Rapid Care Enterprises
126 Avocado Ave. Ste 102, Perris
Call (951) 490-4910
Mon-Fri | 9 a.m. - 9 p.m.
Sat-Sun | 12 p.m. - 5 p.m.
Costs may be associated with this site
Rite Aid Pharmacy
Multiple Locations Available*
Schedule an Appointment
Mon-Fri | 10 a.m. - 8 p.m.
Sat-Sun | 10 a.m. - 5 p.m.
Riverside
Jurupa Valley Family Care Center
8876 Mission Blvd., Riverside
Schedule an Appointment
Riverside
Riverside City Hall Kiosk (test only)
3900 Main St., Riverside
Schedule an Appointment
Riverside
Riverside Neighborhood Health Clinic
7140 Indiana Ave., Riverside
Schedule an Appointment
Riverside
La Sierra Park Drive Through (test only)
5272 Mitchell Ave., Riverside
Schedule an Appointment
Temecula
Vail Ranch Center Kiosk
31699 Temecula Pkwy., Temecula
Schedule an Appointment
For more information on COVID-19 testing sites in Riverside County, please visit the Riverside County Public Health website.
San Bernardino County COVID-19 Testing Sites
Adelanto
Adelanto Health Center
11336 Bartlett Ave., Ste. 11, Adelanto
Call (800) 722-4777
Apple Valley
James A. Woody Community Center
13467 Navajo Rd., Apple Valley
Schedule an Appointment
Barstow
Barstow Adult School
720 E. Main St., Barstow
Schedule an Appointment
Big Bear
Big Bear Health Center
477 Summit Blvd., Big Bear Lake
Schedule an Appointment
Barstow
Barstow Health Center
303 E. Mountain View St., Barstow
Call (800) 722-4777
Bloomington
Kessler Park
COVID-19 Testing Bus
18401 Jurupa Ave., Bloomington
Schedule an Appointment
Borrego Health
Multiple Locations Available
Click here for information on COVID-19 sites in your area.
Chino
CVUSD Chino Valley Adult School
12970 3rd St., Chino
Schedule an Appointment
Chino
Lani City Medical
4036 Grand Ave., Suite A, Chino
(909) 465-5000
Schedule an Appointment
Colton
Arrowhead Regional Medical Center
400 N. Pepper Ave., Colton
Call (855) 422-8029
Colton
Colton Urgent Care Center
1181 N. Mt. Vernon Ave., Colton
Colton Urgent Care Center Online Check-In
Colton
Gonzales Community Center
670 Colton Ave., Colton
Schedule an Appointment
Colton
Unicare Community Health Center
308 N. La Cadena Dr., Colton
Call (909) 457-3603
CVS
Multiple Locations Available
Schedule an Appointment
Fontana
Jessie Turner Health & Fitness Community Center
15556 Summit Ave., Fontana
Schedule an Appointment
Fontana
West Point Medical Center
7774 Cherry Ave., Fontana
Call (909) 355-1296, option 1
Hesperia
Hesperia Health Center
16453 Bear Valley Rd., Hesperia
Call (800) 722-4777
Joshua Tree
Community Center
6171 Sunburst St., Joshua Tree
Schedule an Appointment
Loma Linda
Loma Linda Senior Center
25571 Barton Rd., Loma Linda
Schedule an Appointment
Montclair
Montclair Kid's Station - COVID Testing Bus
4985 Richton St., Montclair
Schedule an Appointment
Montclair
Montclair Place - Moreno St. Market Food Court
5060 N. Montclair Plaza Ln., 2nd Floor, Ste. 2138
Schedule an Appointment
Ontario
Drive-Through COVID Clinic
2500 E. Airport Dr., Ontario
Schedule an Appointment
Ontario
Drive-Through COVID Clinic
1 Mills Circle, Ontario
Schedule an Appointment
Ontario
Ontario Health Center
150 E. Holt Blvd., Ontario
Call (800) 722-4777
Ontario
Parktree Community Health Center
2680 E. Riverside Dr., Ontario
Call (909) 630-7927
Ontario
Unicare Community Health Center
437 N. Euclid Ave., Ontario
Call (909) 988-2555
Rancho Cucamonga
Lani City Medical
1398 Kenyon Way, Suite J, Rancho Cucamonga
(909) 727-3911
Schedule an Appointment
Rancho Cucamonga
RC Family Resource Center
9791 Arrow Rte., Rancho Cucamonga
Schedule an Appointment
Rancho Cucamonga
Terra Vista Town Center - Theater Parking Lot
COVID Testing Bus
10701 Town Center Dr., Rancho Cucamonga
Schedule an Appointment
Rancho Cucamonga
West Point Medical Center
8520 Archibald Ave., St B., Rancho Cucamonga
Call (909) 481-3909, option 1
Redlands
Redlands Urgent Care Center
301 W. Redlands Blvd., Redlands
Redlands Urgent Care Center Online Check-In
Rialto
Carl Johnson Center
214 N. Palm Ave., Rialto
Schedule an Appointment
Rite-Aid Pharmacy
Multiple Locations Available
Schedule an Appointment
San Bernardino
Court Street Square
349 N East St., San Bernardino
Event Dates: March 3, 17 and 31
Schedule an Appointment
San Bernardino
Department of Public Health COVID-19 Testing Bus
172 W. 3rd St., San Bernardino
Schedule an Appointment
San Bernardino
Drive-Through COVID Clinic
500 Inland Center Dr, San Bernardino
Schedule an Appointment
San Bernardino
Premier Urgent Care Centers of California
284 E. Highland Ave., San Bernardino
Daily | 9 a.m. - 9 p.m.
San Bernardino
SAC Health System
250 S. G St., San Bernardino
Call (909) 771-2911
T/W/F | 3 p.m. - 5 p.m.
San Bernardino
San Bernardino Health Center
606 E. Mill St., San Bernardino
Call (800) 722-4777
San Bernardino
West Point Medical Center
1800 Medical Center Dr., St. 99, San Bernardino
Call (909) 880-6400, option 1
Twentynine Palms
Twentynine Palms - Patriotic Hall
5885 Luckie Ave., Twentynine Palms
Schedule an Appointment
Upland
Advanced Medical & Urgent Care Center
974 W. Foothill., Upland
Call (909) 981-2273
Mon-Fri | 8 a.m. - 2:30 p.m.
Upland
Landecena Community Building
1325 San Bernardino Rd., Upland
Schedule an Appointment
Victorville
Drive-Through COVID Clinic
14400 Bear Valley Dr., Victorville
Schedule an Appointment
Victorville
Green Tree Golf Course
Banquet Room
14144 Green Tree Blvd., Victorville
Schedule an Appointment
Victorville
Victor Valley College
65 Mojave Fish Hatchery Rd., Victorville
Portables located behind Construction Technology Building 65
Schedule an Appointment
Walgreens
Multiple Locations Available
Schedule an Appointment
Yucaipa
7th Street Pool
12385 7th St., Yucaipa
Schedule an Appointment
Yucca Valley
Yucca Valley Community Center
COVID-19 Testing Bus
57090 Twentynine Palms Highway, Yucca Valley
Schedule an Appointment
Yucaipa
Yucaipa Urgent Care Center
33494 Oak Glen Rd., Yucaipa
Yucaipa Urgent Care Center Online Check-In
For more information on COVID-19 testing sites in San Bernardino County, please visit the San Bernardino County COVID Testing Sites.
Provider Resources - Facility Site Review
th us to offer our members the highest quality care and service they need. Facility Site Reviews are the required standards by the California Department of Health Care Services (DHCS)/Medi-Cal Managed Care Division (MMCD) for all primary care provider (PCP) sites. Below you will find various resources in regards to DHCS information, Physical Accessibility Reviews (PARS), Facility Site Review (FSR), and Medical Record Reviews (MRR) as well as IEHP’s addendum tools for your reference.
Facility Site Review Training Index:
Department of Health Care Services (DHCS)
IEHP Addendum Tools
PARS
Facility Site Review
Medical Record Review
Department of Health Care Services (DHCS)
2022 Facility Site Review Standards (FSR) (PDF)
2022 Facility Site Review Tool (FSR) (PDF)
2022 Medical Record Review Standards (MRR) (PDF)
2022 Medical Record Review Tool (MRR) (PDF)
APL 22-017 - Facility Site Review and Medical Record Review (PDF)
DPL 14-005 - FSR Physical-Accessibility Reviews (PDF)
PL 12-006 - Revised FSR Tool (PDF)
PL 14-004 - Facility Site Review and Medical Record Review (PDF)
(Back to Index)
IEHP Addendum Tools
Att 06 - IEHP Urgent Care Evaluation Tool (PDF)
IEHP Interim Review (PDF)
(Back to Index)
PARS
APL with PARS C (PDF)
APL with PARS D & CBAS (PDF)
PAR-FSR-C_PARS - Survey (PDF)
PAR-FSR-D_PARS - Ancillary (PDF)
PAR-FSR-E_PARS - CBAS (PDF)
(Back to Index)
Facility Site Review Menu
Click on the following links to jump to that specific section:
Facility Site Review Audit Tool Sections
Additional Documents
Medical Record Review Audit Tool Sections
Additional Documents
(Back to Index)
Access/Safety
Facility Site Review
Blank Pre-Calculated Dosage Chart (PDF)
Emergency Exit Routes Factsheet (PDF)
Evacuation Routes (PDF)
Glucometer Log (PDF)
Hemocue Log (PDF)
Medical Emergency, Earthquake, Fire Protocols (PDF)
Sample of Sizes of Ambu Bags (PDF)
Sample Oxygen Tank Set (PDF)
Workplace Violence (PDF)
(Back to FSR Menu)
Adult Preventive
Medical Record Review
ACES Screening (PDF)
Adult Health History (PDF)
Adult Sterilization & Special Consent P&P (PDF)
Alcohol Resources (PDF)
AUDIT-C (PDF)
Brief Addiction Monitor (BAM) (PDF)
Comprehensive Pediatric and Adult Health Assessment Forms (PDF)
PHQ-2 - Sample (PDF)
PHQ-9 - Sample (PDF)
Required Documentation Checklist for Adult (PDF)
Social Needs Screening Tool (PDF)
TB Risk Assessment Adult (PDF)
(Back to FSR Menu)
Clinical Services
Facility Site Review
Checklist for Safe Vaccine Storage and Handling (PDF)
Clean and Dirty Sign (PDF)
Controlled Substance Distribution Log (PDF)
Controlled Substance Narcotic Log (PDF)
Monthly Expiration Date & Verification Log (PDF)
P&P Distribution of Sample Medications (PDF)
Patient Distribution Log for Samples (PDF)
Plan for Vaccine Protection in Case of Power Outage (PDF)
Radiology - Notice to Employees (PDF)
Sample Radiology Inspection Report (PDF)
Vaccine Information Sheet (VIS) Protocol (PDF)
Vaccine Storage (PDF)
(Back to FSR Menu)
Coordination of Care
Medical Record Review
Adult Progress Note - Sample (PDF)
Missed Appointment Log - Sample (PDF)
Pediatric Progress Note - Sample (PDF)
(Back to FSR Menu)
Documentation
Medical Record Review
Adult General Consent to Treat (PDF)
Advance Health Care Directive Acknowledgement Form (PDF)
CAIR Sharing Request (PDF)
General Consent to Treat Minor (PDF)
Medical Record Release (PDF)
Sample Medication List (PDF)
Signature Page - IEHP (PDF)
(Back to FSR Menu)
Format
Medical Record Review
Acknowledgment of Receipt of Notice of Privacy Practice (PDF)
(Back to FSR Menu)
Infection Control
Facility Site Review
AAP Infection Prevention and Control in Pediatric Ambulatory Settings - COVID (PDF)
Autoclave Log (PDF)
Biohazardous Sign (PDF)
Bloodborne Pathogens & Post Exposure Plan - Fillable (PDF)
Cleaning Schedule (PDF)
Communicable Disease (ISOLATION) Protocol (PDF)
Infection Control, Biohazardous Waste and Disposition of Patients with Contagious Disease (PDF)
Instrument Transportation Log (PDF)
Isolation & Transmissions Based Precautions (PDF)
OSHA Employee Injury Report Form (PDF)
P&P Autoclave (PDF)
P&P Autoclaving Instruments in Peel (PDF)
P&P Chemical Disinfection (PDF)
P&P Cold Sterilization (PDF)
P&P Transport for Reusable Instruments (PDF)
Reusable Sharps Container (PDF)
Safety Needle Fact Sheet (PDF)
Sharps Injury Log Sample (PDF)
Transfer Stations and Treatment Facilities (PDF)
(Back to FSR Menu)
OB/CPSP Preventive
Medical Record Review
CPSP Initial and Trimester Assessment and Care Plan (PDF)
CPSP Postpartum Assessment and Care Plan (PDF)
Edinburgh Postnatal Depression Scale (EPDS) (PDF)
Required Documentation Checklist for OB (PDF)
(Back to FSR Menu)
Office Management
Facility Site Review
Access Standards (PDF)
After Hour Script (PDF)
CLAS Standards (PDF)
Confidentiality Form (PDF)
Fax Sheet (PDF)
Medical Emergency, Earthquake, Fire Protocols (PDF)
Medical Record Release (PDF)
Office Hours Sample Form (PDF)
On-Call Provider Schedule (PDF)
PCP Referral Tracking Log (PDF)
Referral Process (PDF)
Sample Office Hours (PDF)
Wait Time Survey Tool (PDF)
(Back to FSR Menu)
Pediatric Preventive
Medical Record Review
AAP Infection Prevention and Control in Pediatric Ambulatory Settings - COVID (PDF)
AAP Schedule (PDF)
AAP Supplemental Information (PDF)
Alcohol Resources (PDF)
AUDIT-C (PDF)
Brief Addiction Monitor (BAM) (PDF)
CDC BMI Growth Chart - Boys (PDF)
CDC BMI Growth Chart - Girls (PDF)
CDC Growth Chart Head Circumference - Boys (PDF)
CDC Growth Chart Head Circumference - Girls (PDF)
CDC Growth Chart Weight for Age - Boys (PDF)
CDC Growth Chart Weight for Age - Girls (PDF)
Child Health History - English (PDF)
Child Health History - Spanish (PDF)
Comprehensive Pediatric and Adult Health Assessment Forms (PDF)
Edinburgh Postnatal Depression Scale (EPDS) (PDF)
General Consent to Treat Minor (PDF)
PEARLS Assessment (PDF)
PEARLS Teen Self-Assessment (PDF)
PHQ-2 - Sample (PDF)
PHQ-A - Sample (PDF)
Required Documentation Checklist for Pediatric (PDF)
Social Needs Screening Tool (PDF)
TB Risk Assessment Pediatrics (PDF)
What Do You Eat (8-19 years) - English (PDF)
What Do You Eat (8-19 years) - Spanish (PDF)
What Does Your Child Eat (Birth - 8 years) - English (PDF)
What Does Your Child Eat (Birth - 8 years) - Spanish (PDF)
Youth Nutrition and Activity Assessment (8 - 19 years) (PDF)
(Back to FSR Menu)
Personnel
Facility Site Review
Accessibility Obligations of Medical Practices (PDF)
Bloodborne Pathogens & Post Exposure Plan - Fillable (PDF)
Domestic Violence (PDF)
Electronic Resources for Required Employee Training (PDF)
Employee File Checklist (PDF)
IEHP Cultural and Linguistics Training (PDF)
IEHP Evidence of Staff Training (PDF)
IEHP Grievance Resolution Process - English (PDF)
IEHP Grievance Resolution Process - Spanish (PDF)
IEHP P&P Child Abuse Reporting (PDF)
IEHP P&P Elder or Adult Abuse Reporting (PDF)
IEHP P&P Sensitive Services-Access Standards (PDF)
Medical Assistant Letter of Competency - Fillable (PDF)
Medical Assistant Venipuncture Form (PDF)
Medication Administration Procedures (PDF)
Mid-level Supervision of Medical Assistant (PDF)
Notice to Consumer PA Sign - English (PDF)
Notice to Consumer PA Sign - Spanish (PDF)
Notice to Consumer Sign - English (PDF)
Notice to Consumer Sign - Spanish (PDF)
SB697 Practice Agreement (PDF)
SOC 341 (PDF)
Standardized Procedures for Nurse Practitioner (PDF)
Suspected Child Abuse Report (PDF)
(Back to FSR Menu)
Preventive Services
Facility Site Review
Pure Tone Audiometer (PDF)
Sample Eye Chart (PDF)
(Back to FSR Menu)
Additional Documents
Facility Site Review
IEHP Phone List (PDF)
(Back to FSR Menu)
Additional Documents
Medical Record Review
Electronic Resources for Medical Record Review (PDF)
(Back to FSR Menu)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Healthy Living - Coronavirus
how eating right and being active are the secrets to a long, healthy life. These are important. But there’s more you can do to stop disease. Finding health problems early gives you more treatment choices or a cure. That’s where health screenings come in.
Health screenings are vital for all people, from newborns to seniors. These tests are designed to look for signs that you may be at risk for certain conditions. They help spot health problems at an early stage, even if you do not have symptoms.
Types of cancer screenings
Breast Cancer
A mammogram is a breast X-ray. It can spot breast cancer early when it’s most treatable and when your chance of a cure is much higher. Both women and men can get breast cancer and should get screened every two years, starting at age 50. Those who are at high risk or would like to start screening at an earlier age can talk to their Doctor about starting screening at age 40.
Cervical Cancer (Pap Smear)
The Pap test also known as a pap smear, can detect not normal cells on your cervix early enough so they can be treated before cancer has a chance to grow. The screening is recommended for woman ages 21-65 every 3-5 years, depending on the risk and type of screening. To schedule a screening, talk to your Doctor.
Colorectal Cancer
Colorectal cancer affects the colon and the rectum. Screening can find and remove growths in these areas before they turn into cancer. Everyone ages 50-75 should get screened for colorectal cancer every 1-10 years, depending on risk and type of test used. Talk with your Doctor about which test is the best for you.
Lung Cancer
Screening for lung cancer with imaging (CT scan) in people who smoke or who have quit within the past 15 years, can help find cancer at an early stage. Catching it early keeps you healthy. A yearly screening is recommended for anyone ages 50-80 who smokes cigarettes or has quit smoking in the last 15 years.
If you’re due for a screening, call your Doctor today to schedule your appointment. Don’t wait. Take charge of your health!
For help, call IEHP Member Services at 1-800-440-4347, Monday – Friday, 7 a.m. – 7 p.m., and Saturday-Sunday, 8 a.m. – 5 p.m.
CalAIM - Pay for Performance (P4P)
th Care Services (DHCS), California Advancing and Innovating Medi‐Cal
(CalAIM) is a long‐term commitment to transform and strengthen Medi‐Cal, offering Californians a more equitable,
coordinated, and person‐centered approach to maximizing their health and life trajectory.1
DHCS Goals For CalAIM 2
Identify and manage comprehensive needs through whole person care approaches and social drivers of health.
Improve quality outcomes, reduce health disparities, and transform the delivery system through value-based initiatives, modernization, and payment reform.
Make Medi‐Cal a more consistent and seamless system for enrollees to navigate by reducing complexity and increasing flexibility.
Resource Links
DHCS CalAIM page
DHCS CalAIM Transformation Infographic (PDF)
DHCS Medi-Cal Alignment Primer (PDF)
IEHP Enhanced Care Management
IEHP Enhanced Care Management (Member Page)
IEHP Community Support Services
IEHP Community Support Services (Member Page)
1,2https://dhcs.ca.gov/calaim
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Plan Updates - Public Health Advisory
ory Syncytial Virus (RSV) and Seasonal Influenza Activity (PDF)
October 25, 2022 - Riverside University Health Systems - Outbreak of Ebola Virus Disease Due to Sudan Virus in Central Uganda (PDF)
October 21, 2022 - Riverside University Health Systems - Influenza (PDF)
August 18, 2022 - Updated Monkeypox Guidance (PDF)
August 18, 2022 - Riverside University Health System - Monkeypox Home Isolation Instructions (PDF)
August 18, 2022 - CDC - Dear Colleague: 2022 Monkeypox Outbreak (PDF)
July 19, 2022 - Updated Monkeypox Guidance (PDF)
March 14, 2022 - Riverside County Legionnaires' Disease Advisory (PDF)
February 24, 2022 - PHA Gonococcal Infections (PDF)
February 1, 2022 - CHDP Upcoming Trainings (PDF)
January 31, 2022 - San Bernardino County Black Infant Health Program - Two Locations (PDF)
December 01, 2021 - San Bernardino County - Safe Sleep Video (Provided by Children's Network)
November 05, 2021 - CDC - Expansion of Recall of LeadCare Blood Lead Tests Due to Risk of Falsely Low Results (PDF)
March 05, 2021 - Health Alert: Ebola Virus Disease Outbreak (PDF)
By clicking on the links below, you will be leaving the IEHP website.
Medicare DSNP Formulary Search Tool - IEHP DualChoice (HMO D-SNP) Formulary Search Tool
h Plan by searching for the exact name of the medication or by browsing our formulary database. You can also view the IEHP Medicare Formulary (PDF)
Additional resources to help you understand drug coverage information are available via your desktop at https://www.formularylookup.com or download the free mobile app from http://ios.formularylookup.com or http://android.formularylookup.com,
If the prescription is not in IEHP's Formulary, providers may print and submit a new Prescription Drug Prior Authorization (Rx PA) Request Form or submit the Prescription Drug Prior Authorization Online.
Pharmacy Services - Pharmacy Quality Ratings
ated to help IEHP Members to find high-quality local pharmacies for your pharmacy services. This searchable system will display the rating of each participating pharmacy. The ratings range from 1 to 5 stars (with 1 being the lowest and 5 being the highest).
What does the rating scale mean?
The rating is on a scale of 1 to 5 stars (with 1 being the lowest and 5 being the highest).
Star Ratings
Performance Description
1 Star
Well below average
2 Stars
Below average
3 Stars
Average
4 Stars
Good
5 Stars
Exceptional
No Star
No information is available for this pharmacy
Please keep in mind that Pharmacy Quality Star Rating is currently under development and may not reflect the most recent ratings of your Pharmacy at this time.
IEHP Pharmacy Quality Rating is visible with IEHP "Find a Doctor, Urgent Care, or Pharmacy" webpage (select “Pharmacies” and put in your zip code or city, then hit “Find”). The quality rating information is displayed on the right side of each pharmacy.
Information on this page is current as of January 1, 2022
Medicare CMC Formulary Search Tool - IEHP DualChoice (HMO D-SNP) Formulary Search Tool
e Health Plan by searching for the exact name of the medication or by browsing our formulary database. You can also view the IEHP Medicare Formulary (PDF)
Additional resources to help you understand drug coverage information are available via your desktop at https://www.formularylookup.com or download the free mobile app from http://ios.formularylookup.com or http://android.formularylookup.com,
If the prescription is not in IEHP's Formulary, providers may print and submit a new Prescription Drug Prior Authorization (Rx PA) Request Form or submit the Prescription Drug Prior Authorization Online.
Special Programs - Enhanced Care Management
addresses the clinical and non-clinical needs of high-need, high-cost IEHP Members through systematic coordination of services and comprehensive care management. ECM is a collaborative and interdisciplinary approach to providing intensive and comprehensive care management services to individuals. It serves to build on the Health Homes Program (HHP) and Whole Person Care (WPC) pilots and transitions those pilots to one larger program to provide a broader platform to build on positive outcomes from each program.
ECM provides these vulnerable Members an additional care team to help coordinate and manage their care. The care team consists of a Nurse Care Manager, a Behavioral Health Care Manager, a Care Coordinator, and a Community Health Worker. These specially trained professionals collaborate with IEHP Members' Primary Care Physicians, Specialists, and family support systems to create a personalized plan of care.
Beginning January 1, 2022, please direct eligible IEHP Members who need the ECM services to call IEHP Member Services at (800) 440-4347, Monday - Friday, 8am - 5pm. TTY users should call (800) 718-4347.
If you have programmatic questions, please submit them to ECM@iehp.org.
IEHP Enhanced Care Management Member Brochure (PDF)
CalAIM Enhanced Care Management Policy Guide (PDF)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Special Programs - Tobacco Cessation Services
acco Cessation Services
Provider Education Resources
Smoking Cessation Resources - Help your patients quit Tobacco
The CDC's Brief Tobacco Intervention
ASK
In a caring manner,
at each visit,
...if your patients use tobacco
If they do not, congratulate them
If they do, proceed to next step
ADVISE
Patients who use tobacco to consider quitting.
Tobacco products can lead to health problems such as...
Heart and Lung Disease
Diabetes
Stroke
Ongoing infections and colds
Cancer
People exposed to secondhand smoke can also experience these health problems
REFER
If the patient is interested in quitting, connect them to KICK IT CA and any other local resource (below)
Prescribe medications (if appropriate)
Congratulate your patient on the decision to quit
If patient is not ready to quit, user personalized motivational messages to encourage quitting. Let them know you are here when they are ready.
Kick it CA
How it works:
Patient will receive services from a Coach that has undergone rigorous training & apprenticeships, participates in weekly monitoring and case reviews, and attend continuing education courses on cultural competency. To enroll, patients can call, chat, or complete an online web form. The patient will then receive a Kick-Off call to collect their basic information and find out what they are trying to quit. Right after kick-off, coaching begins. The patient will receive clinically sound motivational interviewing. The coach will help patient put together a quit plan and set a quit date. The patient will then receive check-ins at times they are most susceptible to relapse. The coach will see if their quit-plan is working and help them modify as needed.
Phone Number:
English - 1 (800) 300-8086
Spanish - 1 (800) 600-8191
Website: KICKITCA.ORG
Text:
For English: Text "Quit Smoking" or "Quit Vaping" to 66819
For Spanish: Mande "Dejar de Fumar" o "No Vapear" to 66819
Other Smoking Cessation Resources:
Link to Resources on Member page: https://iehp.org/en/members/healthy-living?target=smoking-cessation
Resources in the Inland Empire: Connect IE
Information and Training for Providers:
http://www.CAquits.com
https://www.cdc.gov/tobacco/
Local Tobacco Control Projects:
Tobacco Free San Bernardino County: https://healthcollaborative.org/SBCTobaccoControl/
Tobacco Free Riverside County: https://www.rivcotcp.org/
(Back to Tobacco Cessation Services Menu)
Tobacco Cessation Services
By clicking on these links, you may be leaving the IEHP website.
Training:
Comprehensive Tobacco Cessation Services for Medi-Cal Members (PDF)
The Smoking Cessation Leadership Center's (SCLC):
Recordings Available for CME/CE Credit
Kick it CA Education, Training and Technical Assistance:
https://kickitca.org/health-professionals
5 Major Steps to Intervention:
http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/5steps.html
Tobacco Cessation CPT Codes for Identification
ACA Facts Sheets and Resources (American Lung Association):
https://www.lung.org/policy-advocacy/healthcare-lung-disease/healthcare-policy/affordable-care-act-tobacco
Helpline:
https://kickitca.org/ (also available in Spanish, Chinese, Korean, and Vietnamese)
https://kickitca.org/health-professionals
https://kickitca.myshopify.com/collections/all
Continuing Medical Education California courses offered through UC Schools of Medicine:
https://cmecalifornia.com/Education.aspx
Tip: Use key word in search: Tobacco Cessation
Centers for Disease Control Coverage for Tobacco Use Cessation Treatments:
https://www.cdc.gov/tobacco/quit_smoking/cessation/coverage/
Patients Not Ready to Make a Quit Attempt Now (The “5 R’s”):
http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/clinicians-providers/guidelines-recommendations/tobacco/5rs.pdf
Smokefree.gov:
https://smokefree.gov/help-others-quit/health-professionals
University of California San Francisco’s Smoking Cessation Leadership Center’s Tools and Resources:
https://smokingcessationleadership.ucsf.edu/
USPSTF-Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions:
https://www.uspreventiveservicestaskforce.org/uspstf/index.php/recommendation/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions
USPSTF-Tobacco Use in Children and Adolescents: Primary Care Interventions:
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/tobacco-and-nicotine-use-prevention-in-children-and-adolescents-primary-care-interventions
(Back to Tobacco Cessation Services Menu)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Special Programs - California Children Services
page.
What is CCS?
CCS is a statewide program that enables children with qualifying conditions to receive specialized services related to that condition independent from IEHP. The CCS program provides diagnostic and treatment services, and medical case management for those who have qualifying conditions.
CCS also provides occupational and physical therapy services through the Medical Therapy Program (MTP). The Medical Therapy Program (MTP) is a special program that provides physical therapy (PT), occupational therapy (OT), for children who have disabling conditions, generally due to neurological or musculoskeletal disorders
Who Qualifies?
The CCS program services children and young adults under the age of 21 who have eligible medical conditions. Examples of CCS-eligible conditions include, but are not limited to, chronic and acute medical conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, traumatic injuries, and infectious diseases producing major sequelae.
For a more inclusive list of diagnoses and medical criteria of qualifying conditions please reference the below links:
https://www.dhcs.ca.gov/services/ccs
https://www.dhcs.ca.gov/services/ccs/Documents/CCSMedicalEligibility.pdf
Provider Responsibilities
Primary Care Physicians (PCPs), Specialty Providers, and IPA/Medical Groups are responsible for performing appropriate baseline health assessments and diagnostic evaluations sufficient to identify children and young adults with potential CCS-qualifying conditions and refer to CCS as needed.
PCPs are responsible for all well child and pediatric preventative services as these services are not a covered benefit of CCS. PCPs are also responsible in assisting CCS members with transition from CCS to IEHP authorizations at the age of 21 when members age out of the CCS program.
Benefits of CCS Enrollment
CCS Clients are not restricted to in area providers but have access to any CCS paneled provider within the state of California when a need for the specialty care has been determined to be CCS eligible. Once a client is determined to be eligible for CCS, the client will continue to be medically eligible for CCS until treatment is complete or age 21 when the CCS program ends.
Additional Resources
To assist our valued Providers, every Member active with CCS has a distinct red “CCS” widget in the Provider Portal. Opening that widget enables you to view the diagnosis being treated and any Specialists and their treatment authorization range.
For any questions about your Member’s CCS care or management, please do not hesitate to contact IEHP’s CCS Team at: (800) 706-4347 or by email at CCSCareManagement@iehp.org .
(By clicking on the links below, you will be leaving the IEHP site)
For additional CCS resources please reference the below links:
CCS Program Overview: https://www.dhcs.ca.gov/services/ccs
CCS Program Application: https://www.dhcs.ca.gov/formsandpubs/forms
CCS Brochure (English/Spanish): https://www.dhcs.ca.gov/services/ccs/Pages/CCSBrochure.aspx
How to become a CCS Provider: https://www.dhcs.ca.gov/services/ccs/Pages/ProviderEnroll.aspx
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Join Our Network - IPA
p
2589 E Washington Blvd.,
Pasadena, CA 91107
(626) 817-9217
(626) 817-9207
Dignity Health Medical Network - Inland Empire
3400 Data Drive,
Rancho Cordova, CA 95670
(916) 851-2026
(916) 851-7642
LaSalle Medical Associates
1855 W. Redlands Blvd. 2nd Floor,
Redlands, CA 92373
(888) 554-4562
(626) 943-6369
Optum Care Network - Inland Faculty MG
1860 Colorado Blvd. Ste 200,
Los Angeles, CA 90041
(800) 371-7547
(323) 257-7329
Physicians Health Network
P.O. Box 11429,
San Bernardino, CA 92423
(909) 300-5030
(909) 332-5555
Horizon Valley Medical Group
18564 US Highway 18 Ste 105,
Apple Valley, CA 92307
(760) 813-6950
(760) 813-6947
DualChoice CalMediConnect
CPN - Horizon Valley Medical Group
18564 US Highway 18 Ste. 105,
Apple Valley, CA 92307
(760) 242-7777
(760) 242-0487
Dignity Health Medical Network - Inland Empire
3400 Data Drive,
Rancho Cordova, CA 95670
(916) 851-2026
(916) 851-7642
EPIC Health Plan
1615 Orange Tree Lane,
Redlands, CA 92374
(909) 799-1818
(909) 786-0816
Alliance Desert Physicians, Inc.
Beaver Medical Group
Chaffey Medical Group
FENIX Medical Group
Pinnacle Medical Group
Redlands - Yucaipa Medical Group
TriValley Medical Group
Heritage Provider Network
8510 Balboa Blvd. Ste 275,
Northridge, CA 91325
(818) 654-3461
Desert Oasis Healthcare
275 N El Cielo Rd.,
Palm Springs, CA 92262
(760) 320-8814
Heritage Victor Valley Medical Group
12370 Hesperia Rd.,
Victorville, CA 92395
(760) 245-4747
Regal Medical Group
621 E Carnegie Dr. Ste 140,
San Bernardino, CA 92408
(818) 654-3400
PrimeCare, part of Optum Care
3990 Concourse St.,
Ontario, CA 91764
(909) 605-8000
PrimeCare Chino
15315 Fairfield Ranch Rd. Ste 275,
Chino Hills, CA 91709
(909) 465-1397
(909) 465-6629
Optum Care Network - Citrus Valley
9130 Anaheim Place Ste 130,
Rancho Cucamonga, CA 91730
(909) 466-8000
(909) 484-6825
Optum Care Network - Corona
2275 Sampson Ave. Ste 111,
Corona, CA 92879
(951) 371-8440
(951) 371-3910
Optum Care Network - Hemet Valley
41391 Kalmia St. Ste 310,
Murrieta, CA 92562
(951) 461-0762
(951) 698-5194
Optum Care Network - Inland Valley
9130 Anaheim Pl. Ste 130,
Rancho Cucamonga, CA 91730
(909) 466-8000
(909) 484-6825
Optum Care Network - Moreno Valley
1467 Ford St. Ste 103,
Redlands, CA 92373
(909) 798-7766
(909) 792-8627
Optum Care Network - Redlands
1520 Barton Rd.,
Redlands, CA 92373
(909) 798-7766
(909) 792-8627
Optum Care Network - Riverside
2275 Sampson Ave. Ste 111,
Corona, CA 92879
(951) 371-8440
(951) 371-3910
Optum Care Network - San Bernardino
1467 Ford St. Ste 103,
Redlands, CA 92373
(909) 798-7766
(909) 792-8627
Optum Care Network - Sun City
41391 Kalmia St. Ste 310,
Murrieta, CA 92562
(951) 461-0762
(951) 698-5194
Optum Care Network - Southwestern Valleys
41391 Kalmia St. Ste 310,
Murrieta, CA 92562
(951) 461-0762
(951) 698-5194
Optum Care Network - Valley Physicians
24630 Washington Ave. Ste 203,
Murrieta, CA 92562
(951) 704-1900
(877) 397-7682
Riverside Medical Clinic
3660 Arlington Ave.,
Riverside, CA 92506
Provider Resources - Clinical Practice Guidelines
assist primary care providers in delivering care in accordance with IEHP standards. Resources are reviewed regularly and updated to reflect changes from a regulatory and clinical standpoint.
Preventive Care Guidelines
American College of Obstetricians and Gynecologists (ACOG)
American Academy of Pediatricians (AAP) / Bright Futures
Comprehensive Perinatal Services Program (CPSP)
Clinical Practice Guidelines Library
The guidelines contained on this page are recommended by IEHP with the intent to enhance Member care. IEHP’s Clinical Practice Guidelines topics are organized using the following categories:
United States Preventive Services Task Force (USPSTF);
IEHP Internal Library;
Healthcare Effectiveness Data Information Set (HEDIS); and
Managed Care Accountability Set (MCAS)
Links or documents embedded within the Internal Library category indicate literature that has been published by leading, formal organizations and have been endorsed/approved by IEHP’s Medical Directors and Quality Committee. IEHP produced information relevant to the topic will also be listed in this category. We have also indicated any HEDIS/ MCAS measures that are pertinent to the topic. Additionally, IEHP accepts USPSTF guidelines to help primary care clinicians identify clinical preventive services that are appropriate for their patients. IF there is a USPSTF guideline relevant to the topic, we have identified it below.
Library Catalog
Click on a letter to jump to that specific section:
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
A
Asthma
USPSTF
N/A
IEHP Internal Library
Global Strategy for Asthma Management and Prevention (PDF)
HEDIS
Asthma Medication Ratio (AMR)
Medication Management for People with Asthma (MMA)
MCAS
Asthma Medication Ratio (AMR)
(Back to Library Catalog)
B
Breast Cancer
USPSTF
Breast Cancer Screening
Use of Medications to Prevent Breast Cancer
BRCA Testing
IEHP Internal Library
N/A
HEDIS
Breast Cancer Screening (BCS)
MCAS
Breast Cancer Screening (BCS)
(Back to Library Catalog)
C
Cervical Cancer
USPSTF
Cervical Cancer Screening
IEHP Internal Library
N/A
HEDIS
Cervical Cancer Screening (CCS)
MCAS
Cervical Cancer Screening (CCS)
(Back to Library Catalog)
Chlamydia
USPSTF
Chlamydia and Gonorrhea Screening
IEHP Internal Library
You may also refer to Sexually Transmitted Infections in this resource guide
HEDIS
Chlamydia Screening in Women (CHL)
MCAS
Chlamydia Screening in women (CHL)
(Back to Library Catalog)
Cholesterol
USPSTF
Statin Therapy for Primary Prevention of CVD
Healthful Diet and Physical Activity for CVD Prevention in Adults with CVD Risks
IEHP Internal Library
American Heart Association – Blood Cholesterol Management (PDF)
American Heart Association – Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults (PDF)
HEDIS
Statin Therapy for Patients with Cardiovascular Disease-Adherence (SPC)
Statin Therapy for Patients with Cardiovascular Disease – Statin Therapy (SPC)
MCAS
N/A
(Back to Library Catalog)
Chronic Obstructive Pulmonary Disorder
USPSTF
N/A
IEHP Internal Library
Global Initiative for Chronic Obstructive Lung Disease – COPD (PDF)
HEDIS
Pharmacology Management of COPD Exacerbation – Systemic Corticosteroids (PCE)
Pharmacology Management of COPD Exacerbations – Bronchodilators (PCE)
Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)
MCAS
N/A
(Back to Library Catalog)
Colorectal Cancer
USPSTF
Colorectal Cancer Screening
IEHP Internal Library
N/A
HEDIS
Colorectal Cancer Screening (COL)
MCAS
N/A
(Back to Library Catalog)
D
Depression
USPSTF
Screening for Depression in Adolescents
Screening for Depression in Adults including Pregnant Women
Screening for Perinatal Depression
IEHP Internal Library
American Academy of Pediatrics – Adolescent Depression in Primary Care (PDF)
American Psychiatric Association – Major Depressive Disorder (PDF)
HEDIS
Antidepressant Medication Management Acute Phase (AMM)
Antidepressant Medication Management Continuation Phase (AMM)
MCAS
Antidepressant Medication Management Acute (AMM-Acute)
Antidepressant Medication Management Continuation (AMM-Cont)
(Back to Library Catalog)
Diabetes
USPSTF
Gestational Diabetes Screening
Prediabetes and Type 2 Diabetes: Screening
IEHP Internal Library
American Diabetes Association – Diabetes Care (PDF)
National Kidney Foundation – Diabetes and Chronic Kidney Disease (PDF)
HEDIS
Statin Therapy for Patients with Diabetes – Adherence (SPD)
Statin Therapy for Patients with Diabetes – Statin Therapy (SPD)
Comprehensive Diabetes Care – HbA1C Testing (CDC)
Comprehensive Diabetes Care - HbA1C Control (<=9) (CDC)
Comprehensive Diabetes Care (<8) (CDC)
Comprehensive Diabetes Care - Eye Exam (CDC)
Comprehensive Diabetes Care – Monitoring for Nephropathy (CDC)
Comprehensive Diabetes Care – Blood Pressure Control (<140/90) (CDC)
MCAS
Comprehensive Diabetes Care HbA1C Testing (CDC HT)
Comprehensive Diabetes Care HbA1C Testing >9%) (CDC H9)
(Back to Library Catalog)
E
(Back to Library Catalog)
F
(Back to Library Catalog)
G
Gonorrhea
USPSTF
Chlamydia and Gonorrhea Screening
IEHP Internal Library
You may also refer to Sexually Transmitted Infections in this resource guide
HEDIS
N/A
MCAS
N/A
(Back to Library Catalog)
H
Hepatitis C
USPSTF
Hepatitis C Virus Infection in Adolescents and Adults: Screening
IEHP Internal Library
American Association for the Study of Liver Diseases – Hepatitis C (PDF)
HEDIS
N/A
MCAS
N/A
(Back to Library Catalog)
Human Immunodeficiency Virus (HIV)
USPSTF
HIV Screening in Pregnant Persons
HIV Screening in Adults and Adolescents
HIV Prevention – Preexposure Prophylaxis
IEHP Internal Library
You may also refer to Sexually Transmitted Infections in this resource guide
HEDIS
N/A
MCAS
N/A
(Back to Library Catalog)
Hypertension
USPSTF
Screening for Hypertension in Adults
IEHP Internal Library
Joint National Committee – Hypertension Guidelines (PDF)
HEDIS
Controlling high blood pressure (CBP)
MCAS
Controlling high blood pressure (CBP)
(Back to Library Catalog)
I
(Back to Library Catalog)
J
(Back to Library Catalog)
K
(Back to Library Catalog)
L
(Back to Library Catalog)
M
(Back to Library Catalog)
N
(Back to Library Catalog)
O
Obesity
USPSTF
Weight Loss to Prevent Obesity Related Morbidity and Mortality in Adults - Counseling
Screening for Obesity in Children and Adolescents
Behavioral Health Counseling for Adults that are Overweight or Obese and Have Other CVD Risk Factors
IEHP Internal Library
N/A
HEDIS
Weight Assessment and Counseling (WCC-BMI)
Adult Body Mass Index (ABA)
MCAS
Weight Assessment and Counseling (WCC-BMI)
Adult Body Mass Index (ABA)
(Back to Library Catalog)
Osteoporosis
USPSTF
Osteoporosis to Prevent Fractures: Screening
IEHP Internal Library
N/A
HEDIS
Osteoporosis management in women who have had a fracture (OMW)
MCAS
N/A
(Back to Library Catalog)
P
(Back to Library Catalog)
Q
(Back to Library Catalog)
R
(Back to Library Catalog)
S
Sexually Transmitted Infections
USPSTF
Syphilis Screening in Pregnant Women
Syphilis Screening for those at Increased Risk for Infection
Chlamydia and Gonorrhea Screening
HIV Screening in Pregnant Persons
HIV Screening in Adults and Adolescents
HIV Prevention – Preexposure Prophylaxis
IEHP Internal Library
Centers for Disease Control Public Health Media Library – STD Treatment
You may also refer to individual topics as they appear in this library:
Chlamydia
Gonorrhea
HIV
Syphilis
HEDIS
Chlamydia Screening in women (CHL)
MCAS
Chlamydia Screening in women (CHL)
(Back to Library Catalog)
Skin Cancer Behavioral Counseling
USPSTF
Skin Cancer Prevention: Counseling
IEHP Internal Library
N/A
HEDIS
N/A
MCAS
N/A
(Back to Library Catalog)
Smoking Cessation/Tobacco Usage
USPSTF
Smoking Cessation
Smoking Cessation – Pharmacotherapy
Lung Cancer Screening
Tobacco Use in Children and Adolescents – Primary Care Interventions
IEHP Internal Library
N/A
HEDIS
N/A
MCAS
N/A
(Back to Library Catalog)
Syphilis
USPSTF
Syphilis Screening in Pregnant Women
Syphilis Screening for Those at Increased Risk for Infection
IEHP Internal Library
You may also refer to Sexually Transmitted Infections in this resource guide
HEDIS
N/A
MCAS
N/A
(Back to Library Catalog)
T
Tuberculosis
USPSTF
Latent Tuberculosis Screening
IEHP Internal Library
N/A
HEDIS
N/A
MCAS
N/A
(Back to Library Catalog)
U
(Back to Library Catalog)
V
(Back to Library Catalog)
W
(Back to Library Catalog)
X
(Back to Library Catalog)
Y
(Back to Library Catalog)
Z
(Back to Library Catalog)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Provider Resources - Utilization Management Criteria
e. IEHP has created UM Subcommittee Approved Authorization Guidelines to serve as one of the sets of criteria for medical necessity decisions. Our goal in creating this page is to provide you with easily accessible electronic versions of IEHP’s UM guidelines. IEHP utilizes a variety of sources in developing our UM guidelines which include:
Medicare and Medi-Cal’s coverage policy statements
Evidence in the peer-reviewed published medical literature
Technology assessments and structured evidence reviews
Evidence-based consensus statements
Expert opinions of healthcare Providers
Evidence-based guidelines from nationally recognized professional healthcare organizations and public health agencies.
IEHP is also licensed to use MCG Guidelines, Apollo Medical Review Criteria, and InterQual to guide in utilization management decisions.
Since medical technology is constantly evolving, our clinical guidelines are subject to change without prior notification. Additional UM Subcommittee Guidelines may be developed as needed or may be withdrawn from use.
Please note that benefits may vary based on Member’s line of business; therefore, certain services discussed in the UM Subcommittee Guidelines may not be a covered benefit.
Table of Contents (PDF)
Providers may obtain information about criteria, either in general or relating to specific UM decisions, from IEHP upon request by contacting the IEHP UM Department. Please contact the IEHP Provider Relations Team at (909) 890-2054 to be connected to the UM Department.
Behavioral Health
Behavioral Health Treatment (BHT) Criteria (PDF)
Behavioral Health Home Based Services (PDF)
Criteria for Multidisciplinary Diagnostic Treatment (PDF)
Community Supports Services
Community Transition Services Nursing Facility Transition to a Home (PDF)
Nursing Facility Transition-Diversion to Assisted Living (PDF)
Housing Deposits (PDF)
Housing Transition Navigation Services (PDF)
Housing Tenancy and Sustaining Services (PDF)
Asthma Remediation (PDF)
Environmental Accessibility Adaptations (Home Modifications) (PDF)
Medically Tailored Meals (PDF)
Sobering Centers (PDF)
Recuperative Care (PDF)
Short-Term Post-Hospitalization Housing (PDF)
Diagnostic Testing
Elastography (PDF)
Inflammatory Bowel Disease Serology (PDF)
Vestibular Autorotation Test (PDF)
Gynecology and Obstetrics
Fetal Non-Stress Testing (PDF)
Neurology
Bone Marrow Transplant in Treatment of Multiple Sclerosis (PDF)
Pain Management
Pain Management - Centers of Excellence (COE) (PDF)
Referrals to Pain Management Specialist (PDF)
Pharmacy
Biosimilar Products (PDF)
CAR-T Therapy (PDF)
Surgical Procedures
Adolescent Bariatric Consultation and Surgery (PDF)
Bronchial Thermoplasty (PDF)
Liver Biopsy in Conjunction with Bariatric Surgery (PDF)
Natural Orifice Transluminal Endoscopic Surgery (PDF)
Transgender Services (PDF)
Other
Allocation of Limited Critical Care Resources During a Public Health Emergency (PDF)
Care Plan Option (PDF)
Complementary and Alternative Medicine or Holistic Therapies (PDF)
Congregate Living Health Facilities (PDF)
Criteria for Custodial Care: Medi-Cal (PDF)
Enhanced Care Management (PDF)
Hair Removal Guideline (PDF)
Health Homes Program (HHP) (PDF)
My Path (A Palliative Care Approach) (PDF)
Tertiary Care Center Referral Requests (PDF)
Transitional Care Medicine (PDF)
Transportation Criteria (PDF)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Provider Resources - Pharmacy
gram, Prior Authorization Criteria, Clinical Practice Guidelines, Forms, IEHP Formulary, and Safety Resources with drug recall information.
If you have any questions regarding services provided by the Pharmaceutical Services Department, please feel free to contact the IEHP Pharmacy Department at (909) 890-2049.
Pharmaceutical Services
Provider Resources - Claims
d range of topics for all types of Providers with questions regarding billing requirements and claims processing guidelines. Resources are not limited to webinars, computer based training, and webinars. Providers also have direct access to their Regional Representative and the Small Provider Billing Unit (SPBU) through this link (By clicking on this link, you will be leaving the IEHP website) https://learn.medi-cal.ca.gov/.
Medi-Cal Rates and Codes
By clicking on these links, you will be leaving the IEHP website.
Medi-Cal Rates
The file lists the maximum reimbursement rates payable by the Medi-Cal program for covered procedures described in the HCPCS and CPT-4 coding system.
Resource: website
CPT Codes
This website is aimed at providing information to Providers on Medicare's National CCI edits, but will not address specific CCI edits.
Resource: website
Alpha-Numeric HCPCS Files
These files contain the Level II alpha-numeric HCPCS procedure and modifier codes, their long and short descriptions, and applicable Medicare administrative, coverage, and pricing data.
Resource: website
ZIP code To Carrier Locality File
This file is primarily intended for use by ambulance suppliers to map ZIP Codes to CMS carriers and localities. This file will also map ZIP Codes to their State and can determine whether the ZIP Code has a rural designation as determined by CMS.
Resource: website
Medicare Physician Fee Schedule
Information on services covered by the Medicare Physician Fee Schedule (MPFS).
Resource: website
IEHP Fee Schedule
IEHP Fee Schedule - December 08, 2020 (PDF)
Other Health Coverage (OHC)
Coordination of Benefits with Other Health Coverage (OHC) (PDF)
Frequently Asked Questions (FAQs) - OHC (PDF)
Care After Hours - Get Care After Hours
hen you can't reach your Doctor after-hours or your Doctor is not available, you have options to get your needed care.
Call the IEHP 24-Hour Nurse Advice Line at (888) 244-4347, TTY 711.
1. Speak to our Nurse
Our Nurse can offer you medical advice on the phone or guide you to get the care you need.
Common reasons to call our Nurse:
Cough
Mild stomach ache
Mild fever
Sore throat
Cold or flu
Questions about your medicine
Ear ache
Nurse Advice Video
2. Speak to a Doctor
Our Nurse may decide you need to talk with a Doctor. If so, our Nurse will connect you with a Doctor for a live phone chat or schedule a virtual visit through an app.
3. Visit an IEHP Urgent Care Clinic
Our Nurse may direct you to an Urgent Care Clinic, so you can see a Doctor the same day. Many clinics are open late, weekends and holidays. Some clinics have X-rays and lab tests. We have more than 90 Urgent Care Clinics in our network. For one near you, visit the IEHP Provider Search.
Common reasons to visit an Urgent Care Clinic:
Mild sore throat
Mild fever
Rash
Nose bleed
Minor trauma
Animal or insect bite
Asthma (non-critical)
Cuts & lacerations
Call 911 or go to the nearest Emergency Room (ER) for emergency medical and behavioral health conditions. Don’t wait!
Urgent Care Video
Helpful Information and Resources - Emergency Safety
y when there is a power shutoff or fire. We want to ensure you get the needed care and services to help you during these events. If you are impacted by these events and need help with your durable medical equipment (such as wheelchairs, ventilators, oxygen monitors, etc.) call IEHP Member Services at 1-800-440-IEHP (4347), Monday–Friday, 7am–7pm, and Saturday–Sunday, 8am–5pm. TTY users should call 1-800-718-4347. If you need a medicine refill, go to your pharmacy and request a refill. For medical advice after-hours, please call the IEHP 24-Hour Nurse Advice Line at 1-888-244-4347 or 711 (TTY).
How to prepare for an emergency.
Public Safety Power Shutoff Alerts
A Public Safety Power Shutoff, also called a PSPS, occurs in response to severe weather. Power is turned off to help prevent wildfire and keep communities safe. We encourage you to sign up for alerts so you know when a Public Safety Power Shutoff may occur and when your power is restored.
Click here to sign up.
Medicine Safety
Some medicines may need to be stored in a refrigerator to keep their strength, including many liquid medicines. When the power is out for a day or more, throw away any medicines that should be refrigerated, unless the medicines label says otherwise. If a life depends on the refrigerated medicines (for example, insulin), use them only until a new supply is available. Replace all refrigerated medicines as soon as you can.
Resources
Refrigerated Medicine Storage (PDF)
Insulin Storage and Product Switching in an Emergency (PDF)
Comparison of Insulins (PDF)
Durable Medical Equipment Safety
Use the checklist below to prepare for a power outage.
Check your backup power equipment frequently to ensure it will function during an emergency.
Call your power and water companies about your needs for life-support devices (home dialysis, suction, breathing machines, etc.) in advance of a disaster. Many utility companies keep a “priority reconnection service” list and map of the locations of power-dependent customers for use in an emergency. Ask the customer service department of your utility companies if this service is available.
Keep the shut-off switch for oxygen equipment near you so you can get to it quickly in case of emergency.
Generator users should operate generators in open areas to ensure good air circulation.
Test generators once a month, and take your generator to be serviced at least once a year, to make sure it will work when needed.
Create a plan for how to recharge batteries when the power is out. Reference resources below.
When power is restored, make sure the settings on your medical device have not changed.
Resources
Emergency Power Planning for a Durable Medical Equipment Checklist (PDF): this booklet helps you establish a plan to obtain and organize your medical device information.
How to Prepare for and Handle Power Outages for Medical Devices that Require Electricity - FDA
Emergency Power Planning for People Who Use Electricity and Battery Dependent Assistive Technology and Medical Devices: this checklist will help you create a plan for your electric and battery-dependent devices.
Mental Health
If you have been impacted by a fire and need mental health, related to stress or grief, call IEHP Member Services at 1-800-440-IEHP (4347), 8am-5pm (PST), Monday-Friday. TTY users should call 1-800-718-4347. For medical advice after-hours, please call the IEHP 24-Hour Nurse Advice Line at 1-888-244-4347 or 711 (TTY).
Additional Tips
Build or restock your emergency supply kit, including food, water, flashlights, a radio, fresh batteries, first aid supplies and cash. Click here to find local resources that help you build an emergency supply kit.
Identify backup charging methods for phones such as a battery power pack, a car charger and solar battery charger.
Learn how to manually open your garage door. Create a plan based off what you can do by yourself and what you will need help with.
Create an emergency contact list.
If you own a backup generator, ensure it is ready to safely operate.
Create an emergency action plan that includes evacuation planning for your home, family and pets.
Resources
https://www.sce.com/wildfire: how to safety prepare for a wildfire
https://www.sce.com/wildfire/psps: Power Safety Power Shutoff resources
https://prepareforpowerdown.com/: how to prepare for a power shutoff
http://www.jik.com: emergency preparedness information prepared by Jule Kiles
https://www.readyforwildfire.org/prepare-for-wildfire/get-set/: how to prepare for a wildfire
Emergency Supplies Kits for People with Disabilities and Activity Limitations: checklist suggests emergency kit contents including no cost supplies, that you can tailor to your needs and abilities.
Emergency Evacuation Preparedness: Taking Responsibility For Your Safety, A Guide For People with Disabilities and Other Activity Limitation: how to develop plans that integrates people with disabilities and others with access and functional needs.
Emergency Health Information: Savvy Health Care Consumer Series: a guide to develop your emergency health information.
Emergency Travel Safety Tips for Overnight Stays: a guide for people with disabilities.
Tips for Emergency Use of Mobile Devices: preparing your device for an emergency.
Senior Health - Advanced Care Planning
ing is not just about old age. At any age, a medical crisis could leave you too ill to make your own health care decisions. Even if you are not sick now, planning for health care in the future is an important step toward making sure you get the medical care you would want, if you are unable to speak for yourself and doctors and family members are making the decisions for you.
MY LIFE. MY CHOICE. is IEHP’s Advance Care Planning program for IEHP DualChoice Members. The online program helps you fill out Advance Care Directive forms and gives you a place to keep them safe to share with your Doctor. IEHP can also store related documents like Physician Orders for Life-Sustaining Treatment, Living Wills, Health Care Power of Attorney and Do Not Resuscitate forms. MY LIFE. MY CHOICE. is accessible through the IEHP Member Portal. You can easily upload your Advance Care Directives and access them at any time from your home computer or smartphone. You can also share your forms with your family, friends and caregivers by email, SMS and fax. If you get sick and cannot make medical decisions, having these documents lets others know your wishes about medical care. This ensures you get the treatment and medical care you want.
You can learn more about Advance Care Planning by accessing MY LIFE. MY CHOICE. through the IEHP Member Portal OR attending an in-person workshop.
Register online:
Log in to the Member portal.
Log in to MY LIFE. MY CHOICE.
Follow the steps to begin your Advance Care Planning.
Register for an in-person workshop:
Log in to the Member portal at www.iehp.org.
Click the Health & Wellness tab.
Choose “Senior Health” for a list of workshops with dates and times.
Choose the workshop you want to attend.
For assistance with MY LIFE. MY CHOICE. please call IEHP Member Services at 1-800-440-IEHP (4347). TTY users should call 1-800-718-4347.