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MTM is a term to describe a broad range of services offered by Pharmacists on our health care team.  The IEHP Clinical Pharmacy Team reviews the Members’ medicines, making sure they’re taking the right ones for their health conditions. If you are a Provider for IEHP Members who qualify for the MTM Program, you can let them know to look out for a letter from us. They will be enrolled automatically—unless they opt-out. MTM is offered to Members at no additional cost. IEHP's MTM services include these core elements: Medication therapy reviews Medication education Disease management A team of Pharmacists and Doctors developed these MTM services to help provide better prescription drug coverage for our Members. For example, MTM also helps identify possible medication errors. Medicare MTM Program This is a free program under Medicare Part D for IEHP DualChoice Members who have multiple medical conditions, take many prescription drugs, and have high drug costs to assist with better medication management and overall health. IEHP DualChoice Members’ enrollment includes a yearly comprehensive medication review (CMR) and regular targeted medication review (TMR) services throughout the year. MTM services include: Comprehensive Medication Review (CMR) An IEHP Clinical Pharmacist will provide an annual comprehensive review of the IEHP DualChoice Member’s medications over the phone. The Pharmacist will review IEHP DualChoice Member’s medications and make clinical recommendations to IEHP DualChoice Members and Providers. Targeted Medication Review (TMR) The IEHP Clinical Pharmacy Team will also offer TMRs through the year by reviewing issues with the participating IEHP DualChoice Member’s medicines. The team will perform TMRs for all enrolled beneficiaries every three months. The beneficiary may get TMR recommendations by mail and their Primary Care Provider may receive recommendations by fax—if the IEHP Clinical Pharmacy Team deems it necessary. For more information, IEHP DualChoice Members eligible for CMR or TMR services can call 1-877-273-IEHP (4347), 8am-5pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347.  Click here for a blank personal medication list. Medicare MTM Program services may have limited eligibility criteria. They are available for the following conditions: 1.   The IEHP DualChoice Member has a minimum of three (3) disease states: Bone Disease-Arthritis-Osteoporosis Bone Disease-Arthritis-Rheumatoid Arthritis Chronic Heart Failure (CHF) Diabetes Dyslipidemia End-Stage Renal Disease (ESRD) Hypertension Mental Health Chronic/ Disabling Mental Health Conditions Respiratory Disease – Asthma Respiratory Disease – Chronic Obstructive Pulmonary Disease (COPD) 2.   The IEHP DualChoice Member is prescribed a minimum of five (5) different medications to treat those disease states: ACE-Inhibitors Angiotensin II Receptor Blockers (ARBs) Antidepressants Antihyperlipidemic Antihypertensives Antipsychotics Beta Blockers Bronchodilators Calcium Channel Blockers Disease-Modifying Anti-Rheumatic Drugs (DMARDs) Diuretics Insulins Oral Hypoglycemics Selective Serotonin Reuptake Inhibitors (SSRIs) Tumor Necrosis Factors (TNFs) Inhaled Corticosteroids Calcimimetic Cardiac Glycoside Colony Stimulating Factors Glucagon-Like Peptide-1 Glucocorticosteroids Neprilysin Inhibitor NSAIDs Phosphate Binders Vitamin D Analogs 3. Drug costs of $1,233.75 (one-fourth of $4,935) for the previous three months are likely to be incurred. To learn more about MTM, call IEHP DualChoice (HMO-DSNP) at 1-877-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347.   For answers to frequently asked questions, please download the FAQ document below: MTM FAQs (PDF) For details, contact the IEHP Pharmaceutical Services Department at (909) 890-2049, Monday-Friday, 8am-5pm. IEHP DualChoice (HMO-D-SNP) [Medicare-Medicaid Plan] is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Information on this page is current as of March 2023. H5355_CMC_20_1900233_Accepted 

ude printable reference documents for your convenience and ease of use. Go to the Quality & Clinical Resources and Tools page. In this section find information regarding Clinical Practice Guidelines. Safety Resources

P DualChoice (HMO D-SNP) is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. It is an organization made up of doctors, hospitals, pharmacies, providers of long-term services and supports, behavioral health providers, and other providers. It also has care coordinators and care teams to help you manage all your providers and services. They all work together to provide the care you need.   What is the goal of this program? The goal is to improve care by integrating the following healthcare services: Medicare and Medi-Cal benefits Long-term care Behavioral health Home and community-based services (HCBS) such as Community-Based Adult Services (CBAS) and Multipurpose Senior Services Program (MSSP). Who is eligible for IEHP DualChoice (HMO D-SNP)? People who have both Medicare and Medi-Cal. For a complete list of who is included or excluded, visit Who Qualifies?   Plans and Benefits IEHP DualChoice (HMO D-SNP) integrates healthcare services to better coordinate care and improve health.   How to Enroll To enroll, please call: IEHP DualChoice (HMO D-SNP) Team at 1-800-741-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays. TTY/TDD users should call 1-800-718-4347, OR Health Care Options (HCO) at 1-844-580-7272, 8am – 5pm (PST), Monday – Friday. TTY/TDD users should call 1-800-430-7077. For more information, visit the DHCS website. By clicking on this link, you will be leaving the IEHP DualChoice (HMO D-SNP) website. You may also call IEHP DualChoice (HMO D-SNP) for help at 1-877-273-IEHP (4347), 8am – 8pm (PST), 7 days a week, including holidays. TTY/TDD users should call 1-800-718-4347 (4347). Plan Benefits and Cost-Sharing: Find out about plan benefits which are the types of medical care that are covered. Also view information on cost-sharing which is how much you will pay for services or prescription drugs, including monthly plan premium and co-payment. Part D Prescription Drugs: Get information on pharmacy benefits, IEHP network pharmacies, out-of-network coverage, pharmacy transition process, drug utilization management, and prescription mail order. Provider Access Information: Learn about network providers, primary care providers, specialists and how to choose a provider in our network. Read about our quality assurance activities and find out what happens if your doctor leaves our plan. Grievances, Coverage Determination and Appeals Process: Find out what to do if you have a problem or complaint about your medical care or Part D. Helpful Information: View your rights and responsibilities upon disenrollment and as a Member of IEHP. You will also find important forms, such as our Privacy Notice, Plan Transition Process and the section of CMS' website regarding Best Available Evidence. Service Area: Only people who live in our service area can join IEHP DualChoice. Our service area includes all of Riverside and San Bernardino counties.   IEHP DualChoice (HMO D-SNP) is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees. Information on this page is current as of April 19, 2023. H5355_CMC_19_1059755 Accepted      

r Community Affiliated Health Plans (ACAP)

Círculo para Niños Formato: Grupo pequeño Duración: Sesión de 30 minutos Edades: de 0 a 5 años, los niños deben estar acompañados por el padre, la madre o el tutor. Estas clases están diseñadas para familias con bebés, niños y niños de 0 a 5 años. Las clases promueven el desarrollo saludable y las habilidades relacionadas con la formación de los hijos mediante juegos atractivos e interacción social. Los padres son motivados a acceder a recursos de atención medica y trabajar con sus pediatras en las evaluaciones de desarrollo y las intervenciones tempranas. Aprenda sobre la educación para la salud incluyendo temas esenciales como consultas para un bebé saludable, alimentación, desarrollo del lenguaje, seguridad, actividad física y vacunas. Las evaluaciones de desarrollo están disponibles a petición.  Para solicitar una evaluación del desarrollo de su hijo, envíenos un correo electrónico a screening@iehp.org Consulte también: Al hacer clic en los enlaces a continuación usted saldrá del sitio web de IEHP. Etapas del Desarrollo Calendario para las Visitas del Niño Saludable Calendario de Vacunación Citas preventivas para ninos (PDF)    

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) (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 Emergency Exit Routes Factsheet (PDF) Evacuation Routes (PDF) Glucometer Log (PDF) Hemocue Log (PDF) Medical Emergency, Earthquake, Fire Protocols (PDF) Emergency Exit Routes Factsheet (PDF) Pre-filled Emergency Medications Dosage Chart (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) CRAFFT-2.0 Clinician Interview (PDF) Hepatitis Risk Assessment Tool (PDF) Intimate Partner Violence (IPV) Screening Tools (PDF) Intimate Partner Violence (IPV) and Sexual Violence Victimization Assessment Instruments for Use in Healthcare Settings (PDF) PHQ-2 - Sample (PDF) PHQ-9 - Sample (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) CRAFFT-2.0 Clinician Interview (PDF) Edinburgh Postnatal Depression Scale (EPDS) (PDF) General Consent to Treat Minor (PDF) Hepatitis Risk Assessment Tool (PDF) Intimate Partner Violence (IPV) Screening Tools (PDF) Intimate Partner Violence (IPV) and Sexual Violence Victimization Assessment Instruments for Use in Healthcare Settings (PDF) Oral Health Risk Assessment Tool (PDF) PEARLS Assessment (PDF) PEARLS Teen Self-Assessment (PDF) PHQ-2 - Sample (PDF) PHQ-A - Sample (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) Visual Acuity Screen Tips (PDF) (Back to FSR Menu) Additional Documents Facility Site Review IEHP Phone List (PDF) (Back to FSR Menu) Additional Documents Medical Record Review Online 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.

offer in place of services or settings covered under the Medicaid State Plan. These services should be medically appropriate and cost-effective alternatives. Beginning January 1, 2022, IEHP began offering 11 DHCS Preapproved Community Supports services. Effective July 1, 2023, 3 additional services were added. Please click on the service for additional details. Asthma Remediation Community Transition Services/Nursing Facility Transition to a Home Home Modifications Housing Deposits Housing Tenancy and Sustaining Services Housing Transition Navigation Services Medically Supportive Food/Meals/Medically Tailored Meals Nursing Facility Transition/Diversion to Assisted Living Facilities, such as Residential Care Recuperative Care (Medical Respite) Short-Term Post-Hospitalization Housing Sobering Centers (Riverside County) Day Habilitation  Personal Care and Homemaker Services  Respite Services  Community Supports FAQs (PDF) Please return the completed Community Supports Service Provider Assessment (PDF) via email to DGCommunitySupportTeam@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.

s for Contracted and Non-Contracted Providers Emergency and Post-Stabilization Care for IEHP Members IEHP DualChoice (HMO D-SNP) Model of Care Training for Non-Contracted Providers Provider Referral Outside of the IEHP Network Provider Dispute Resolution Process for Contracted and Non-Contracted Providers   Definition of a Provider Dispute A provider dispute is a written notice from the provider to Inland Empire Health Plan (IEHP) that: Challenges, appeals, or appeals, or requests reconsideration of a claim (including a bundled group of similar claims) that has been denied, adjusted, or contested Challenges a request for reimbursement for an overpayment of a claim Seeks resolution of a billing determination or other contractual dispute   What is not Considered to be a Provider Dispute Claims denied for missing or additional documentation requirements such as consent forms, invoices, Explanation of Benefits from primary carrier, or itemized bills are not considered Provider Disputes Corrected Claims Pre-Service Authorization Denials   Provider Dispute Time Frame IEHP accepts disputes from providers if they are submitted within 365 days of receipt of IEHPs decision (for example, IEHPs Remittance Advice (RA) indicating a claim was denied or adjusted).   Submission of Provider Disputes When submitting a provider dispute, a provider should use a Provider Dispute Resolution Request form. If the dispute is for multiple, substantially similar claims, complete the spreadsheet on page 2 of the Provider Dispute Resolution Request Form All Provider Disputes and supporting information must be submitted to: IEHP Claims Appeal Resolution Unit PO BOX 4319 Rancho Cucamonga, CA 91729-4349   Acknowledgement of Provider Dispute IEHP acknowledges receipt of each provider dispute, regardless of whether the dispute is complete, within 15 business days of receipt.   Resolution Timeframe IEHP resolves each provider dispute within 45 business days following receipt of the dispute, and provides the provider with a written determination stating the reasons for determination.   PDR Determination Resulting in Additional Payment If IEHP determines to pay additional monies based on information originally provided and/or available at the time the claim was first presented to IEHP for adjudication, or a result of a processing error IEHP will automatically include the appropriate interest amount if payment is not issued within required regulatory timeframes.   Non-Contracted Provider Disputes Resolution Process for IEHP DualChoice (HMO D-SNP) A non-contracted provider, on his or her own behalf, is permitted to file a standard appeal for a denied claim only if the non-contracted provider completes a waiver of liability statement, which provides that the non-contracted provider will not bill IEHP DualChoice (HMO D-SNP) Plan Members.   Who to Call with Questions on IEHPs PDR Process Contracted providers may visit our online secure provider portal at www.iehp.org for more information. Providers may also call the IEHP Provider Call Center at (909) 890-2054 or (866) 223-4347 Monday-Friday, 8:00 am to 5pm PST.   (Back to Non-Contracted Providers Menu) Emergency and Post-Stabilization Care for IEHP Members   Triage and Advice Systems IEHP provides Members triage, screening, and advice services by telephone 24 hours a day, 7 days a week through its Nurse Advice Line (NAL). By calling the NAL, Members receive assistance with access to urgent or emergency services from an on-call physician, or licensed triage personnel. IEHP Members can reach this 24/7 Nurse Advice Line at (888)-244-IEHP (4347) or 711 (TTY).   Post-Stabilization Care IEHP requires contracted and non-contracted hospitals to obtain prior authorization for post-stabilization care for Members (patients). IEHP requests the patient’s diagnosis as indicated by the treating physician or surgeon and any other information reasonably necessary for the Plan to decide on whether to authorize post-stabilization care or to assume management of the patient’s care by prompt transfer to another facility. The hospital should request prior authorization from IEHP’s Utilization Management (UM) Department by: Phone at (866) 649-6327; or Fax at (909) 477-8553 to send clinical notes for medical necessity review.   IEHP makes every effort to respond to requests for necessary post-stabilization care within thirty (30) minutes of receipt. The services are considered approved if IEHP does not respond within this timeframe. All subsequent hospital day are subject to review for medical necessity. IEHP will inform the provider of the Plan’s decision and will coordinate the transfer of the Member if IEHP denies the request for authorization of post-stabilization care and elects to transfer the Member to another health care provider.   Non-Emergency Services If a Member presents at the emergency department for non-emergency services, please refer the Member to their IEHP Member Handbook, section 3 (How to Get Care), which outlines the process for obtaining a referral.   Claims Reimbursement Complete facility claims for authorized health care services must be sent to: Inland Empire Health Plan Attn: Claims Department – IEHP Direct PO BOX 4349 Rancho Cucamonga, CA 91729-4349 Complete professional claims for authorized health care services must be sent to: For IEHP-Direct Members, please send to address above. For IEHP Members assigned to an IPA, please click for here for more information on how to send to the appropriate IPA.   Billing IEHP Members Providers under the Medi-Cal program must not submit claims to, demand or otherwise collect reimbursement from a Medi-Cal beneficiary, or from other persons on behalf of the beneficiary, for any service included in the Medi-Cal program’s scope of benefits in addition to a claim submitted to the Medi-Cal program for that service.   (Back to Non-Contracted Providers Menu) IEHP DualChoice (HMO D-SNP) Model of Care Training for Non-Contracted Providers   The Centers for Medicare & Medicaid Services (CMS), the Department of Health Care Services (DHCS), and National Committee for Quality Assurance (NCQA) requirement that out-of-network providers routinely seen by IEHP DualChoice (HMO D-SNP) Members, receive training on IEHPs Model of Care for our D-SNP Members:   IEHP DualChoice (HMO D-SNP) Model of Care Training (PDF) IEHP DualChoice (HMO D-SNP) Model of Care Training (HTML)   *We recommend opening file in: Mozilla Firefox, MS Edge, Chrome or MS Internet Explorer 2023 IEHP DualChoice (HMO D-SNP) Model of Care eAOR 2023 IEHP DualChoice (HMO D-SNP) Model of Care Non-Contracted Provider AOR (PDF) Report an Issue To report any issues with this system or process or for any questions, please send an email to DGHospitalRelationsServiceTeam@iehp.org   (Back to Non-Contracted Providers Menu) Provider Referral Outside of the IEHP Network   In cases where an out-of-network provider that has been approved to provide service(s) to an IEHP Member and needs to refer said IEHP Member to another out-of-network provider, the approved out-of-network provider must first contact the Member’s IPA to request the referral. The Member’s IPA will review the request for referral and provide a decision within regulatory timeframes. The Member’s IPA will approve the request if it is deemed medically necessary and if IEHP or the IPA does not have an appropriate alternative provider available within its network. If you have any questions or if you would like to request a referral, please reach out to the Member’s IPA.   (Back to Non-Contracted Providers 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.

th IEHP’s inspiring and compelling Mission to “Heal and Inspire the Human Spirit,” we are mindful of the cost of caring on clinician health and well-being and we want you to know we care about you, stand with you, and want to support you in ways that help you sustain joy in your work. We have provided best-practice and highly respected resources here for provider well-being. May you continue to find purpose and fulfillment in your calling to this very sacred work of health care.   Resources Standford Well MD A robust site of resources, courses, publications, self-assessments, research, innovation, conferences, and trainings. https://wellmd.stanford.edu/   National Academy of Medicine A compilation of key resources for improving clinician well-being. https://nam.edu/compendium-of-key-resources-for-improving-clinician-well-being/   American Association of Physician Leadership (AAPL) Resources, courses, and tools for Physician Wellness, Physician Leadership, and more. https://www.physicianleaders.org/resources/wellness   Coalition for Physician Wellness Resources, mobile app, research, podcasts, books and publications. https://www.forphysicianwellbeing.org/   Healthcare Burnout Symposium  Annual conference that addresses the multiple facets of burnout crisis and how to increase the well-being of physicians, nurses and administrators. Visit website to learn more about conference agenda and how to earn continuing education credits. https://www.stophealthcareburnout.com/   American Medical Association Alliance (AMA) Steps Forward Program: Improving Physician Resilience Resources for physicians to enhance their resiliency and prevent burnout. Visit website to learn more about the AMA’s Steps Forward guide and module. Physicians might be able to earn continuing education credits by completing the training. https://amaalliance.org/physician-burnout/   American College of Physicians Online learning center with webinar and videos available on physician well-being and professional fulfillment. https://www.acponline.org/online-learning-center/physician-well-being-and-professional-fulfillment   Los Angeles County Medical Association (LACMA) Interactive Wellness dashboard and resources for physicians. https://www.lacmainteractive.com/mdlifeline   National Suicide Prevention Hotline The lifeline provides 24/7, free and confidential support, prevention and crisis resources for anyone in need and best practices for professionals in the United States. https://988lifeline.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.

atives that MCPs may offer in place of services or settings covered under the California Medicaid State Plan. Beginning January 1, 2022, IEHP began offering 11 DHCS Preapproved Community Supports services. Effective July 1, 2023,  3 additional services were added. Please click on the service for additional details. Asthma Remediation Environmental Asthma Trigger Remediations are physical modifications to a home environment that are necessary to ensure the health, welfare, and safety of the individual, or enable the individual to function in the home and without which acute asthma episodes could result in the need for emergency services and hospitalization. Community Transition Services/Nursing Facility Transition to a Home Assist members to live in the community and avoid further institutionalization. These services are non-recurring set-up expenses for individuals who are transitioning from a licensed facility to a living arrangement in a private residence where the person is directly responsible for his or her own living expenses. Environmental Accessibility Adaptations (Home Modifications) Environmental Accessibility Adaptations (EAAs also known as Home Modifications) are physical adaptations to a home that are necessary to ensure the health, welfare, and safety of the individual, or enable the individual to function with greater independence in the home: without which the Member would require institutionalization. Housing Deposits Housing Deposits assist with identifying, coordinating, securing, or funding one-time services and modifications necessary to enable a person to establish a basic household that do not constitute room and board. Housing Tenancy & Sustaining Services This service provides tenancy and sustaining services, with a goal of maintaining safe and stable tenancy once housing is secured. Housing Transition Navigation Services Housing transition services assist Members with obtaining housing. Medically Supportive Food/Meals/Medically Tailored Meals Malnutrition and poor nutrition can lead to devastating health outcomes, higher utilization, and increased costs, particularly among Members with chronic conditions. Meals help individuals achieve their nutrition goals at critical times to help them regain and maintain their health. Results include improved Member health outcomes, lower hospital readmission rates, a well-maintained nutritional health status, and increased Member satisfaction. Nursing Facility Transition/Diversion to Assisted Living Facilities Nursing Facility Transition/Diversion services assist individuals to live in the community and/or avoid institutionalization when possible. The goal is to both facilitate nursing facility transition back into a home-like, community setting and/or prevent skilled nursing admissions for Members with an imminent need for nursing facility level of care (LOC). Individuals have a choice of residing in an assisted living setting as an alternative to long-term placement in a nursing facility when they meet eligibility requirements. Recuperative Care (Medical Respite) Recuperative care, also referred to as medical respite care, is short-term residential care for individuals who no longer require hospitalization, but still need to heal from an injury or illness (including behavioral health conditions) and whose condition would be exacerbated by an unstable living environment. An extended stay in a recovery care setting allows individuals to continue their recovery and receive post-discharge treatment while obtaining access to primary care, behavioral health services, case management and other supportive social services, such as transportation, food, and housing. Short-Term Post-Hospitalization Housing Short-Term Post-Hospitalization housing provides Members who do not have a residence and who have high medical or behavioral health needs with the opportunity to continue their medical/psychiatric/substance use disorder recovery immediately after exiting an inpatient hospital (either acute or psychiatric or Chemical Dependency and Recovery hospital), residential substance use disorder treatment or recovery facility, residential mental health treatment facility, correctional facility, nursing facility, or recuperative care and avoid further utilization of State plan services. Sobering Centers (Riverside County) Sobering centers are alternative destinations for individuals who are found to be publicly intoxicated (due to alcohol and/or other drugs) and would otherwise be transported to the emergency department or jail. Sobering centers provide these individuals, primarily those who are homeless or those with unstable living situations, with a safe, supportive environment to become sober. Day Habilitation Programs Effective July 1st - Day Habilitation Programs are provided in a participant’s home or an out-of-home, non-facility setting. The programs are designed to assist the participant in acquiring, retaining, and improving self-help, socialization, and adaptive skills necessary to reside successfully in the person’s natural environment. Respite Services Effective July 1st - These are provided to caregivers of participants who require intermittent temporary supervision. The services are provided on a short-term basis because of the absence or need for relief of those persons who normally care for and/or supervise them and are non-medical in nature. Personal Care and Homemaker Services Effective July 1st - This service is provided for individuals who need assistance with Activities of Daily Living (ADL), such as bathing, dressing, toileting, ambulation, or feeding. Personal Care Services can also include assistance with Instrumental Activities of Daily Living (IADL), such as meal preparation, grocery shopping, and money management. IEHP Direct and Delegated Providers can submit referrals for Community Supports via the Provider Portal. For questions on how to submit a referral or more information relating to the above services, Providers can call the Provider Call Center at (909) 890-2054 or (866) 223-4347. Please continue to direct IEHP Members needing additional information on Community Supports services to IEHP Member Services at (800) 440-4347, Monday - Friday, 8am - 5pm. TTY users should call (800) 718-4347. If you have programmatic questions, please email DGCommunitySupportTeam@iehp.org Community Supports Provider Brochure - English (PDF) | Spanish (PDF) | Chinese (PDF) | Vietnamese (PDF) Community Supports FAQs (PDF) Medi-Cal Community Supports or In Lieu of Services (ILOS) 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.

Click on the following links to jump to that specific section: After Hours Care After Hours Phone Numbers IEHP Access Standards IEHP Direct Adult Hospitalists Urgent Care Clinics After Hours Care IEHP Providers can direct Members to access care after hours. After hour care includes the 24-Hour Nurse Advice Line, DocOnline and Urgent Care Clinics. Fever? Pain? Cold? Call our 24-Hour Nurse Advice Line --> Your Members can call the IEHP 24-Hour Nurse Advice Line for medical advice anytime, day or night: 1-888-244-IEHP (4347) DocOnline, an extension to the Nurse Advice Line, allows Members to speak with a board-certified Physician for advice after hours using telephonic and/or video devices. DocOnline Physicians will triage, assess, and provide diagnoses for minor acute conditions. Physicians may also give treatment advice, refill select prescriptions and refer Members for in-person care. DocOnline FAQs (PDF) Prescription Medication Refill List (PDF) (Back to Additional Resources Menu) After Hours Phone Numbers for Coverage Determination and Expedited Appeals IEHP DualChoice (HMO D-SNP) Members The following numbers are to be used for after hour requests: Coverage Determinations: Phone: (888) 860-1297 Expedited Appeals: Phone: (866) 223-4347  Fax: (909) 890-5748 (Back to Additional Resources Menu) IEHP Access Standards On an annual basis, IEHP conducts the Appointment Availability Access Study. All Members must receive access to all covered services without regard to sex, race, color, religion, ancestry, national origin, creed, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, sexual orientation, or identification with any other persons or groups defined in Penal Code Section 422.56, except as needed to provide equal access to Limited English Proficiency (LEP) Members or Members with disabilities, or as medically indicated. Appointment Standards for All Provider Types (PDF)| Last Revised: 12/12/2022 Appointment Standards for Behavioral Health (PDF)| Last Revised: 01/11/2023 (Back to Additional Resources Menu) IEHP Direct Adult Hospitalists Direct Adult Hospitalist (PDF) | Last Revised: 02/27/2023 (Back to Additional Resources Menu) Urgent Care Clinics --> Any of your IEHP Members needing medical attention may visit an Urgent Care Clinic after regular business office hours and on weekends. A listing of all Urgent Care Clinics is found on the IEHP Doctor Search. (Back to Additional Resources 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.

ness. Any pricing disputes, whether it be brand or generic, are to be handled by MedImpact. MedImpact also addresses pharmacy provider appeals on drug pricing. Please direct related inquiries and pricing appeals to MedImpact Pharmacy Provider line at 1-888-495-3147, with a 24/7/365 availability. Information on this page is current as of June 02, 2023

s the Medi-Cal Renewal process, is currently underway across our state. This initiative is the biggest challenge facing the Medi-Cal program in its history. Up to 400,000 IEHP Members could potentially lose their Medi-Cal coverage if they don't complete the necessary renewal paperwork on time. The impact on Providers across the entire healthcare system will be significant, potentially resulting in: Increased use of the emergency department for primary care Decreased capacity of bed availability Delays in hospital discharges while awaiting coverage Increased length of stay for patients with delayed preventative or chronic care Increased cost of care Interruptions of ongoing care However, with every challenge comes opportunities to help our collective health care mission and partnership grow even stronger. IEHP takes this challenge seriously and we are committed to helping Members keep their Medi-Cal coverage and Providers keep their assigned Members without interruption. Resources to Help with the Medi-Cal Renewal Process The following resources for Providers offer more information about the Medi-Cal Renewal process and tools to help your office proactively engage and encourage Members to renew their Medi-Cal coverage on time. Medi-Cal Renewal Flyers and Provider Information IEHP Medi-Cal Renewal Flyer for Members PDF – (English, Spanish, Chinese, Vietnamese) Annual Eligibility Renewal (AER) FAQs Medi-Cal Redetermination PowerPoint presentation - (Providers and IPAs) Department of Health Care Services (DHCS) Toolkits – Medi-Cal Continuous Coverage Requirement IEHP Eligibility Renewal Support Team IEHP’s Eligibility Renewal Support team is here to answer calls from Members needing more one-on-one support during the Medical-Renewal process! We support: Application print outs Online submissions via BenefitsCal.com Assistance in connecting with the appropriate county department Serving as a centralized eligibility hub for all eligibility-related issues (on hold, disenrolled, out of area, etc.) Helping Members update contact information (national change of address, undeliverable address, etc.) Please let your patients and our Members know that additional application support is just a phone call away. IEHP Eligibility Renewal Support Team Hotline Phone and Hours of Operation: 1-888-860-1296, Monday-Friday, 8 am - 5 pm (PST) Additional information for IEHP Members Additional Communication from IEHP IEHP’s Medi-Cal Renewal specific Provider Communication is provided here for your convenience as well as here on our Correspondence page: June 15, 2023 - Medi-Cal Renewal Date Does NOT Override Member's Eligibility Status (PDF) June 09, 2023 - URGENT: What can I do to help patients keep their Medi-Cal (PDF) May 04, 2023 - New: Annual Medi-Cal Eligibility Renewal (AER) Roster Now Available to Download Under CSV! (PDF) April 17, 2023 - Now Live! Annual Medi-Cal Eligibility Renewal (AER) Alerts and Roster! (PDF) April 06, 2023 - Phone Number CORRECTION: IEHP Eligibility Renewal Support Team First Round of Yellow Medi-Cal Renewal Packets Mailed to Members! (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.

isciplinary Care Team (ICT) DualChoice Medicare CM IPA Training Alzheimer's and Dementia Care Specialty Mental Health Care Coordination National LGBT Health Education Webinars Online Cultural Competency Training   Interdisciplinary Care Team (ICT) Fact Sheet (PDF) Healthcare Provider Toolkit: Assisting Patients with Requests for Workplace Accommodations or Leaves of Absence (PDF) DualChoice Medicare CM IPA Training 2021 Care Management Delegation Oversight Medi-Cal IPA Training (MP4 Video) - December 08, 2021 Discussion Topics: Health Risk Assessments (HRA) Individual Care Plans (ICP) Interdisciplinary Care Team (ICT) Coordination of Care Delegated IPA Reporting Requirements   2021 Care Management Delegation Oversight Medi-Cal IPA Training (MP4 Video) - February 16, 2021 Alzheimer's and Dementia Care Project ECHO Opportunities from the Alzheimer's Association for Inland Empire Primary Care Clinics Alzheimer’s Association / UCSF Memory and Aging Center Alzheimer’s and Dementia Care ECHO Faculty Partners: UCSF Memory and Aging Center faculty When: Thursdays beginning February 16, 2023 until July 20, 2023 from 12:00 pm - 1:00 pm PT via Zoom Who can be involved: All California based Primary care practice teams (including MD/DO, NP, PA, social work, MA) UCSF/Inland Empire ECHO 2023 Flyer (PDF) To register, please contact Kelsey Burnham at kburnham@alz.org  UCLA ADC ECHO Faculty Partners: UCLA Alzheimer’s and Dementia Care (ADC) program faculty When: Wednesdays beginning March 29, 2023 until September 6, 2023 from 11:00 am - 12:00 pm PT via Zoom Who can be involved: Nationwide teams interested in adding to their own knowledge and skills and those interested in learning about or implementing the highly effective UCLA ADC program ADC ECHO 2023 Flyer (PDF) To register, please contact Rachel Goldberger at rbgoldberger@alz.org Specialty Mental Health Care Coordination The Centers for Medicare and Medicaid Services (CMS) is requiring IEHP and its IPAs to document and report the efforts made to coordinate the care of IEHP DualChoice (HMO D-SNP)  Members receiving specialty mental health services through the County Mental Health Plans.   As of June 1, 2018, IEHP has put policies and procedures in place to comply with these process and reporting requirements: On the first (1st) of each month, IEHP will provide IPAs and County MH Clinics a list of IEHP DualChoice (HMO D-SNP) Members known to be receiving specialty mental health services through the County MH Plans. IPAs are expected to outreach to these Members and their County MH Clinic Provider, as well as, document their outreach attempts and outcomes as outlined in Policy 25C2, “Care Management Requirements – Delegated IPA Responsibilities.” IPAs are required to provide data elements specific to this measure, as outlined in Policy 25F1, “Encounter Data Reporting - Medicare MMP Reporting Requirements – IEHP DualChoice (HMO D-SNP)" and Attachment, “Medicare Provider Reporting Requirements Schedule” in Section 25. IEHP, through its Delegation Oversight process, will monitor the IPAs’ compliance with documentation and reporting requirements, as outlined in Policy 25A2, “Delegation Oversight Audit.” To access the On-Site training material presented to IPAs and County Mental Health Clinics, click here (PDF). National LGBT Health Education Webinars IEHP has put together a list of webinars, provided by a third party, to provide educational programs, resources, and consultation to health care organizations with the goal of optimizing quality, cost-effective health care for lesbian, gay, bisexual, transgender, and all sexual and gender minority (LGBT) people. The National LGBT Health Education Center is part of the Division of Education and Training at The Fenway Institute, Fenway Health. The Fenway Institute (TFI) is an interdisciplinary center for research, training, education, and policy development that works to ensure access to quality, culturally affirming medical and mental health care for traditionally underserved communities, including LGBTQIA+ people and those affected by HIV/AIDS. The mission of Fenway Health is to enhance the wellbeing of the LGBTQIA+ community as well as people in our neighborhoods and beyond through access to the highest quality health care, education, research, and advocacy. Fenway Health is one of the largest providers of LGBTQIA+ health care and HIV primary care in the country; as such, it is a leader in the field of LGBTQIA+ health and informs much of the promising practices and innovative models that the Education Center disseminates to health centers nationwide. By clicking on these links, you will be leaving the IEHP website. The National LGBT Health Education Center Webinars  Courses Include:  HIV Prevention/PrEP at Health Centers: An Overview and Current Best Practices What’s new in PrEP and STIs? Cases From a Sexual Health Clinic Insurance Considerations for Navigating Gender-affirming Care Building Your Family: LGBTQ Reproductive Options Behavioral Health Assessments and Referral for Gender-Affirming Surgery Navigating Gender Affirming Care Collecting Sexual Orientation and Gender Identity (SO/GI) Data In Electronic Health Records Providing Mental Health Assessments for Gender Affirming Surgery Referral Letters Online Cultural Competency Training AHRQ Health Literacy Modules Available for Continuing Education (CE) and Maintenance of Certification (MOC) Credit  Physicians and nurses can earn CE credits while learning about the challenges in caring for patients with low health literacy as well as strategies to improve overall patient communication and care. OptumHealth Education is issuing continuing education credit for taking the AHRQ-developed Health Literacy Knowledge Self-Assessment. No fees are charged for the two CE activities: By clicking on these links, you will be leaving the IEHP website. 1. An Updated Overview of Health Literacy Link (optumhealtheducation.com) 2. Improving Health Literacy by Improving Communication Skills Link (optumhealtheducation.com) Pediatricians and family physicians can earn credit for re-certification (MOC Part 2) as well as CE by taking the Health Literacy Knowledge Self-Assessment through the American Board of Pediatrics and the American Academy of Family Physicians, respectively. To learn about AHRQ’s tools to address health literacy, visit Health Literacy Topics at:  https://www.ahrq.gov/health-literacy/index.html To find out about other free AHRQ continuing education opportunities, go to: https://www.ahrq.gov/patient-safety/education/continuing-ed/index.html To contact AHRQ, visit https://www.ahrq.gov/contact/index.html   Office of Minority Health: https://cccm.thinkculturalhealth.hhs.gov/ CDC: www.cdc.gov U.S. Department of Health and Human Service, Health Resources and Services Administration: www.hrsa.gov You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

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.  

s del COVID-19 Las personas con COVID-19 han reportado diversos síntomas, de leves a enfermedad grave. Los síntomas pueden aparecer 2-14 días después de la exposición al virus. Cualquier persona puede tener síntomas de leves a graves, incluyendo: Fiebre o escalofríos Tos Falta de aire o dificultad para respirar Cansancio Dolores en los músculos o en el cuerpo Dolor de cabeza Pérdida del gusto o del olfato que antes no tenía Dolor de garganta Congestión o goteo nasal Náuseas o vómitos Diarrea Vaya al hospital o busque atención médica de emergencia inmediatamente si tiene síntomas graves de COVID-19, incluyendo: Problemas para respirar Dolor o presión persistente en el pecho Confusión que antes no tenía Incapacidad para despertarse o permanecer despierto Piel, labios o lecho de las uñas pálidos, de color gris o azul, según la tonalidad de la piel Qué debe hacer si se siente enfermo Si tiene alguno de estos síntomas, considere las siguientes medidas: Hágase una prueba de COVID-19: es gratuita. IEHP también pagará por los miembros que se hagan la prueba estándar de COVID-19 y las pruebas que les indique el doctor, independientemente del tipo de prueba. Su doctor debe facturarle directamente a IEHP por esas pruebas. Vaya a su doctor o a un centro de cuidado de urgencia, en persona o mediante telesalud, en un plazo de 24 horas desde el comienzo de los síntomas. Para los miembros de IEHP, si no pueden comunicarse con su doctor o si es después del horario de atención, pueden llamar a la línea de Consejos de Enfermería las 24 Horas de IEHP al 1-888-244-4347 o al 711 para usuarios de TTY, las 24 horas, los siete días de la semana. Nuestros enfermeros capacitados ofrecen asesoría médica y, si es necesario, lo pondrán en contacto con un doctor por teléfono o por videoconferencia. Información sobre los tratamientos del COVID-19 La mayoría de los tratamientos del COVID-19 son con pastillas que usted toma en casa. Los medicamentos para el COVID-19 son gratuitos en California. No es necesario que tenga seguro médico ni que sea ciudadano americano. Los medicamentos para el COVID-19 funcionan mejor si se empiezan a tomar lo antes posible, en los primeros 5-7 días desde que aparezcan los síntomas. Si cree que puede tener COVID, no espere a que los síntomas empeoren. Los medicamentos para el COVID-19 son seguros y eficaces para evitar que la enfermedad sea grave; pueden disminuir a la mitad, o más, el riesgo de enfermedad grave, hospitalización y muerte por COVID-19. Los medicamentos para el COVID-19 pueden ayudar a que su prueba dé negativo antes y pueden reducir el riesgo de tener síntomas de COVID de largo plazo.* Los medicamentos para el COVID-19 se recomiendan para personas mayores de 12 años que tengan determinados problemas de salud u otros factores comunes que aumenten el riesgo. El doctor puede decirle si es elegible para recibir medicamentos para el COVID-19 y cuál es el mejor para usted. Los medicamentos para el COVID-19 son eficaces esté vacunado o no. Si da positivo en la prueba de COVID-19, tiene síntomas y cumple los siguientes criterios, debe buscar tratamiento: Es mayor de 50 años, O No está vacunado o no está al día con la vacuna del COVID-19, O Tiene un problema de salud u otros factores que aumenten el riesgo. Entre estos factores se incluye obesidad; asma; diabetes; falta de actividad física; tabaquismo; condiciones de salud mental, como depresión; pertenecer a una minoría racial/étnica y otros. Obtenga más información sobre las afecciones que aumentan el riesgo de enfermar gravemente de COVID-19. Haga clic aquí para obtener más información sobre las condiciones de salud mental y del estado de ánimo. * Las primeras evidencias sugieren que el medicamento para tratar el COVID-19, Paxlovid, puede reducir el riesgo de tener síntomas de largo plazo de COVID. Estos síntomas pueden durar semanas, meses o años después de una infección por COVID-19. Cómo hacerse una prueba de COVID-19 Es importante saber cómo y cuándo hacerse la prueba de COVID-19. La prueba puede darle tranquilidad, información para ayudarlo a tomar decisiones sobre su salud y ayudarlo a ralentizar la propagación del virus en nuestra comunidad. Dónde hacerse una prueba de COVID-19 Visite nuestro enlace: Qué hacer si da positivo en la prueba de COVID-19 Aíslese para evitar la propagación del virus; haga clic aquí para obtener consejos sobre el aislamiento y las precauciones para personas con COVID-19. Busque opciones de tratamiento de inmediato Cómo obtener tratamiento Comuníquese con el consultorio de su doctor Comuníquese con su farmacia Vaya a un centro de prueba y tratamiento

Procurement department is continuously looking for suppliers of the varied goods and services it procures.  IEHP procures goods and services through the solicitation process, and in the case of repetitively purchased items, establishes long-term contracts. With the exception of Public Works (construction type bids) and a few specialty bids, most bids for goods and services procured are completed using a third-party solicitation website called Bonfire. Vendors have the option to view IEHP’s open solicitations on the Bonfire website. IEHP invites all vendors to register with Bonfire and participate in IEHP’s fair and open solicitation process for goods and services. Mission Statement The Procurement department is committed to supporting the mission of IEHP, which is “to organize and improve the delivery of quality, accessible and wellness based healthcare services for our community”. As a community-developed health plan, we are accountable to the public. IEHP’s Procurement professionals possess the necessary skill set, knowledge base, and negotiating skills to assist IEHP with the acquisition of materials, equipment and contractual services. Utilizing this expertise, our best procurement practices, and the highest standards of professional ethics and integrity, we ensure that procurement decisions made are in the best interest of IEHP and in compliance with all applicable laws, regulations and policies. Compliance with Economic Sanctions Imposed in Response to Russia’s Actions in Ukraine On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (EO) regarding sanctions in response to Russian aggression in Ukraine. The EO is located at https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf. This serves as a notice under the EO that as a vendor, contractor or grantee, compliance with the economic sanctions imposed in response to Russia’s actions in Ukraine is required, including with respect to, but not limited to, the federal executive orders identified in the EO and the sanctions identified on the U.S. Department of the Treasury website (https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information/ukraine-russia-related-sanctions). Failure to comply may result in the termination of contracts or grants, as applicable. For general inquiries, please email procurement@iehp.org. Code of Ethics Policy Click to Download Our Code of Ethics Policy

o, que son opciones especiales de atención. Se los pueden ofrecer (en lugar de los servicios cubiertos por planes estatales) a Miembros calificados con niveles de riesgo mediano o alto. Los Servicios de Apoyo Comunitario pueden ayudarlo a mantenerse sano, a disminuir las complicaciones por enfermedades y a evitar estancias innecesarias en el hospital, en centros de enfermería y en departamentos de emergencias Es posible que los Servicios de Apoyo Comunitario con IEHP lo ayuden durante una transición de vivienda o en la atención. Si necesita ayuda para manejar su salud, los Servicios de Apoyo Comunitario de IEHP podría ser la opción indicada. Si necesita más atención Los Servicios de Apoyo Comunitario de IEHP se ofrecen a para cualquier Miembro de Medi-Cal o de IEHP DualChoice Cal MediConnect Plan (plan de Medicare-Medicaid) que necesite atención de apoyo. Los Servicios de Apoyo Comunitario pueden favorecer la salud general, cuidando el cuerpo y la mente. Los Miembros que podrían beneficiarse de los Servicios de Apoyo Comunitario son aquellos que: Pueden estar enfrentando la falta de vivienda. Pueden estar teniendo dificultades para conseguir comida para sus seres queridos. Pueden estar teniendo problemas por el asma y necesitan hacer cambios en el lugar donde viven. Cómo puede ayudarlo el Equipo para Coordinar su Atención Médica Si puede recibir asistencia de los Servicios de Apoyo Comunitario, es posible que le asignen un Equipo para Coordinar su Atención Médica que puede ayudarlo a identificar sus necesidades. Después, ellos coordinarán los servicios gratuitos, incluyendo encontrar recursos para vivienda, atención después de salir del hospital y cómo manejar el asma en casa. Quiénes pueden formar el Equipo para Coordinar su Atención Médica: Enfermera administradora de la atención Administrador de atención de salud del comportamiento Coordinador de atención médica Trabajador de salud de la comunidad Apoyo cuando lo necesite El Equipo para Coordinar su Atención Médica puede ayudarlo por teléfono o personalmente, y hasta puede reunirse con usted donde esté. Con los Servicios de Apoyo Comunitario de IEHP usted no está solo. ¿Qué tipos de apoyo comunitario se ofrecen? Servicios de vivienda (para facilitar la transición a la comunidad de un hospital o de un centro de enfermería) Atención después del hospital Recursos para que su casa sea segura Comidas para mantenerse sano (incluye comidas para afecciones médicas) Atención para la recuperación Transición de un centro de enfermería Comunicación con centros de vivienda asistida Atención del asma (incluye servicios para adaptar el lugar donde vive para reducir los factores desencadenantes del asma) Para obtener más información sobre los Servicios de Apoyo Comunitario, llame a Servicios para Miembros de IEHP al 1-800-440-IEHP (4347), 8am – 5pm (Hora del Pacífico), lunes – viernes. Los usuarios de TTY deben llamar al 1-800-718-4347.

os adolescentes van a la escuela, salen con amigos, hacen deportes y van a bailar. ¡Pero eso no es todo! También toman decisiones importantes sobre su futuro durante ese tiempo de transición. Muchas de las decisiones que toman los adolescentes afectarán su salud a medida que crecen. IEHP quiere ayudar a asegurar que los adolescentes tomen las decisiones más saludables posibles.  IEHP quiere asegurarse de que los adolescentes se mantengan alejados de los hábitos de riesgo, como: Tabaquismo Consumo de alcohol y otras sustancias Mantener relaciones sexuales sin protección Faltar a la escuela IEHP desea promover hábitos saludables como: Tener una dieta saludable y equilibrada Cuidar la salud mental de los adolescentes Hacer ejercicio Dormir lo suficiente Consultar al doctor de manera regular ¿Busca información?  Visite los siguientes enlaces para obtener información y herramientas útiles sobre temas de salud para adolescentes. Al hacer clic en los enlaces a continuación usted saldrá del sitio web de IEHP. Centros para el Control y la Prevención de Enfermedades (CDC) Departamento de Salud y Servicios Humanos de EE.UU.: Office of Adolescent Health (sitio solo en ingles) 

es una preocupación para millones de americanos. En el último conteo del Censo de los EE. UU., aproximadamente el nueve por ciento de los residentes del Condado de San Bernardino menores de 65 años no tenían seguro. Por eso, Inland Empire Health Plan (IEHP) proporciona cobertura a millones de Miembros en los condados de San Bernardino y Riverside. Descubra el plan médico que pone a sus Miembros en el centro de su universo. IEHP no descansará hasta que nuestras comunidades gocen de una atención óptima y una salud vibrante. Continúe leyendo para obtener más información sobre IEHP y los beneficios que se ofrecen a los beneficiarios de Medi-Cal. IEHP proporciona cobertura a los beneficiarios de Medi-Cal del Condado de San Bernardino Medi-Cal es un programa de cobertura médica de bajo costo o sin costo. Proporciona cobertura médica, dental y de la vista a los residentes de California que tengan bajos ingresos y que califiquen. IEHP es el plan médico para los beneficiarios de Medi-Cal en el Condado de San Bernardino. Estamos comprometidos a darles a nuestros Miembros y a las comunidades locales una atención óptima y una salud vibrante. Servicios de Medi-Cal de primer nivel Medi-Cal es un programa de cobertura médica de bajo costo o sin costo. Proporciona cobertura médica, dental y de la vista a los residentes de California que tengan bajos ingresos y que califiquen. IEHP es el plan médico para los beneficiarios de Medi-Cal en el Condado de San Bernardino. Estamos comprometidos a darles a nuestros Miembros y a las comunidades locales una atención óptima y una salud vibrante. Con la cobertura de IEHP y de Medi-Cal, los Miembros tienen acceso a atención médica general, y a atención avanzada y especializada, entre otros: Servicios para personas transgénero Servicios de laboratorio Servicios de radiología Atención pediátrica Servicios de salud mental Atención de rehabilitación para adicciones Estos son solo algunos ejemplos de cómo la red de Proveedores de IEHP les da a los Miembros y sus familias en el Condado de San Bernardino una amplia gama de atención médica. Para solicitar Medi-Cal en el Condado de San Bernardino, llame a los Asesores de Inscripción de IEHP al (866) 294-4347, lunes – viernes, 8am – 5pm. Los usuarios de TTY deben llamar al (800) 720-4347. También puede comunicarse con Health Care Options llamando al 1-800-430-4263 o visitando www.healthcareoptions.dhcs.ca.gov. Los usuarios de TTY deben llamar al 1-800-430-7077. Servicios de la vista IEHP ofrece cobertura de la vista y tiene una amplia red de especialistas. Los Miembros de IEHP tienen un examen gratis de la vista cada 24 meses, y tienen cubiertos exámenes de la vista adicionales o más frecuentes, si son médicamente necesarios, como los de las personas con diabetes. También obtienen un par de anteojos, con el armazón y las lentes, cada 24 meses, con receta médica válida. Los lentes de contacto y las pruebas para lentes de contacto pueden tener cobertura si el uso de anteojos no es posible por una afección o una enfermedad en los ojos. Servicios dentales de Medi-Cal San Bernardino Mediante Medi-Cal, usted y su familia reciben servicios dentales profesionales. Este beneficio está incluido en su cobertura de Medi-Cal, sin costo o con un costo mínimo.  Entre los tipos de atención dental que se ofrecen se incluye: Higiene dental preventiva y de diagnóstico (como exámenes, radiografías, y limpiezas dentales) Servicios de emergencia para control del dolor Extracciones de dientes Tratamientos de conductos (anteriores/posteriores) Raspaje y alisado radicular Coronas (prefabricadas/laboratorio) Ortodoncia para niños que califiquen Dentaduras postizas completas y parciales Fluoruro tópico Si tiene alguna pregunta o necesita ayuda para encontrar un proveedor dental de Medi-Cal, llame a la Línea Dental de Servicio al Cliente de Medi-Cal al 1-800-322-6384, o visite www.smilecalifornia.org. Transporte para servicios médicos Sus beneficios de Medi-Cal incluyen transporte de ida y vuelta para servicios médicos cubiertos por el plan y para servicios cubiertos por Medi-Cal, como salud mental, abuso de sustancias y servicios dentales, dentro de los condados de San Bernardino y Riverside. IEHP cubre: Visitas a su Doctor de Cuidado Primario, Especialistas y clínicas de atención urgente. Visitas para servicios dentales, de salud mental, por abuso de sustancias, entre otros. Haga clic aquí para obtener más información sobre los servicios de transporte que ofrece IEHP. Condado de San Bernardino: Cómo solicitar Medi-Cal La misión de IEHP de sanar e inspirar el espíritu humano es posible gracias a su Visión: no descansar hasta que nuestras comunidades gocen de una atención óptima y una salud vibrante.  Por eso, seguimos sirviendo a todas las comunidades del Condado de San Bernardino. Tiene muchas opciones para solicitar Medi-Cal, que incluyen: Llamar a IEHP Llame al 1-866-294-4347, 8am – 5pm, lunes – viernes. Los usuarios de TTY deben llamar al 1-800-720-4347. Hablará con uno de los amables Asesores de Inscripción bilingües de IEHP. Enviar la solicitud por correo Puede enviar su solicitud completada y firmada por correo a:   Covered California P.O. Box 989725 West Sacramento, CA 95798-9725 O enviarla a la Oficina de Medi-Cal del Condado de Riverside. Presentar la solicitud en persona Haga clic aquí para encontrar la Oficina de Medi-Cal del Condado de Riverside. Presentar la solicitud en línea Haga clic aquí para presentar su solicitud en línea. Obtenga cobertura médica ahora Sea miembro de la familia de IEHP y obtenga acceso al seguro médico mejor calificado del estado de California. Durante más de 25 años, IEHP ha servido con orgullo a los residentes de Inland Empire y a sus familias. Inscríbase ahora en IEHP y haga de su salud nuestra máxima prioridad.