Search Results For : " MAKE FREEDHARDEMAN UNIVERSITY "
Governing Board - Dawn Rowe
in December 2018. Supervisor Rowe served on the Yucca Valley Town Council from 2010 to 2014.
Supervisor Rowe represents one of the largest districts in the county, spanning the Mojave Basin to the mountain communities and the city of Barstow to the valley communities. Supervisor Rowe was appointed to the IEHP Governing Board in January 2021.
Governing Board - Karen Spiegel
ities of Canyon Lake, Corona, Eastvale, Jurupa Valley, Lake Elsinore, and Norco, along with the unincorporated communities of Coronita, El Cerrito, Gavilan Hills, Home Gardens, Lake Mathews, Lakeland Village, Temescal Valley, Warm Springs, Woodcrest.
She was appointed to the IEHP Governing Board in February 2019, became vice chair in January 2020 and chair in 2021. Supervisor Spiegel began her political career as the elected city treasurer for the city of Corona in 1996. She continued her service in Corona as a council member for 16 years and as mayor for four terms.
Governing Board - Andrew Williams
Governing Board - Curt Hagman
California State Assembly from 2008 to 2014 and represented communities in San Bernardino, Orange and Los Angeles counties.
Supervisor Hagman was appointed to the IEHP Governing Board in January 2015, became vice chair in February 2017, and served three years as chair beginning in January 2018. Supervisor Hagman has an extensive resume of public service prior to his state office election.
Governing Board - Eileen Zorn
tional management, research and quality improvement. She was first appointed to the IEHP Governing Board in January 2003.
Ms. Zorn was appointed vice chair in February 2015 and chair in February 2016. Ms. Zorn has published many health care-related articles and has received many recognitions and awards during her career.
Governing Board - Daniel P. Anderson
nprofit sector. Mr. Anderson has spent the last 15 years advocating health care access for low-income and uninsured residents. In April 2008, he was appointed to the IEHP Governing Board and served as the vice chair from January 2018 to December 2020.
Mr. Anderson has addressed the health needs of underserved and uninsured residents in his many lectures and presentations to the community. He is currently the president/CEO of Riverside Community Health Foundation.
Helpful Information and Resources - Personal Injuries and Accidents
l eligible, Please contact the Department of Health Care Services at (916) 445-9891 or visit DHCS.ca.gov/PI.
Operating hours: 8am – 12pm and 1pm – 5pm, Monday through Friday. Closed on weekends and holidays.
Mailing address:
Department of Health Care Services
Third Party Liability and Recovery Division
Casualty Insurance Section – MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
IEHP DualChoice (HMO D-SNP) Medicare-Medicaid Plan Members
If you are a Medicare Member and would like to report a potential liability settlement, judgment, award or other payment you have received, or to request your Protected Health Information, please click here for Authorization of Release (PDF).
Plan Updates - Medicare Beneficiary Identifier (MBI)
d Services (CMS) to remove Social Security Numbers (SSN) from all Medicare cards to address the risk of Medicare beneficiary medical identity theft. CMS will mail out new Medicare Cards to Medicare Beneficiaries starting April 2018 through April 2019.
By clicking on the CMS web links below, you will be leaving the IEHP website.
For more information regarding the new Medicare cards, please visit https://www.cms.gov/medicare/new-medicare-card/nmc-home.html.
For an overview of the new Medicare cards, please visit https://www.cms.gov/medicare/new-medicare-card/nmc-home.
New Medicare card resources:
New Medicare Card: Information for Partners & Stakeholders (PPT)
You're getting a new Medicare card! (PDF)
New Card! New Number! (PDF)
"10 Things to Know About Your New Medicare Card" (PDF)
Your New Medicare Card: Information for People with Medicare (PPT)
For additional resources regarding the new Medicare cards, please visit https://www.cms.gov/Medicare/New-Medicare-Card/Partners-and-Employers/Partners-and-Employers.html.
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 - Regulatory Updates
reventable Conditions. Visit Reporting of Provider Preventable Conditions for DHCS instructions for online reporting.
By clicking on these links, you will be leaving the IEHP website.
Medicare Outpatient Observation Notice (MOON)
In the event any Medicare recipient has been in a status of outpatient observation for greater than 24 hours, Acute Hospitals are required to provide Medicare Members with a Medicare Outpatient Observation Notice (MOON). Medicare recipients must receive the MOON within 36 hours of admission to observation level of care.
Please refer to the following website for further details on MOON requirements at https://www.federalregister.gov/articles/2016/08/22/2016-18476/medicare-program-hospital-inpatient-prospective-payment-system-for-acute-care-hospitals-etc. By clicking on this link, you will be leaving the IEHP website.
Document Catalog:
MOON FAQs (PDF)
MOON Instruction Summary (PDF)
CMS Manual System 10611_Pub 100-04 Medicare Claims Processing MOON Instructions (PDF)
MOON Forms
MOON English (PDF)
MOON Spanish (PDF)
MOON Correspondence (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.
Pharmacy Services - DHCS Medi-Cal Rx
e January 1, 2022, the Medi-Cal pharmacy benefits and services are administered by DHCS in the Fee-For-Service (FFS) delivery system, known as "Medi-Cal Rx."
Magellan Medicaid Administration, Inc. (MMA) assumes operations for Medi-Cal Rx on behalf of the State of California Department of Health Care Services (DHCS).
How to Register for the User Administration Console (UAC) (PDF)
User Administration Console (UAC) Quick Start Guide (PDF)
Medi-Cal Rx 101 Webinar Presentation (PDF)
IEHP and DHCS strongly recommends our Providers to visit the new Medi-Cal Rx website (https://medi-calrx.dhcs.ca.gov) to register for the Magellan Medi-Cal Rx portal, review schedule of trainings available on the new Medi-Cal Rx Portal, and review general information about the transition.
Communication from DHCS
Please refer to the DHCS Medi-Cal Rx: Transition and DHCS Medi-Cal Provider Pharmacy News Bulletins pages for additional information.
Communication from IEHP
While you can always refer to Pharmacy Communication and Provider Correspondence pages, the below list is provided for your convenience.
January 02, 2023 - IEHP DualChoice (HMO D-SNP): PBM Update and Medicare Part B Coinsurance (PDF)
December 22, 2022 - Cal MediConnect (CMC) to Medi-Cal Rx/HMO D-SNP Transition (PDF)
October 28, 2022 - Cal MediConnect to Medi-Cal RX Transition (D-SNP) (PDF)
July 29, 2022 - NEW DATE: Medi-Cal RX Gradual Reinstatement of Prior Auths (PAs) – Phase 1 – September 16, 2022 (PDF)
July 13, 2022 - DHCS Medi-Cal Rx Update: Postponement of Implementation of NCPDP Reject Code 80 (PDF)
July 11, 2022 - Medi-Cal Rx Gradual Reinstatement of PAs - Phase 1 (PDF)
June 03, 2022 - Medi-Cal RX Transition: Blood Pressure Monitors and Cuffs (PDF)
June 03, 2022 - Medi-Cal RX Billing Policy for Physician Administered Drugs (PADs) (PDF)
February 17, 2022 - RETRACTION - Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM - PCP) (PDF)
February 17, 2022 - RETRACTION - Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM - IPA) (PDF)
February 14, 2022 - Medi-Cal Rx Transition Survey - Your Response is Important! (PDF)
February 11, 2022 - Updated - Medi-Cal Rx Transition - Implantable and Injectable Contraceptives FAQs (PDF)
February 09, 2022 - Medi-Cal Rx Transition - Hyaluronic Acid Knee Injections (PDF)
February 07, 2022 - Medi-Cal Rx UPDATE: Revised Prior Auth Policy for Prescribers and Emergency Fill Quantity Limit (PDF)
February 07, 2022 - Medi-Cal Rx Transition - How To Assist IEHP Members (PDF)
January 18, 2022 - Medi-Cal Rx Transition - Implantable and Injectable Contraceptives (PDF)
January 18, 2022 - Medi-Cal Rx (Magellan) Customer Service (PDF)
January 18, 2022 - Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM) (PDF)
January 04, 2022 - CORRECTION! Medi-Cal Rx: Mail Order for Blood Pressure Monitors and Nebulizers (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 - Major Organ Transplant (MOT)
nd Empire Health Plan (IEHP) is now responsible for coverage of the Major Organ Transplant (MOT) benefit for adult and pediatric transplant recipients and donors, including related services such as organ procurement and living donor care.
What Transplant Services are Available for Members?
Autologous Islet Cell
Bone Marrow
Cornea
Heart
Heart-Lung
Liver
Liver-Heart
Liver-Intestinal
Liver -Lung
Lung
Kidney
Kidney-Liver
Kidney - Pancreas
Pancreas (after Kidney)
Centers of Excellence (COE)
For transplant care, IEHP has partnered with various, local, Centers of Excellence (COE). A COE is a recognized program within an existing healthcare center that provides a concentration of specialized care, delivered in a comprehensive, interdisciplinary manner. Their focused care in distinct areas provides exceptional, integrated care that can lead to better Member outcomes.
Bone Marrow - CHLA, City of Hope, LLUMC, UCSD, USC (Norris)
Heart - USC (Keck), LLUMC, Rady's Children, Sharp Memorial, UCSD
Intestinal - CHLA
Kidney-Pancreas - LLUMC, UCI
Liver- CHLA, LLUMC, USD, USC (Keck)
Lung - UCSD
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 - Total Fracture Care
ticipating Orthopedist for global fracture care without a prior authorization. This Program ensures that Members in need of fracture care by an Orthopedist, as determined by an Emergency Department Physician, Urgent Care Physician or Primary Care Provider, will receive timely access to care.
Policy Reference:
10 - Medical Care Standards
Total Fracture Care Providers
Arrowhead Orthopaedics
For more information and locations, please visit: https://www.arrowheadortho.com/
Newport Care Medical Group
For more information please call: (951) 363-5064
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Enroll with IEHP DualChoice
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Trust your heart when it comes to your health-enroll with IEHP DualChoice (HMO D-SNP)
If you have both Medi-Cal and Medicare, you may be eligible to enroll in the IEHP DualChoice (HMO D-SNP) plan. Our IEHP DualChoice plan helps you get the care you need to achieve your best possible health.
Get covered benefits for $0 including:
Doctor visits such as routine checkups and sick visits
Prescriptions from the IEHP DualChoice formulary
Hospital care such as emergency room and urgently needed servicesAre currently eligible for Medi-Cal, and
Specialist case
PLUS extra benefits like:
Vision care: Up to $350 limit every twelve months for eyeglasses (frames). Lenses are separately reimbursable based on prior approval and medical necessity.
Contact Lenses are covered up to $350 every twelve months in lieu of eyeglasses (Lenses and Frames).
Utilities allowance of $40 for covered utilities. You must qualify for this benefit.
Who is eligible for IEHP DualChoice (HMO D-SNP)?
IEHP DualChoice is for people with both Medicare (Part A and B) and Medi-Cal. The following information explains who qualifies for IEHP DualChoice (HMO D-SNP).
Included Population:
With mandatory enrollment for Medi-Cal benefits, including Long-Term Services and Supports (LTSS) benefits and Medicare benefits.
You are eligible for our Plan as long as you:
Live in our service area (incarcerated individuals are not considered living in the geographic service area even if they are physically located in it.), and
Are age 21 and older at the time of enrollment, and
Have both Medicare Part A and Medicare Part B, and
Are currently eligible for Medi-Cal, and
Are a full-benefit dual eligible beneficiary and enroll in IEHP DualChoice for your Medicare benefits and Inland Empire Health Plan (IEHP) for your Medi-Cal benefits. This is known as “Exclusively Aligned Enrollment”, and
Are a United States citizen or are lawfully present in the United States
For questions or to enroll over the phone, please call the IEHP DualChoice Medicare Team at 1-800-741-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347.
Enroll in IEHP DualChoice Today!
IEHP DualChoice Enrollment Form (PDF)
IEHP DualChoice (HMO D-SNP) is a HMO Plan with a Medicare contract. Enrollment in IEHP DualChoice (HMO D-SNP) depends on contact renewal.
Information on this page is current as of October 01, 2022.
H8894_DSNP_23_3241532_M Pending Accepted
Plan Updates - Newsletters
Provider Staff Newsletter; keep you in the know about our newest programs, incentive opportunities, study results, and more.
Volume 34 - Summer 2022 (PDF)
Volume 33 - Fall 2021 (PDF)
Volume 32 - Spring 2021 (PDF)
Volume 31 - Fall 2020 (PDF)
Volume 30 - Fall 2019 (PDF)
Volume 34 - Winter 2022 (PDF)
Volume 33 - Spring 2021 (PDF)
Volume 32 - Winter 2021 (PDF)
Volume 30 - Winter 2020 (PDF)
Volume 29 - Spring 2019 (PDF)
Volume 28 - Winter 2018 (PDF)
Volume 27 - Summer 2018 (PDF)
To access past Newsletters, please contact the Provider Relations Team at (909) 890-2054.
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 - Alcohol & Drug (SABIRT)
ant to the Department of Health Care Services (DHCS) APL 21-014 (PDF), “Alcohol and Drug SABIRT,” IEHP has updated its requirements for alcohol and substance use screening in the primary care setting. Helpful resources:
Correspondence - June 2022 - Alcohol and Drug SABIRT
Training Guide (PDF)
Screening Tools
Alcohol Use Disorders Identification Test (AUDIT-C)
Brief Addiction Monitor (BAM) (PDF)
Cut Down-Annoyed-Guilty-Eye-Opener Adapted to Include Drugs (CAGE-AID) (PDF)
Tobacco Alcohol, Prescription Medications and other Substances (TAPS) (PDF)
National Institute on Drug Abuse (NIDA) Quick Screen for Adults (PDF)
Drug Abuse Screening Test (DAST-10) (PDF)
Parents, Partner, Past, and Present (4Ps) for pregnant women and adolescents (PDF)
Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) for non-pregnant adolescents (PDF)
Michigan Alcoholism Screening Test Geriatric (MAST-G) alcohol screening for geriatric population (PDF)
Assessment Tools
Alcohol Use Disorders Identification Test (AUDIT) (PDF)
Brief Addiction Monitor (BAM) (PDF)
NIDA-Modified Alcohol, Smoking and Substance Involvement Screening Test (NM-ASSIST) (PDF)
Drug Abuse Screening Test (DAST-20) (PDF)
Pamphlets
Riverside Brochure (English) (PDF)
Riverside Brochure (Spanish) (PDF)
San Bernardino Brochure (English) (PDF)
San Bernardino Brochure (Spanish) (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.
Join Our Network - IPA
p
1668 S. Garfield 2nd Fl.
Alhambra, CA 91801
(877) 282-8272
(626) 943-6329
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
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
Join Our Network - Ancillary
ly contracted provider.
PLEASE NOTE, IEHP is currently not accepting new:
DME
Hospice
Specialty Pharmacy
Clinical Laboratories
Please check monthly for updates on Network Availability.
Prior to extending a contract, we must receive the following documents:
1. Ancillary Provider Network Participation Request Form (PDF)
2. W-9 Form
A current Taxpayer Identification Number and Certification Form
3. Liability Insurance Certificate
Professional general liability in the minimum amount of One Million Dollars ($1,000,000) per occurrence.
Three Million Dollars ($3,000,000) aggregate per year for professional liability.
4. Ownership Information (PDF)
Name, Title and Percentage of Ownership
5. Provider Accreditation Certificate
6. CMS/DHCS Passing Site Survey (Approval Letter)
Required for each facility
7. California State License (if applicable)
Required for each facility
8. Urgent Care Minimum Qualifications (if applicable)
All Ages (PDF)
Pediatrics (PDF)
9. Medi-Cal Number
Ancillary Providers need to successfully enroll in the State's Medi-Cal Program
10. Provider Acknowledgment of Receipt (AOR) (PDF)
IEHP is required by State and Federal regulators to maintain an AOR form on file for our Providers signifying your receipt and review of the Policy & Procedure manuals, including annual updates
11. Electronic Remittance Advice (ERA) Form (PDF)
Ancillary Providers must complete the ERA form
Contracts Maintenance Request Form can be found here (PDF).
Any delay in receiving the above stated documents will affect the effective date of the contract that will be mailed to you.
The contract collateral and other supporting contract documents should be e-mailed to contract@iehp.org.
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.