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Thông Báo Không Phân Biệt Đối Xử của IEHP

mpire Health Plan, IEHP) tuân thủ pháp luật về dân quyền của Tiểu Bang và Liên Bang. IEHP không phân biệt đối xử, loại trừ người nào hoặc đối xử khác biệt với họ một cách trái pháp luật vì lý do liên quan đến xác định giới, sắc tộc, màu da, tôn giáo, tổ tiên, nguồn gốc quốc gia, nhận dạng nhóm dân tộc, tuổi tác, tình trạng khuyết tật tâm thần, tình trạng y tế, thông tin di truyền, tình trạng hôn nhân, giới tính, bản dạng giới hoặc khuynh hướng tính dục. IEHP cung cấp: Các công cụ hỗ trợ và dịch vụ miễn phí cho người khuyết tật để họ có thể giao tiếp hiệu quả với chúng tôi, như: Thông dịch viên ngôn ngữ ký hiệu có chuyên môn Thông tin bằng văn bản ở các định dạng khác (bản in chữ lớn, định dạng âm thanh, định dạng điện tử có thể truy cập, các định dạng khác)   Dịch vụ ngôn ngữ miễn phí cho những người có ngôn ngữ chính không phải là tiếng Anh, chẳng hạn như: Thông dịch viên có chuyên môn Thông tin dạng văn bản viết bằng ngôn ngữ khác Nếu quý vị cần sử dụng những dịch vụ này, vui lòng liên hệ Dịch Vụ Hội Viên IEHP trong khoảng từ 8 giờ sáng đến 5 giờ chiều (Giờ Chuẩn Thái Bình Dương, PST), bằng cách gọi số 1-800-440-IEHP (4347), 7 ngày mỗi tuần, bao gồm cả ngày nghỉ lễ. Nếu quý vị không thể nghe hoặc nói tốt, vui lòng gọi số 1-800-718-4347. Nếu quý vị yêu cầu, tài liệu này có thể được cấp cho quý vị dưới dạng in chữ nổi braille, bản in chữ lớn, băng cát-sét hoặc dưới dạng điện tử. Để được nhận bản sao tài liệu theo một trong những định dạng thay thế này, vui lòng gọi hoặc gửi thư đến: Inland Empire Health Plan 10801 6th St., Rancho Cucamonga, CA 91730-5987 1-800-440-4347 (TTY: 1-800-718-4347/Tiếp Âm California 711) Cách nộp đơn khiếu nại Nếu quý vị cho rằng IEHP đã không cung cấp những dịch vụ này hoặc phân biệt đối xử trái pháp luật theo cách khác vì lý do liên quan đến xác định giới, sắc tộc, màu da, tôn giáo, tổ tiên, nguồn gốc quốc gia, nhóm dân tộc, tuổi tác, tình trạng khuyết tật tâm thần, tình trạng y tế, thông tin di truyền, tình trạng hôn nhân, giới tính, bản dạng giới hoặc khuynh hướng tính dục, quý vị có thể nộp đơn khiếu nại đến Điều Phối Viên Phụ Trách Dân Quyền của IEHP. Quý vị có thể nộp đơn khiếu nại qua điện thoại, bằng văn bản, trực tiếp hoặc qua hình thức điện tử: Qua điện thoại: Liên hệ với Điều Phối Viên Phụ Trách Dân Quyền của IEHP từ 8 giờ sáng đến 5 giờ chiều (PST), bằng cách gọi số 1- 800-440-4347. Hoặc nếu quý vị không thể nghe hoặc nói tốt, vui lòng gọi TTY: 1-800-718-4347/Tiếp Âm California 711. Bằng văn bản: Điền biểu mẫu than phiền hoặc viết thư và gửi đến IEHP’s Civil Rights Coordinator, 10801 6th St., Rancho Cucamonga, CA 91730-5987 Trực tiếp: Ghé qua văn phòng bác sĩ của quý vị hoặc IEHP và nói quý vị muốn nộp đơn khiếu nại. Bằng hình thức điện tử: Nộp đơn khiếu nại trực tuyến. Văn phòng Dân Quyền (Office of Civil Rights) - Sở Dịch Vụ Chăm Sóc Sức Khỏe California (California Department of Health Care Services) Quý vị cũng có thể nộp đơn than phiền về dân quyền tới Sở Dịch Vụ Chăm Sóc Sức Khỏe California, Văn Phòng Dân Quyền qua điện thoại, bằng văn bản hoặc theo hình thức điện tử: Qua điện thoại: Gọi theo số (916)-440-7370. Nếu quý vị không thể nghe hoặc nói tốt, vui lòng gọi số 711 (Dịch Vụ Tiếp Âm Viễn Thông). Bằng văn bản: Điền biểu mẫu Than Phiền hoặc gửi thư đến - Deputy Director, Office of Civil Rights Department of Health Care Services Office of Civil Rights, P.O. Box 997413, MS 0009 Sacramento, CA 95899-7413 Bằng hình thức điện tử: Gửi email tới địa chỉ CivilRights@dhcs.ca.gov. Văn Phòng Dân Quyền - Bộ Y Tế và Dịch Vụ Nhân Sinh Hoa Kỳ (U.S. Department of Health and Human Services) Nếu quý vị tin rằng mình bị phân biệt đối xử vì lý do liên quan đến sắc tộc, màu da, nguồn gốc quốc gia, tuổi tác, tình trạng khuyết tật hoặc giới tính, quý vị cũng có thể khiếu nại về dân quyền lên Bộ Y Tế và Dịch Vụ Nhân Sinh Hoa Kỳ, Văn Phòng Dân Quyền qua điện thoại, bằng văn bản hoặc theo hình thức điện tử: Qua điện thoại: Gọi số 1-800-368-1019. Nếu quý vị không thể nghe hoặc nói tốt, vui lòng gọi số TTY/TDD 1-800- 537-7697. Bằng văn bản: Điền biểu mẫu than phiền hoặc gửi thư đến U.S. Department of Health and Human Services, 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 Bằng hình thức điện tử: Truy cập Cổng Thông Tin Than Phiền của Văn Phòng Dân Quyền tại https://ocrportal.hhs.gov/ocr/portal/lobby.jsf HỖ TRỢ NGÔN NGỮ English ATTENTION: If you need help in your language call 1-800-440-4347 (TTY: 1-800-718-4347). Aids and services for people with disabilities, like documents in braille and large print, are also available. Call 1-800-440-4347 (TTY: 1-800-718-4347). These services are free of charge. الشعار بالعربي ة (Arabic) يُر جى الانتباه:ى إذا احتجت إلى المساعدة بلغتك، فاتصل ب 1-800-440-4347 (TTY: 1-800-718-4347) .ى تتوفر ا ً أيض المساعدات والخدمات للأشخاص ذوي الإعاقة، مث ى ل المستندات المكتوبة بطريقة بريل والخ ى ط الكب ري.ى اتصل ب 1-800-440-4347 (TTY: 1-800-718-4347) . هذه الخدمات مجانيةى. Հայերեն պիտակ (Armenian) ՈՒՇԱԴՐՈՒԹՅՈՒՆ: Եթե Ձեզ օգնություն է հարկավոր Ձեր լեզվով, զանգահարեք 1-800-440-4347 (TTY: 1-800-718-4347)։ Կան նաև օժանդակ միջոցներ ու ծառայություններ հաշմանդամություն ունեցող անձանց համար, օրինակ` Բրայլի գրատիպով ու խոշորատառ տպագրված նյութեր։ Զանգահարեք 1-800-440-4347 (TTY: 1-800-718-4347)։ Այդ ծառայություններն անվճար են։ ឃ្លាសម្គាល់ជាភាសាខ្មែរ (Cambodian) ចំណំ៖ ប ើអ្នក ត្រូវ ការជំនួយ ជាភាសា រ ស់អ្នក សូម ទូរស័ព្ទបៅបេខ 1-800-440-4347 (TTY: 1-800-718-4347)។ ជំនួយ និង បសវាកមម សត្ា ់ ជនព្ិការ ដូចជាឯកសារសរបសរជាអ្កសរផុស សត្ា ់ជនព្ិការភ្ននក ឬឯកសារសរបសរជាអ្កសរព្ុមពធំ ក៏អាចរកបានផងភ្ដរ។ ទូរស័ព្ទមកបេខ 1-800-440-4347 (TTY: 1-800-718-4347)។ បសវាកមមទំងបនេះមិនគិរថ្លៃប ើយ។ 简体中文标语(Chinese) 请注意:如果您需要以您的母语提供帮助,请致电1-800-440-4347 (TTY: 1-800-718-4347)。另外还提供针对残疾人士的帮助和服务,例如盲文和需要较大字体阅读,也是方便取用的。请致电1-800-440-4347 (TTY: 1-800-718-4347)。这些服务都是免费的。 (Farsi) مطلب به زبان فارسی توجه: اگر میخواهید به زبان خود کمک دریافت کنید، با 1-800-440-4347 (TTY: 1-800-718-4347) تماس بگیرید. کمکها و خدمات مخصوص افراد دارای معلولیت، مانند نسخههای خط بریل و چاپ با حروف بزرگ، نیز موجود است. با 1-800-440-4347 (TTY: 1-800-718-4347) تماس بگیرید. این خدمات رایگان ارائه میشوند. ह िंदी टैगलाइन (Hindi) ध्यान दें: अगर आपको अपनी भाषा में सहायता की आवश्यकता है 1-800-440-4347 (TTY: 1-800-718-4347) पर कॉल करें। अशक्तता वाले लोगोों के ललए सहायता और सेवाएों, जैसे ब्रेल और बडे लरोंट में भी दस्तावेज़ उपलब्ध हैं। 1-800-440-4347 (TTY: 1-800-718-4347) पर कॉल करें। ये सेवाएों लन: शुल्क हैं। Nqe Lus Hmoob Cob (Hmong) CEEB TOOM: Yog koj xav tau kev pab txhais koj hom lus hu rau 1-800-440-4347 (TTY: 1-800-718-4347). Muaj cov kev pab txhawb thiab kev pab cuam rau cov neeg xiam oob qhab, xws li puav leej muaj ua cov ntawv su thiab luam tawm ua tus ntawv loj. Hu rau 1-800-440-4347 (TTY: 1-800-718-4347). Cov kev pab cuam no yog pab dawb xwb. 日本語表記 (Japanese) 注意日本語での対応が必要な場合は 1-800-440-4347 (TTY: 1-800-718-4347)へお電話ください。点字の資料や文字の拡大表示など、障がいをお持ちの方のためのサービスも用意しています。1-800-440-4347 (TTY: 1-800-718-4347) へお電話ください。これらのサービスは無料で提供しています。 한국어 태그라인 (Korean) 유의사항: 귀하의 언어로 도움을 받고 싶으시면 1-800-440-4347 (TTY: 1-800-718-4347) 번으로 문의하십시오. 점자나 큰 활자로 된 문서와 같이 장애가 있는 분들을 위한 도움과 서비스도 이용 가능합니다. 1-800-440-4347 (TTY: 1-800-718-4347) 번으로 ___________문의하십시오. 이러한 서비스는 무료로 제공됩니다. ແທກໄລພາສາລາວ (Laotian) ປະກາດ: ຖ້າທ່ານຕ້ອງການຄວາມຊ່ວຍເຫ ຼືອໃນພາສາຂອງທ່ານໃຫ້ໂທຫາເບີ 1-800-440-4347 (TTY: 1-800-718-4347). ຍັງມີຄວາມຊ່ວຍເຫ ຼືອແລະການບໍລິການສໍາລັບຄົນພິການ ເຊັ່ນເອກະສານທີ່ເປັນອັກສອນນູນແລະມີໂຕພິມໃຫຍ່ ໃຫ້ໂທຫາເບີ 1-800-440-4347 (TTY: 1-800-718-4347). ການບໍລິການເຫ ົ່ານີ້ບໍ່ຕ້ອງເສຍຄ່າໃຊ້ຈ່າຍໃດໆ. Mien Tagline (Mien) LONGC HNYOUV JANGX LONGX OC: Beiv taux meih qiemx longc mienh tengx faan benx meih nyei waac nor douc waac daaih lorx taux 1-800-440-4347 (TTY: 1-800-718-4347). Liouh lorx jauv-louc tengx aengx caux nzie gong bun taux ninh mbuo wuaaic fangx mienh, beiv taux longc benx nzangc-pokc bun hluo mbiutc aengx caux aamz mborqv benx domh sou se mbenc nzoih bun longc. Douc waac daaih lorx 1-800-440-4347 (TTY: 1-800-718-4347). Naaiv deix nzie weih gong-bou jauv-louc se benx wang-henh tengx mv zuqc cuotv nyaanh oc. ਪੰਜਾਬੀ ਟੈਗਲਾਈਨ (Punjabi) ਧਿਆਨ ਧਿਓ: ਜੇ ਤੁਹਾਨ ੂੰ ਆਪਣੀ ਭਾਸਾ ਧ ਿੱਚ ਮਿਿ ਿੀ ਲੋੜ ਹੈ ਤਾਂ ਕਾਲ 1-800-440-4347 (TTY: 1-800-718-4347). ਅਪਾਹਜ ਲੋਕਾਂ ਲਈ ਸਹਾਇਤਾ ਅਤੇ ਸੇ ਾ ਾਂ, ਧਜ ੇਂ ਧਕ ਬ੍ਰੇਲ ਅਤੇ ਮੋਟੀ ਛਪਾਈ ਧ ਿੱਚ ਿਸਤਾ ੇਜ਼, ੀ ਉਪਲਬ੍ਿ ਹਨ| ਕਾਲ ਕਰੋ 1-800-440-4347 (TTY: 1-800-718-4347). ਇਹ ਸੇ ਾ ਾਂ ਮੁਫਤ ਹਨ| Русский слоган (Russian) ВНИМАНИЕ! Если вам нужна помощь на вашем родном языке, звоните по номеру 1-800-440-4347 (TTY: 1-800-718-4347). Также предоставляются средства и услуги для людей с ограниченными возможностями, например документы крупным шрифтом или шрифтом Брайля. Звоните по номеру 1-800-440-4347 (TTY: 1-800-718-4347). Такие услуги предоставляются бесплатно. Mensaje en español (Spanish) ATENCIÓN: si necesita ayuda en su idioma, llame al 1-800-440-4347 (TTY: 1-800-718-4347). También ofrecemos asistencia y servicios para personas con discapacidades, como documentos en braille y con letras grandes. Llame al 1-800-440-4347 (TTY: 1-800-718-4347). Estos servicios son gratuitos. Tagalog Tagline (Tagalog) ATENSIYON: Kung kailangan mo ng tulong sa iyong wika, tumawag sa 1-800-440-4347 (TTY: 1-800-718-4347). Mayroon ding mga tulong at serbisyo para sa mga taong may kapansanan,tulad ng mga dokumento sa braille at malaking print. Tumawag sa 1-800-440-4347 (TTY: 1-800-718-4347). Libre ang mga serbisyong ito. แท็กไลน์ภาษาไทย (Thai) โปรดทราบ: หากคุณต้องการความช่วยเหลือเป็นภาษาของคุณ กรุณาโทรศัพท์ไปที่หมายเลข 1-800-440-4347 (TTY: 1-800-718-4347)นอกจากนี้ ยังพร้อมให้ความช่วยเหลือและบริการต่าง ๆ สาหรับบุคคลที่มีความพิการ เช่น เอกสารต่าง ๆ ที่เป็นอักษรเบรลล์และเอกสารที่พิมพ์ด้วยตัวอักษรขนาดใหญ่ กรุณาโทรศัพท์ไปที่หมายเลข 1-800-440-4347 (TTY: 1-800-718-4347) ไม่มีค่าใช้จ่ายสาหรับบริการเหล่านี้ Примітка українською (Ukrainian) УВАГА! Якщо вам потрібна допомога вашою рідною мовою, телефонуйте на номер 1-800-440-4347 (TTY: 1-800-718-4347). Люди з обмеженими можливостями також можуть скористатися допоміжними засобами та послугами, наприклад, отримати документи, надруковані шрифтом Брайля та великим шрифтом. Телефонуйте на номер 1-800-440-4347 (TTY: 1-800-718-4347). Ці послуги безкоштовні. Khẩu hiệu tiếng Việt (Vietnamese) CHÚ Ý: Nếu quý vị cần trợ giúp bằng ngôn ngữ của mình, vui lòng gọi số 1-800-440-4347 (TTY: 1-800-718-4347). Chúng tôi cũng hỗ trợ và cung cấp các dịch vụ dành cho người khuyết tật, như tài liệu bằng chữ nổi Braille và chữ khổ lớn (chữ hoa). Vui lòng gọi số 1-800-440-4347 (TTY: 1-800-718-4347). Các dịch vụ này đều miễn phí.    

Provider Resources - Forms

liance Delegation Oversight Audit (DOA) Grievance Growth Chart Health and Wellness  Inland Regional Center Medi-Cal Letter Templates Medicare-Medicaid Plan Letter Templates D-SNP Letter Templates Medicare Non-Contracted Providers Perinatal Pharmacy Provider Preventable Conditions (PPC) Staying Healthy Assessment UM/CM Vision Other Behavioral Health ABA 6 Month and Exit Progress Report Template (Word) ABA FBA Report Template (Word) ABA Service Hour Log (Word) ABA School BHT Services Request Form (Word) Authorization Release of Information Form - English (PDF) Authorization Release of Information Form - Spanish (PDF) Behavioral Health Authorization Request Form (PDF) BHT Social Skills Template (Word) Coordination of Care Treatment Plan Form (PDF) No Further Treatment Request Form (PDF) Psych Testing Battery Plan (for Psychologist use only) (PDF)  Claims For Integrated Denial Notices please click here. Please select on the links below to obtain the revised CMS 1500 form (version 02/12) and the CMS 1500 Reference Instruction Manual. Provider Identified Overpayment Form (PDF) Provider Identified Overpayment Form (Multiple) (PDF) Provider Dispute Resolution (PDR) (PDF) Claims Project Spreadsheet (Excel) Clean Claim Tool Guide - UB04 Inpatient Form (PDF) Clean Claim Tool Guide - UB04 Outpatient Form (PDF) Waiver of Liability Statement - Cal MediConnect Plan (PDF) Waiver of Liability Statement - IEHP Dual Choice (HMO D-SNP) - effective January 2023 (PDF) Revised CMS 1500 Health Insurance Claim Form (PDF) CMS 1500 Reference Instruction Manual (PDF) (Back to top) Compliance Member Incentive Forms Focus Group Incentive (FGI) - Request for Approval Form (PDF) Focus Group Incentive (FGI) - Evaluation Form (PDF) Member Incentive (MI) Program - Request for Approval (PDF) Member Incentive (MI) Program - Annual Update/End of Program Evaluation (PDF) Survey Incentive (SI) - Request for Approval Form (PDF) Survey Incentive (SI) - Evaluation Form (PDF) Nondiscrimination Language Nondiscrimination Language Access Notice: Medi-Cal (PDF) Medicare (PDF) (Back to top) Delegation Oversight Audit (DOA) Biographical Information Sheet Credentialing DOA Audit Tool HIPAA Security - Medi-Cal DOA HIPAA Security - Medicare Medi-Cal DOA Tool UM/CM/QI Medicare DOA Tool UM/CM/QI Medi-Cal UM Referral Template Sub-Contracted Facility/Agency Services and Delegated Functions (Back to top) Grievance The Grievance Forms below are for your Member's use when filing a complaint, or has an appeal regarding any aspect of care or service provided by you. Please select the Appeal and Grievance form appropriate for their use: Medi-Cal Form      English (PDF)      Spanish (PDF)      Chinese (PDF)      Vietnamese (PDF) Medicare Form      English (PDF)      Spanish (PDF)      Chinese (PDF)      Vietnamese (PDF) The following IEHP DualChoice (HMO D-SNP) Letters will be effective January 1, 2023:      English (PDF)      Spanish (PDF)      Chinese (PDF)      Vietnamese (PDF) (Back to top) Growth Chart Inland Empire Health Plan (IEHP) offers you easy access to useful reference materials and forms you may need. It's just one click away. Select the growth chart form that you need by clicking on the link below: (0-36 months): Head Circumference-For-Age And Weight- For-Length Percentiles           Boys (PDF)          Girls (PDF) (0-36 months): Length and Weight-For-Age Percentiles           Boys (PDF)          Girls (PDF) (2-20 years): Stature and Weight-For-Age-Percentiles           Boys (PDF)         Girls (PDF) (2-20 years): Body Mass Index For-Age Percentiles           Boys (PDF)          Girls (PDF) (Back to top) Health and Wellness DPP Rx Pad (PDF) (Back to top) Inland Regional Center Early Start (0-36 months) Referral (PDF) Early Start Online Application Eligibility and Intake IRC Referrals (3-99+ years): San Bernardino County: For Providers - (909) 890-4711 // Intake - (909) 890-3148 Riverside County: For Providers - (909) 890-4763 // Intake - (951) 826-2648 (Back to top) Medi-Cal Letter Templates A complete template includes all documents listed under each template in the order specified listed. Changes can only be made to highlighted areas, any changes made outside of the highlighted areas are strictly prohibited by DHCS. Click on the title to expand the menu and download desired document. Carve-Out Template English Last Updated: 10/18/2017   Spanish Last Updated: 10/18/2017   Chinese Last Updated: 01/13/2022   Vietnamese Last Updated: 01/13/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 Member Authorization Letter English Last Updated: 09/20/2022 Spanish Last Updated: 09/20/2022   Chinese Last Updated: 09/20/2022   Vietnamese Last Updated: 09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 Continuity of Care Authorization Letter English Last Updated: 09/20/2022   Spanish Last Updated: 09/20/2022   Chinese Last Updated: 09/20/2022   Vietnamese Last Updated: 09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 Notice of Action Taken - Denied English Last Updated: 10/18/2017   Spanish Last Updated: 10/18/2017   Chinese Last Updated: 01/13/2022   Vietnamese Last Updated: 01/13/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 Notice of Action Taken - Modified English Last Updated: 10/18/2017   Spanish Last Updated: 10/18/2017   Chinese Last Updated: 01/13/2022   Vietnamese Last Updated: 01/13/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 Notice of Action Taken - Terminated English Last Updated: 10/18/2017   Spanish Last Updated: 10/18/2017   Chinese Last Updated: 01/13/2022   Vietnamese Last Updated: 01/13/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 Other Health Care Coverage Requesting Provider Letter English Last Updated: 03/17/2021   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 Continuity of Care Terminate Letter English Last Updated: 09/20/2022   Spanish Last Updated: 09/20/2022   Chinese Last Updated: 09/20/2022   Vietnamese Last Updated: 09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 Specialist Termination Letter English Last Updated: 09/20/2022   Spanish Last Updated:09/20/2022   Chinese Last Updated:09/20/2022   Vietnamese Last Updated:09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 Prior Authorization Not Required English Last Updated: 09/20/2022   Spanish Last Updated:09/20/2022   Chinese Last Updated:09/20/2022   Vietnamese Last Updated:09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated July 1, 2022 (Back to top) Medicare-Medicaid Plan Letter Templates A complete template includes all documents listed under each template in the order specified listed. Changes can only be made to highlighted areas, any changes made outside of the highlighted areas are strictly prohibited by CMS. Click on the title to expand the menu and download desired document. Carve-Out Information Letter English Last Updated: 11/12/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Denial Reason Matrix English Last Updated: 07/03/2018   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Detailed Explanation of Non-Coverage English Last Updated: 12/17/2021   Spanish Last Updated: 12/17/2021   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Detailed Notice of Discharge English Last Updated: 12/17/2021   Spanish Last Updated: 12/17/2021   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Expedited Criteria Not Met English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Extension Needed for Additional Information English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Integrated Denial Notice - Part B Drugs - 7 day appeal - IPA English Last Updated: 02/14/2022   Spanish Last Updated: 02/14/2022   Chinese Last Updated: 02/14/2022   Vietnamese Last Updated: 02/14/2022   Independent Medical Review - [English] [Spanish] [Chinese] [Vietnamese] Updated October 7, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Integrated Denial Notice - Part C - 30 day appeal - IPA English Last Updated: 03/08/2022   Spanish Last Updated: 02/14/2022   Chinese Last Updated: 02/14/2022   Vietnamese Last Updated: 02/14/2022   Independent Medical Review - [English] [Spanish] [Chinese] [Vietnamese] Updated October 7, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Integrated Denial of Payment Notice - 7 day appeal - IPA English Last Updated: 03/17/2021   Spanish Last Updated: 10/18/2021   Independent Medical Review - [English] [Spanish] [Chinese] [Vietnamese] Updated October 7, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Integrated Denial of Payment Notice - 30 day appeal - IPA English Last Updated: 03/17/2021   Spanish Last Updated: 04/12/2017   Independent Medical Review - [English] [Spanish] [Chinese] [Vietnamese] Updated October 7, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Notice of Authorization of Services English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/17   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Notice of Dismissal of Coverage English Last Updated:03/10/2022   Spanish Last Updated:03/10/2022   Chinese Last Updated:03/10/2022   Vietnamese Last Updated:03/10/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Notice of Medicare Non-Coverage English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Notice of Reinstatement of Coverage English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 (Back to top) NEW D-SNP Letter Templates These templates should not be used until the effective date of January 2, 2023. Please continue using the current Medicare DualChoice letter templates currently seen on this webpage for the remainder of 2022. A complete template includes all documents listed under each template in the order specified listed. Changes can only be made to highlighted areas, any changes made outside of the highlighted areas are strictly prohibited by CMS. Click on the title to expand the menu and download desired document. AOR Dismissal Letter English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 AOR Request Letter English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Continuity of Care - Notice of Authorization English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Continuity of Care – Notice of Termination English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Detailed Explanation of Non-Coverage English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Detailed Notice of Discharge English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Expedited Criteria Not Met English Last Updated: 09/26/2022   Spanish Last Updated: 09/26/2022   Chinese Last Updated: 09/26/2022   Vietnamese Last Updated: 09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Extension Needed for Additional Information English Last Updated: 09/26/2022   Spanish Last Updated: 09/26/2022   Chinese Last Updated: 09/26/2022   Vietnamese Last Updated: 09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Informational Letter to Beneficiary and PCP English Last Updated: 09/26/2022   Spanish Last Updated: 09/26/2022   Chinese Last Updated: 09/26/2022   Vietnamese Last Updated: 09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Notice of Authorization of Services English Last Updated: 09/27/2022   Spanish Last Updated: 09/27/2022   Chinese Last Updated: 09/27/2022   Vietnamese Last Updated: 09/27/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Notice of Dismissal of Coverage Request English Last Updated: 09/26/2022   Spanish Last Updated: 09/26/2022   Chinese Last Updated: 09/26/2022   Vietnamese Last Updated: 09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Notice of Medicare Non-Coverage English Last Updated:09/27/2022   Spanish Last Updated:09/27/2022   Chinese Last Updated:09/27/2022   Vietnamese Last Updated:09/27/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Cancelled Relocation Letter English Last Updated: 09/22/2022   Spanish Last Updated:09/22/2022   Chinese Last Updated:09/22/2022   Vietnamese Last Updated:09/22/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Long-Term Care IPA and PCP Change Letter English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Coverage Decision Letter Part B - 7 Day Appeal English Last Updated: 10/03/2022   Spanish Last Updated:10/03/2022   Chinese Last Updated:10/03/2022   Vietnamese Last Updated:10/03/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Coverage Decision Letter Medical – 30 Day Appeal English Last Updated: 10/03/2022   Spanish Last Updated:10/03/2022   Chinese Last Updated:10/03/2022   Vietnamese Last Updated:10/03/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022 Coverage Decision Letter - Claims English Last Updated: 11/22/2022   Spanish Last Updated:11/22/2022   Chinese Last Updated:11/22/2022   Vietnamese Last Updated:11/22/2022   Multi-Language Insert - [All Languages] Updated July 26, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated September 07, 2022   (Back to top) Medicare Certificates of Medical Necessity (CMN) & DME Information Forms (DIF) Positive Airway Pressure Devices for Obstructive Sleep Apnea (PDF) Enteral and Parenteral Nutrition (PDF) External Infusion Pump (PDF) Osteogenesis Stimulators (PDF) Oxygen (PDF) Seat Lift Mechanisms (PDF) Continuation Form (PDF) Transcutaneous Electrical Nerve Stimulator (TENS) (PDF) Pneumatic Compression Device (PDF) (Back to top) Non-Contracted Providers To submit a referral to IEHP, please fill out the referral form below, include all clinical notes and fax it to IEHP. If you are referring back to yourself, please indicate such. If you need IEHP to direct the referral, please indicate that on the form. Referral Authorization Request Form - Non-Contracted Providers (PDF) If you are interested in becoming a network Provider, please click here. (Back to top) Perinatal IEHP provides standard risk assessment forms that can be used by all Providers of obstetrical (OB) services. Please refer to IEHP Provider Policy 10D1, "Obstetrical Services, Guidelines for Obstetrical Services" for further detail. To obtain copies, simply click on the links below. Edinburgh Postnatal Depression Screening Tool - English (PDF) Edinburgh Postnatal Depression Screening Tool - Spanish (PDF) ACOG Antepartum Record (PDF) (Back to top) Pharmacy Click here for Pharmacy forms. (Back to top) Provider Preventable Conditions (PPC) By clicking on these links, you will be leaving the IEHP website. On May 23,2017, the Department of Healthcare Services (DHCS) released All Plan Letter (APL) 17-009, reporting requirements related to Provider Preventable Conditions. In conjunction, DHCS released Dual Plan Letter (DPL) 17-002. As part of these instructions, the Health Plan, Network Providers, Delegates, Contracted Hospitals, and ambulatory surgical centers must report using PPC Form on DHCS secure online portal for both Medicare and Medi-Cal lines of business. Further information is available on the following pages: Instructions for Completing Online Reporting of PPCs Medi-Cal Guidance on Reporting Provider-Preventable Conditions Frequently Asked Questions All Plan Letter (APL) 17-009 Duals Plan Letter (DPL) 17-002 PPC Form Medicare and Medi-Cal lines of business must follow the instructions below: Providers are REQUIRED to send a copy of the completed PPC submission from the DHCS secure online portal to IEHP by fax at (909) 890-5545 within five (5) business days of reporting to DHCS; IEHP does not pay Provider claims nor reimburse a Provider for a PPC, in accordance with 42 CFR Section 438.3(g) and IEHP's three-way Cal MediConnect contract. Per IEHP policy and the Coordinated Care Initiative 3-Way Contract, IEHP reserves the right to recover or recoup any claim related to a PPC; As outlined in both the APL/DPL - Reporting Requirements related to Provider Preventable Conditions, the following classify as PPCs and must be reported: Category 1 - HCACs (For Any Inpatient Hospital Setting in Medicaid) Any unintended foreign object retained after surgery A clinically significant air embolism An incidence of blood incompatibility A stage III or stage IV pressure ulcer that developed during the patient's stay in the hospital A significant fall or trauma that resulted in fracture, dislocation, intracranial injury, crushing injury, burn, or electric shock A catheter-associated urinary tract infection Vascular catheter-associated infection Any of the following manifestations of poor glycemic control: diabetic ketoacidosis; nonketotic hyperosmolar coma; hypoglycemic coma; secondary diabetes with ketoacidosis; or secondary diabetes with hyperosmolarity A surgical site infection following: Coronary artery bypass graft (CABG) - mediastinitis Bariatric surgery; including laparoscopic gastric bypass, gastroenterostomy, laparoscopic gastric restrictive surgery Orthopedic procedures; including spine, neck, shoulder, elbow Cardiac implantable electronic device procedures Deep vein thrombosis/pulmonary embolism following total knee replacement or hip replacement with pediatric and obstetric exceptions Latrogenic pneumothorax with venous catheterization A vascular catheter-associated infection Category 2 - Other Provider Preventable Conditions (For Any Health Care Setting) Wrong surgical or other invasive procedure performed on a patient Surgical or other invasive procedure performed on the wrong body part Surgical or other invasive procedure performed on the wrong patient (Back to top) Staying Healthy Assessment PCPs are responsible for assuring the Staying Healthy Assessment (SHA) Questionnaire is administered during the Initial Health Assessment to each IEHP Member within 120 days of the Member's enrollment. The SHA Questionnaire is available in over nine different languages and in nine separate age categories.  Printed English and Spanish versions are available through your IPA or you can get the forms you need by using the menu below. Please see the PDFs below in the language of your choice. 7098 A    0-6 Months  Select Language: English, Spanish, Arabic, Armenian, Chinese, Hmong, Korean, Russian, Tagalog, Vietnamese 7098 B    7-12 Months  Select Language: English, Spanish, Arabic, Armenian, Chinese,  Hmong, Korean, Russian, Tagalog, Vietnamese 7098 C    1-2 Years Select Language: English, Spanish, Arabic, Armenian, Chinese,  Hmong, Korean, Russian, Tagalog, Vietnamese 7098 D    3-4 Years Select Language: English, Spanish, Arabic, Armenian, Chinese,  Hmong, Korean, Russian, Tagalog, Vietnamese 7098 E    5-8 Years Select Language: English, Spanish, Arabic, Armenian, Chinese,  Hmong, Korean, Russian, Tagalog, Vietnamese 7098 F    9-11 Years Select Language: English, Spanish, Arabic, Armenian, Chinese,  Hmong, Korean, Russian, Tagalog, Vietnamese 7098 G    12-17 Years Select Language: English, Spanish, Arabic, Armenian, Chinese,  Hmong, Korean, Russian, Tagalog, Vietnamese 7098 H    Adult Select Language: English, Spanish, Arabic, Armenian, Chinese,  Hmong, Korean, Russian, Tagalog, Vietnamese 7098 I    Senior  Select Language: English, Spanish, Arabic, Armenian, Chinese,  Hmong, Korean, Russian, Tagalog, Vietnamese (Back to top) UM/CM Acute Hospital Discharge Needs Request Form (PDF) Authorization for Use and/or Disclosure of Patient Health Information - English (PDF) Authorization for Use and/or Disclosure of Patient Health Information - Spanish (PDF) Care Management Referral Form (PDF) Consent for HIV Test - English (PDF) Consent for HIV Test - Spanish (PDF) Health Risk Assessment (HRA) - IEHP DualChoice (CMC) - English (PDF) Health Risk Assessment (HRA) - IEHP DualChoice  (CMC)- Spanish (PDF) Health Risk Assessment (HRA) - IEHP DualChoice (HMO D-SNP) - English (PDF) - effective 1/1/2023 Health Risk Assessment (HRA) - IEHP DualChoice (HMO D-SNP) - Spanish (PDF) - effective 1/1/2023 Health Risk Assessment (HRA) - IEHP DualChoice (HMO D-SNP) - Chinese (PDF) - effective 1/1/2023 Health Risk Assessment (HRA) - IEHP DualChoice (HMO D-SNP) - Vietnamese (PDF) - effective 1/1/2023 HIV Testing Sites - Riverside and San Bernardino (PDF) Home Health Check Off List (PDF) Home Modification Consent Form (PDF) Long Term Care (LTC) Data Sheet (PDF) Non-Emergency Medical Transportation (NEMT) Physician Certification Statement (PCS) (PDF) Pain Assessment and Treatment Plan Form (PDF) Referral Form (PDF) Service Request for Skilled Nursing Facilities (PDF) SNF Initial Review (PDF) SNF Follow-up Review (PDF) Standing Referral and Extended Access Referral to Specialty Care (PDF) Sterilization Consent Form PM-330 PM-330 Form - Tips and Example (PDF) PM-330 Form - English (PDF) PM-330 Form - Spanish (PDF) Transportation Requests Form (SNF & LTC) (PDF) Transportation Requests Form (Hospital) (PDF) Wound Assessment - Admission (PDF) Wound Assessment - Follow - Up (PDF) Wound Assessment - Addendum (PDF) (Back to top) Vision Ophthalmologist Referral Form (PDF) Vision Exception Request (VER) Form (PDF) PCP Vision Report Form (PDF) IEHP Lab Form (PDF) Medi-Cal Non-Covered Services/Materials Waiver Form-English (PDF) Medi-Cal Non-Covered Services/Materials Waiver Form-Spanish (PDF) Medi-Cal Non-Covered Services/Materials Waiver Form-Chinese (PDF) Medi-Cal Non-Covered Services/Materials Waiver Form-Vietnamese (PDF) Cal MediConnect (CMC) Non-Covered Services/Materials Waiver Form-English (PDF) Cal MediConnect (CMC) Non-Covered Services/Materials Waiver Form-Spanish (PDF) Cal MediConnect (CMC) Non-Covered Services/Materials Waiver Form-Chinese (PDF) Cal MediConnect (CMC) Non-Covered Services/Materials Waiver Form-Vietnamese (PDF) The following IEHP DualChoice (HMO D-SNP) Letters will be effective January 1, 2023: IEHP DualChoice (HMO D-SNP) Non-Covered Services/Materials Waiver Form-English (PDF) IEHP DualChoice (HMO D-SNP) Non-Covered Services/Materials Waiver Form-Spanish (PDF) IEHP DualChoice (HMO D-SNP) Non-Covered Services/Materials Waiver Form-Chinese (PDF) IEHP DualChoice (HMO D-SNP) Non-Covered Services/Materials Waiver Form-Vietnamese (PDF) (Back to top) Other Authorization of Release - Use & Disclosure of PHI - English (PDF) Authorization of Release - Use & Disclosure of PHI - Spanish (PDF) CMS 1696 Appointment of Representative - English (PDF) CMS 1696 Appointment of Representative - Spanish (PDF) Contracts Maintenance Request Form (PDF) Provider Services Materials Request Form (PDF) 2017 Model Output Report (MOR) Data File Layout (PDF) (Back to top) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Thông Tin Hữu Ích và Nguồn Lực Hỗ Trợ - Lịch Nghỉ Lễ

day, January 17, 2022 President's Day - Monday, February 21, 2022 Memorial Day - Monday, May 30, 2022 Juneteeth - Monday, June 20, 2022 Independence Day - Monday, July 4, 2022 Labor Day - Monday, September 5, 2022 Veteran's Day - Friday, November 11, 2022 Thanksgiving Day - Thursday, November 24, 2022 Day after Thanksgiving - Friday, November 25, 2022 Day before Christmas Eve - Friday, December 23, 2022 Day after Christmas - Monday, December 26, 2022 Day before New Year's Eve - Friday, December 30, 2022  

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. 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.

Cuộc Họp của Ban Quản Trị - 2022 Meeting Schedule and Locations

n to the public. We invite you to join us at the next board meeting. You can also download a copy of our most current monthly board report. Dr. Bradley P. Gilbert Center for Learning and Innovation 9500 Cleveland Avenue Rancho Cucamonga, CA 91730 Click here to view the meeting room map.  Any Member of the public may observe the scheduled proceedings by using the link listed below. Click here to join the virtual meeting.   Inland Empire Health Plan Dates & Times Monday, January 10, 2022 9:00 a.m. Thursday, February 17, 2022 - Meeting canceled   Monday,  March 14, 2022 9:00 a.m. Monday, April 11, 2022 9:00 a.m. Monday, May 9, 2022 9:00 a.m.  Monday, June 13, 2022 9:00 a.m.  Monday, July 11, 2022 9:00 a.m.  Monday, August 8, 2022 9:00 a.m.  Monday, September 12, 2022 9:00 a.m.  Tuesday, October 11, 2022 9:00 a.m. Monday, November 14, 2022 9:00 a.m.  Monday, December 12, 2022 9:00 a.m. 

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.

P4P - Proposition 56 - GEMT - Pay for Performance (P4P)

(IEHP) Pay for Performance program, also known as P4P. IEHP’s P4P was designed to increase the provision of preventive health services to IEHP Members as well as improve HEDIS® results to ensure that all IEHP Direct DualChoice Members receive timely annual assessment visits with an emphasis on review and management of chronic illnesses. IEHP Direct PCPs will be reimbursed directly by IEHP through the DualChoice Annual Visit program. PCPs participating in IEHP's network through an IPA only are not eligible for this program: Overview (PDF) DualChoice Annual Visit (PDF) To learn more about P4P IEHP DualChoice Annual Visit, contact a Provider Services Representative at (909) 890-2054. Click on the following links to jump to that specific section: Provider Quality Incentives Brochure Medicare P4P IEHP Direct Global Quality P4P Program OB/GYN P4P Program Hospital P4P Program Provider Quality Incentives Brochure Inland Empire Health Plan (IEHP) is pleased to announce the 2022 Provider Quality Incentive Brochure. 2022 Provider Quality Incentive Brochure (PDF) | June 22, 2022 (Back to P4P Menu) Medicare P4P IEHP Direct Program Inland Empire Health Plan (IEHP) is pleased to announce the Medicare P4P IEHP Direct Program.  The goal of the program is designed to reward IEHP Direct Primary Care Providers (PCPs) for providing quality care to IEHP DualChoice Members. Medicare P4P IEHP Direct - Kickoff Meeting (PDF) | May 20, 2021 Medicare P4P IEHP Direct Program Guide (PDF) Published: May 03, 2022 (Back to P4P Menu) Global Quality P4P Program If you would like more information about IEHP’s GQ P4P Program or best practices to help improve quality scores and outcomes, visit our Secure Provider Portal, email the Quality Team at QualityPrograms@iehp.org or call the IEHP Provider Relations Team at (909) 890-2054. 2022 IEHP Global Quality P4P Program Guide PCP (PDF) Published: October 20, 2022 2022 IEHP Global Quality P4P Program Guide IPA (PDF) Published: October 20, 2022 2021 IEHP Global Quality P4P Program Guide PCP (PDF) Published: August 30, 2022 2021 IEHP Global Quality P4P Program Guide IPA (PDF) Published: August 30, 2022 2022 Provider Quality Resource Guide (PDF) Published: July 14, 2022 (Back to P4P Menu) Quality Improvement Activity Strategy Forms The Quality Improvement Activity (QIA) Strategy Forms can be used for the following 2022 Global Quality P4P QIA Activities: Reducing Health Disparities and Potentially Avoidable Emergency Department Visits or Potentially Preventable Admissions. 2022 Equity Quality Improvement Activity #1 - Strategy Form (PDF) 2022 Quality Improvement Activity #2 - Strategy Form (PDF) (Back to P4P Menu) Potentially Avoidable Emergency Department (ED) Visits: Potentially Preventable Diagnosis Codes The Potentially Preventable Diagnosis Code List includes diagnosis codes for visits to an ED in which the condition could be treated by a Physician or other health care Provider in a non-emergency setting or conditions that are potentially preventable or are ambulatory care sensitive. Potentially Preventable Diagnosis List (PDF) Published: February 04, 2022 Patient Experience This toolkit is full of proven tips and successful strategies based on the kinds of questions your IEHP Members could be asked to answer regarding their Provider's service. Your Provider Relations Team has targeted nine specific topics in this toolkit to help Providers and their staff continue to achieve the highest marks in Patient experience from their IEHP Members. Serve Well Customer Service Toolkit (PDF) Well Child 2021 Recommendations for Preventive Pediatric Health Care from the American Academy of Pediatrics (PDF) Immunizations IEHP provides vaccine coverage based on the latest ACIP recommendation and guidelines. Please refer to the Immunization Update and "Summary of Recommendations" for both Child and Adolescents AND Adult Vaccines as follows: 2022 Immunization Timing Chart - English (PDF) 2022 Immunization Timing Chart - Spanish (PDF) 2022 Immunization Timing Chart - Chinese (PDF) 2022 Immunization Timing Chart - Vietnamese (PDF) Immunization Updates (PDF) 2021 Recommended Child and Adolescent Immunization Schedule (0-18 years) (PDF) 2021 Recommended Adult Immunization Schedule (19+ years) (PDF) Adult Vaccines are a covered benefit and do not require prior authorization (must adhere to CDC/ACIP Immunization Recommendation and/or FDA approved indication). Grow Well Childhood Immunization Toolkit for Providers (PDF) This toolkit contains commonly used immunization codes, best practices for reporting immunizations including information on registering with CAIR, tips on talking with parents and information on understanding vaccination hesitancy. CAIR2 Resource Guide (PDF) This guide contains helpful links and contact information for locations to register for CAIR2 or current users. Reimbursement process: Complete a CMS1500 form by including the appropriate CPT codes, quantity dispensed and billed amount. Mail:  IEHP Claims Department P.O. Box 4349  Rancho Cucamonga, CA 91729-4349. For the latest updates and news regarding the vaccines, please visit CDC's ACIP website at https://www.cdc.gov/vaccines/hcp/acip-recs/index.html. By clicking on this link, you will be leaving the IEHP website. (Back to P4P Menu) OB/GYN P4P Program Inland Empire Health Plan (IEHP) has released the OB/GYN P4P Program Guide which details the program requirements, performance measures, updated code sets, and payment timelines. OB/GYN P4P Program Guide (PDF) Published: September 07, 2022 OB P4P Frequently Asked Questions FAQs (PDF) Published: March 09, 2022 Postpartum Depression Screening (PDF) (Back to P4P Menu) Hospital P4P Program Inland Empire Health Plan (IEHP) is pleased to announce the Hospital Pay For Performance Program (Hospital P4P) for IEHP Medi-Cal contracted Hospitals servicing Riverside and San Bernardino Counties. The goal of the Hospital P4P Program is to provide substantial financial rewards to Hospitals that meet quality performance targets and demonstrate high-quality care to IEHP Members. 2022 Hospital P4P Program Guide (PDF) Published: August 30, 2022 P4P 2022 MX Data Contribution (PDF) Published: April 18, 2022 P4P 2022 MX Data Guidelines (PDF) Published: April 18, 2022 2021 Hospital P4P Program Guide (PDF) Update #3, Published: April 01, 2021 P4P 2021 Data Guidelines (PDF) Update #2, Published: April 16, 2021 P4P 2021 MX Data Contribution (PDF) Published: January 12, 2021 (Back to P4P Menu) Potentially Avoidable Emergency Department (ED) Visits: Potentially Preventable Diagnosis Codes The Potentially Preventable Diagnosis Code List includes diagnosis codes for visits to an ED in which the condition could be treated by a Physician or other health care Provider in a non-emergency setting or conditions that are potentially preventable or are ambulatory care sensitive. Potentially Preventable Diagnosis List (PDF) Published: February 04, 2022 (Back to P4P Menu) Substance Use Disorders and Mental Health Diagnosis Lists The Substance Use Disorders and Mental Health Diagnosis Lists includes diagnosis codes to identify substance use disorders, drug overdose, mental health or intentional self-harm diagnoses. Mental Health Diagnosis List (PDF) Published: February 02, 2022 Substance Use Disorders Diagnosis List (PDF) Published: February 02, 2022 (Back to P4P 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

Plan Updates - Correspondence

here. TITLE DATE RECIPIENTS December 2022     COVID-19 Isolation in SNF 12/01 All SNFs Effective Today! - IEHP Contracts with Call The Car For Transportation 12/01 All SNFs & Hospitals Living the Mission Awards Nomination Form 12/01 All IEHP Providers November 2022     Inland Empire Community Health Assessment 11/30 All PCPs, IPAs, Specialists, & Behavioral Health Providers Pharmacy Benefits Manager (PBM) Change for DualChoice (HMO D-SNP) - Member Outreach in Process 11/29 All DualChoice PCPs & Medicare IPAs ID Cards with Errors Reissued to Dual Choice Members 11/23 Select Dual Choice PCPs Inland Caregiver Resource Center Informational Webinar - ECHO 11/23 All PCPs IEHP’s Quarterly Behavioral Health Provider Training 11/18 All Behavioral Health (BH) Providers Thanksgiving Holiday 11/18 All IEHP Providers IEHP Outbound Daily 834 Delta File Delay 11/18 All 834 Trading Partners CoverMyMeds - Prior Authorization Submission Method for Dual Choice Members– Effective January 1, 2023 11/17 All IEHP DualChoice PCPs IEHP DualChoice (HMO D-SNP) 2023 Vision Benefits 11/17 All Vision Providers Riverside County Medical Association's Physician Holiday Social 11/17 All Riverside County PCPs & Specialists RUHS - PHA - Early Respiratory Syncytial Virus (RSV) and Seasonal Influenza Activity 11/17 All Riverside County PCPs Global Quality P4P PCP Meeting - 2023 Program Preview 11/16 All Medi-Cal PCPs BHT (QASP) Provider Training 11/15 All BHT (QASP) Providers Reminder - BH Emergency Instruction Standards 11/15 All BH Providers Reminder - PCP and Specialist Emergency Instruction Standards 11/15 All PCPs & Specialists UPDATE! D-SNP Letter Templates (Effective January 2, 2023) 11/15 All Medicare IPAs UPDATE - Revised UM Authorization Guidelines to November 3, 2022 - UM-BH 08 11/14 All Medi-Cal IPAs & BHT Providers Pharmacy Recalls, Withdrawals & Safety Alerts - October 2022 11/14 All PCPs REMINDER: IEHP DualChoice (HMO D-SNP) begins Jan 2023 11/10 All Medicare PCPs, Specialists & BH Providers REMINDER: Help Your Members Update Their Contact Information! 11/10 All IEHP PCPs Maternal Wellness Event Flyer 11/09 All Medi-Cal PCPs, OB/GYNs, Peds, BH Providers & IPAs Essure System - No Longer a Covered Benefit 11/09 All OB/GYNs ACTION REQUIRED -Submit 2023 Provider Policy and Provider Manual Acknowledgement of Receipt (AOR) - Win a $50 Gift Card 11/08 All IEHP Providers Veterans Day 11/04 All IEHP Providers & IPAs Revised UM Authorization Guidelines 11/03 All BH Providers & IPAs Pharmacy Recalls, Withdrawals & Safety Alerts - September 2022 11/02 All PCPs October 2022     Medicare - Nondiscrimination Notice and Taglines Templates 10/31 All Medicare IPAs REMINDER: IEHP Interpreter Services – A Covered Benefit! 10/31 All PCPs & IPAs Continuous Glucose Monitors 10/28 All Medicare PCPs, Endocrinologists & IPAs Health Education Classes Available in Riverside Area 10/27 All Riverside Area PCPs, Specialists & OBs PHA - Outbreak of Ebola Virus Disease Due to Sudan Virus in Central Uganda 10/25 All Riverside County PCPs 834 Eligibility File Format Changes 10/25 All IHEP 834 Trading Partners Global Quality P4P IPA Meeting – 2023 Program Preview 10/21 All Medi-Cal IPAs REMINDER DHCS Hospice Rates – Prospective Calculation Based on Medicaid Rates 10/21 All Hospice Providers NEW! D-SNP Letter Templates (Effective January 2, 2023) 10/21 All Medicare IPAs Help Protect Your Members Against the Flu 10/20 All PCPs & IPAs Public Health Emergency (PHE) Ending Soon – Help Your Members Reenroll! 10/19 All IEHP PCPs REMINDER - Balance Billing of IEHP Members Not Permitted! 10/14 All IEHP Providers ACTION REQUIRED - Correct Prioritization of Authorization Requests 10/14 All PCPs, Specialists & IPAs Global Quality P4P PCP Meeting – 2023 Program Preview 10/13 All Medi-Cal PCPs Flu Vaccine Notice -Access to Pharmacy Vaccine Network 10/13 All PCPs  Cal MediConnect Sunsets and IEHP Dual Choice (D-SNP) Begins 10/12 All PCPs Academic Detailing Services Now Offered 10/11 All IEHP Providers & Pharmacies REMINDER - ACTION REQUIRED - Electronic Visit Verification (EVV) Implementation Requirements – Self Registration Required by October 19, 2022 10/10 All Home Health Care Services (HHCS) Providers & Personal Care Services (PCS) UPDATE - Independent Medical Review (IMR) Forms 10/10 All Medicare IPAs UPDATE to September 8, 2022 Communication Authorization Timeframes 10/6 All Medi-Cal IPAs Special Fraud Alert - Exercise Caution with Purported Telemedicine Companies 10/6 All IEHP Providers & IPAs FAQs For Delegate Monitoring of Utilization Measures 10/5 All IPAs September 2022     Global Quality P4P Programs – NEW 2022 Quality Bonus Services! 09/30 All Medi-Cal PCPs Diversity Awareness Month - October 2022 - Please Join Us! 09/30 All IEHP Providers & IPAs REMINDER - IEHP Coordination of Benefits Agreement (COBA) Implementation – Action Required! 09/30 All PCPs, Specialists, ANC & Hospitals ICD-10-CM Risk Adjustment Code Changes for CMS HCC Code Capture 09/26 All Direct Dual Choice PCPs UPDATE! – Continuous Glucose Monitoring (CGM) Systems (IPA) 09/23 All Medi-Cal IPAs UPDATE! – Continuous Glucose Monitoring (CGM) Systems 09/22 All Medi-Cal PCPs & Endocrinologists ACTION REQUIRED - Electronic Visit Verification (EVV) Implementation Requirements – Self Registration Required by October 19, 2022 09/22 All Home Health Care Services (HHCS) Providers & Personal Care Services (PCS) UPDATED Medi-Cal Letter Templates 09/22 All Medi-Cal IPAs URGENT ATTENTION: Phishing Email Alert 09/21 All IEHP Providers Pharmacy Times - Medication Reconciliation 09/21 All Dual Choice PCPs Grievance Process Updates - Grievance Summary Form - Due Date 09/15 All IPAs Continuity of Care (COC) Rosters Now Available on SFTP 09/15 All IPAs REMINDER - Enhanced Care Management Available for Members 09/15 All Medi-Cal ANC and Vision Providers  Coordination of Benefits Agreement (COBA) Implementation - Action Required 09/12 All PCPs, Specialists, ANC & Hospitals REMINDER - Dilated Retinal Exam (DRE) for Diabetic Members 09/09 All PCPs & Vision Providers Revised UM Authorization Guidelines 09/09 All IPA Administrators & Medical Directors Annual BH&CM Medi-Cal IPA Training Survey 09/08 All Medi-Cal IPA Care Management Staff IEHP Provider Portal Updates – Reports now Viewable by TIN 09/08 All Medi-Cal PCPs NEW - Collecting Social Determinants of Health Data (SDOH) 09/08 All Medi-Cal PCPs, Specialists & BH Providers Authorization Timeframes Notice of Action (NOA) Translation & Attachment 09/08 All Medi-Cal IPAs Please Notify IEHP if Your Availability has Changed due to Area Fires 09/08 All Hemet and Big Bear Area Providers  Recalls, Withdrawals & Safety 09/08 All IEHP Providers & Pharmacies IEHP Formulary Changes (P&T) 09/07 All IEHP PCPs Access Standards - Appointment Availability - Specialists 09/02 All Specialists Access Standards - Appointment Availability - PCP, Ob 09/02 All PCPs & Obs Access Standards - Appointment Availability - BH 09/02 All Behavioral Health Providers Vaccination Clinic and Resource Fair - September 10 09/02 All Direct PCPs IEHP Medi-Cal Medical Benefit Formulary 09/02 All Medi-Cal PCPs, Specialists & Psychiatrists August 2022 P&T Update 09/02 All IEHP Providers & Pharmacies August 2022     2022 - 2023 Flu Vaccination for IEHP Members  08/31 All IEHP Providers & Pharmacies REMINDER: Medi-Cal Rx Gradual Reinstatement of PAs – Phase 1 08/31 All Medi-Cal PCPs & Specialists Labor Day Holiday 08/30 All IEHP Providers & IPAs REMINDER: Enhanced Care Management Available for Members 08/30 All Medi-Cal PCPs & IPAs Final REMINDER: Submit the 2022 Provider Satisfaction Survey 08/29 All PCPs, Specialists & BH Providers REMINDER: Community Supports Services Available for Members 08/29 All PCPs, Specialists & BH Providers Medication Reconciliation Program 08/29 All IEHP Providers & Pharmacies NOTICE: DHCS Approved Letter – Prior Authorization Not Required 08/26 All Medi-Cal IPAs NOTICE: DHCS Approved Letter – Prior Authorization Not Required 08/26 All Medi-Cal PCPs, Specialists & Ambulatory Surgery Centers REMINDER: Aug 2022 Provider Educational Series: “How to Navigate Rosters & Reports” 08/24 All Direct Medi-Cal PCPs NEW: Health Education Classes Offered in Desert Hot Springs and Mecca 08/24 All Coachella Valley PCPs ADVISORY: Updated Monkeypox Guidance 08/23 All Riverside County PCPs San Bernardino County Public Health - Monkeypox Guidance 08/23 All San Bernardino County PCPs & Specialists REMINDER: Medication Reconciliation 08/22 All IEHP Providers REMINDER: 2022 Provider Satisfaction Survey 08/22 All PCPs, Specialists, & BH Providers REMINDER: DHCS Quarterly Timely Access Survey 08/22 All Medi-Cal PCPs, Specialists, BH & Ancillary Providers Medication Reconciliation Program 08/22 All IEHP Providers & Pharmacies Reinstatement of PA Requirements for 11 Drug Classes 08/17 All Medi-Cal PCPs REMINDER: Appropriate Billing for Dispensing of Vision Materials 08/17 All Vision Providers REMINDER: Provider Directory Verification Form due August 26th 08/17 Select PCPs & Specialists Medication Reconciliation Program 08/15 All IEHP Providers & Pharmacies REMINDER: Timely Provision of Denial Packets 08/12 All Medicare IPAs Member Grievance Updates: Medical Record Requests 08/12 All Direct PCPs, Specialists, & Ancillary 2022 Global Quality P4P Program Guide Updates - SDOH Rate Measure 08/12 All Medi-Cal PCPs & IPAs Medi-Cal Letter Templates 08/11 All Medi-Cal IPAs Recalls, Withdrawals & Safety 08/10 All IEHP Providers & Pharmacies UPDATE: IEHP’s Network is Open to New QASP Providers 08/08 All BHT Providers 2022 Provider Educational Series – How to Navigate Rosters & Reports 08/08 All Direct Medi-Cal PCPs Proposition 56 – Don’t Miss Out on Available Supplemental Payments 08/05 All Medi-Cal PCPs 2022 Provider Quality Resource Guide 08/05 All PCPs Changes to Quarterly Workplan Requirements 08/03 All IPAs REMINDER: Provider Preventable Conditions - Reporting Requirements 08/03 All IEHP Providers, Ambulatory Surgical Centers & IPAs Webinar: COVID-19 In the Black and Brown Community and the Post Long-Term Effects 08/01 All PCPs & IPAs Medication Reconciliation Program 08/01 All IEHP Providers & Pharmacies July 2022     NEW DATE: Medi-Cal Rx Gradual Reinstatement of Prior Auths (PAs) – Phase 1 – September 16, 2022 07/29 All Med-Cal PCPs & Specialists Practitioner Reporting Requirements - UB-04 Claim Form 07/29 All SNFs, Hospitals, & Ancillary Free Webinar: It Takes a Village to Manage COVID-19 07/27 All PCPs & IPAs REMINDER: Medi-Cal Rx Gradual Reinstatement of PAs – Phase 1 – August 1, 2022 07/25 All Medi-Cal PCPs & Specialists ALERT: Hospice Policy and Procedures 07/25 Select Contract and Non-Contracted Hospice Providers Inappropriate Treatment Delays and Denials for HIV PrEP and PEP 07/22 All Medi-Cal PCPs & Specialists UPDATED: Telehealth Services FAQs 07/21 All PCPs, Specialists, BH, BHT Providers & IPAs 2022 Global Quality P4P Program – Provider Directory Verification 07/20 All Medi-Cal PCPs NEW: Riverside County Public Health: Updated Monkeypox Guidance 07/20 All Riverside County PCPs & Specialists DHCS Plan Data Feed Project – Files Available on SFTP 07/19 All IPAs 2022 Global Quality P4P PCP Program Guide- UPDATES 07/18 All Medi-Cal PCPs 2022 Global Quality P4P IPA Program Guide- UPDATES 07/18 All Medi-Cal IPAs 2022 Appointment Availability Survey – Fax Survey 07/15 All PCPs & IPAs 2022 Appointment Availability Survey – Fax Survey 07/15 All BH Providers 2022 Appointment Availability Survey – Fax Survey 07/14 All Specialists, Ancillary & IPAs UPDATE: Diabetic Vision Outreach Campaign – EXTENDED to July 22, 2022 07/14 All Vision Providers Medi-Cal Rx Gradual Reinstatement of PAs – Phase 1 07/11 All Medi-Cal PCPs & Specialists 2022 Global Quality P4P (GQ P4P) Interim Reports Data Refresh 07/11 All Medi-Cal PCPs & IPAs Update: Risk Adjustment Telehealth and Telephone Services 07/11 All Dual Choice PCPs, Specialists & BH Providers Cal MediConnect Sunsets and IEHP Dual Choice (D-SNP) Begins 07/08 All Medicare PCPs, Specialists & BH Providers 2022 Provider Satisfaction Survey 07/07 All PCPs, Specialists & BH Providers 2022 Provider Educational Series - Provider Directory Verification Process (Virtual) 07/07 All Medi-Cal PCPs Recalls, Withdrawals & Safety 07/07 All IEHP Providers & Pharmacies IEHP Medi-Cal Medical Benefit Formulary 07/01 All Medi-Cal PCPs, Specialists & Psychiatrists IEHP Providers Can Post Jobs and Find Candidates for Free on SoCalDocJobs.com 07/01 All PCPs June 2022     ALERT: No Prior Authorization for Biomarker Testing for Stage 3 and 4 Metastatic Cancers 06/29 All PCPs, Specialists & IPAs REMINDER – KidVaxGrant Application Deadline Approaching 06/29 All Medi-Cal PCPs REMINDER - 2022 Provider Educational Series: Provider Directory Verification Process 06/28 All Direct Medi-Cal PCPs DHCS Plan Data Feed Project 06/27 All IPAs  Alzheimer’s and Dementia Care: A FREE CME Project Echo Opportunity 06/27 All IEHP Family Practice & Internal Medicine Providers Independence Day Holiday 06/27 All IEHP Providers & IPAs Standards for Determining Threshold Languages, Nondiscrimination Requirements, and Language Assistance Service 06/27 All Medi-Cal IPAs UPDATED - Telehealth Services POS Code Updates 06/26 All PCPs, Specialists & BH Providers Clinical Practice Guidelines 06/24 All PCPs & IPAs Access Standards – Appointment Availability for Specialists 06/24 All Specialists NOTICE: No Prior Authorizations for Preventive Services - IPAs 06/23 All Medi-Cal IPAs NOTICE: No Prior Authorizations for Preventive Services - Providers 06/23 Direct Medi-Cal PCPs & Specialists Billing of IEHP Members Guidance 06/22 All IEHP Providers & IPAs May 2022 P&T Update 06/22 All IEHP Providers & Pharmacies REMINDER - 2022 Provider Educational Series: Provider Directory Verification Process 06/21 All Direct Medi-Cal PCPs Access Standards – Appointment Availability for PCPs and OB Providers 06/21 All PCPs & OB Providers Access Standards – Appointment Availability for BH Providers 06/21 All Behavioral Health Providers REMINDER – Authorizations Required for All Follow-up Visits! 06/17 All BH & BHT Providers REMINDER: 2022 Global Quality P4P Program – CAIR2 Participation Requirement 06/17 All Medi-Cal PCPs Member Campaign on Preventive Care Services 06/17 All Medi-Cal PCPs & IPAs Updates/Amendments to AB 1184: Confidential Communication of Medical Information Involving Sensitive Services 06/16 All Medi-Cal Providers & IPAs IEHP Alternative Format Requirement Overview 06/14 All IEHP Providers & IPAs Juneteenth Holiday 06/13 All IEHP Providers & IPAs REMINDER - Authorizations Required for Vision Services 06/10 All Vision Providers Alcohol and Drug Screening Assessment Brief Interventions and Referral to Treatment (SABIRT) 06/10 All PCPs & IPAs 2022 Provider Educational Series - Provider Directory Verification Process 06/10 All Direct Medi-Cal PCPs Navigating the Formula Crisis Webinar 06/08 All Medi-Cal PCPs & OB/GYN MTM Medi-Cal Provider Mailing Campaign 06/08 All IEHP Providers & Pharmacies MTM Medicare Provider Mailing Campaign 06/08 All IEHP Providers & Pharmacies  Recalls, Withdrawals & Safety 06/05 All IEHP Providers & Pharmacies  Academic Detailing Services Now Offered 06/04 All IEHP Providers & Pharmacies Medi-Cal Rx Billing Policy for Physician Administered Drugs (PADs) 06/03 All Medi-Cal PCPs, Specialists & IPAs New and Revised UM Authorization Guidelines 06/03 All IPA & BHT Providers UPDATES COMING SOON – Changes to UM Semi-Annual and Annual Reporting Requirements 06/01 All IPAs UPDATE - Facility Site Review (FSR) and Medical Record Review (MRR) Tools and Standards – Effective July 1, 2022 06/01 All PCPs & IPAs May 2022     IEHP’s Bi-Annual BHT Provider Training 05/27 All Behavioral Health Treatment (BHT) Providers Memorial Day Holiday 05/23 All Providers & IPAs REMINDER: CMC Transition to D-SNP - Model of Care Early Preview Meeting - June 13, 2002 05/23 All IPA CM & Quality Staff 2022 Global Quality P4P Program - NEW 2022 Interim Reports 05/20 All Medi-Cal PCPs IEHP UM Department Availability 05/20 All PCPs, Specialists & BH Care Coordination REMINDER – Review the Early Start Roster on IEHP’s Portal 05/17 All Medi-Cal PCPs & IPAs CMC Transition to D-SNP - Model of Care Early Preview Meeting - June 13, 2002 05/16 All IPA CM & Quality Departments REMINDER: 2022 Global Quality P4P Program – CAIR2 Participation Requirement 05/16 All Medi-Cal PCPs REMINDER: 2022 Global Quality P4P Program – Manifest MedEx Connectivity 05/16 All Medi-Cal PCPs  eReferral Submission to IEHP now available for IPA assigned Medi-Cal Members: Transplants (MOT) and Community Support Services 05/13 All Medi-Cal PCPs & IPAs Applied Changes for Medicare Members on the 835 Files 05/10 IEHP Trading Partners Sunsetting of Proposition 56: Value Based Payment Program 05/09 All Medi-Cal PCPs, Specialists, BH & IPAs HIV/AIDS Specialist Survey 05/06 All Specialists UPDATED FAQs: Members with Other Health Coverage (OHC) 05/06 All Providers & IPAs Revised/Retired UM Authorization Guidelines 05/06 All Medi-Cal IPAs & BH Community Supports Services Modifier Guidance 05/06 All Medi-Cal PCPs, Specialists, BH & IPAs  Recalls, Withdrawals & Safety Alerts 05/05 All IEHP Providers & Pharmacies Providers REMINDER: No Prior Authorizations Needed for Preventive Services 05/03 All IPAs Alzheimer’s and Dementia Care: A Project Echo Opportunity 05/03 All PCPs Webinar - IWIN COVID and the Community 05/02 San Bernardino County PCPs April 2022     2022 Global Quality P4P Program - Manifest MedEx Connectivity Reminder 04/29 All Medi-Cal PCPs REMINDER - Physician Certification Statement (PCS) Requirement 04/29 All Medi-Cal PCPs, Specialists, BH & IPAs Maternal Wellness Events - May 2022 - IEHP Community Resource Centers 04/28 All Medi-Cal PCPs, OB/GYN, Peds, BH & IPAs Letter to Primary Care Providers RE-Response to GSF 04/27 All Medi-Cal PCPs Letter to Providers RE-Response to GSF 04/26 All Medi-Cal IPAs & Specialists Initial Health Assessment (IHA) Roster 04/22 All Medi-Cal PCPs & IPAs REMINDER: IEHP Interpreter Services – Benefit for Members! 04/20 All PCPs & IPAs REMINDER - 2022 Global Quality P4P Program – CAIR2 Participation Requirement 04/15 All Medi-Cal PCPs COVID-19 “Test to Treat” Initiative 04/13 All PCPs & IPAs Revised UM Authorization Guideline 04/12 All Medi-Cal IPA Administrators and Medical Directors & BH Providers Public Health Service (PHS) 340B Participating Provider Billing Reminder 04/12 All FQHCs and DSHs Care Plans and Health Risk Assessments (HRAs) Reminder 04/08 All PCPs, Specialists, SNFs & CBAS 2nd Round of Free At-Home COVID-19 Test Kits Available 04/08 All Medi-Cal PCPs Misdirected Claims Testing – Meeting Request 04/07 IEHP Trading Partners Alzheimer’s and Dementia Care: A Project Echo Opportunity 04/06 All IEHP PCPs Standing Orders Enrollment - Respond Today! 04/06 All Medicare PCPs Medicare P4P IEHP Direct – Blood Pressure Control Billing Guidance 04/05 All Direct DualChoice PCPs Important Notice: Proton Pump Inhibitor Overutilization 04/05 All IEHP Providers & Pharmacies Recalls, Withdrawals & Safety Alerts 04/05 All IEHP Providers & Pharmacies March 2022     CORRECTION - Standing Orders Enrollment- Respond Today! 03/31 All Medi-Cal PCPs Complex Case Management (CCM) Program – Severe Chronic Conditions 03/30 All Medi-Cal PCPs, Specialists, BH Providers & IPAs Major Organ Transplants (MOT) and TAR Approval DATE Impact 03/29 All Medi-Cal IPAs & COEs Standing Orders Enrollment - Respond Today! 03/29 All Medi-Cal PCPs MTM Medi-Cal Provider Mailing Campaign 03/29 All IEHP Providers & Pharmacies MTM Medicare Provider Mailing Campaign 03/29 All IEHP Providers & Pharmacies Initial Health Assessment (IHA) 03/28 All Medi-Cal PCPs REMINDER - 2022 OB P4P Kickoff Meeting – March 31, 2022! 03/28 All Medi-Cal OB/GYNs CMS Signature Requirement Guidelines for Member Medical Records 03/25 All IPAs, PCPs, Specialists & BH Providers REMINDER: IEHP Claims, Appeals/Disputes and Audit Recovery Mailing Addresses 03/25 All Direct PCPs, Specialists & BH Providers 2021 GQ P4P Program- Data Submission Extension Until March 31, 2022 03/22 All Medi-Cal PCPs REMINDER: IEHP Wants to Know Your Interest in Pilot Program to Implement a Community Electronic Health Record (EHR) 03/22 All Medi-Cal PCPs REMINDER - American Rescue Plan Act – Extension of Postpartum Care Coverage 03/21 All Medi-Cal PCPs, OBs & IPAs Behavioral Health Access Standards – Appointment Availability 03/16 All Behavioral Health Providers New DHCS DUR Board Educational Article 03/16 All IEHP Providers & Pharmacies IEHP Wants to Know: Interest in Pilot Program to Implement a Community Electronic Health Record (EHR)? 03/15 All Medi-Cal PCPs REMINDER - 2022 Global Quality P4P Program – CAIR2 Participation Requirement 03/14 All Medi-Cal PCPs & IPAs Riverside County Legionnaires' Disease Advisory 03/14 All PCPs & IPAs Coordination of Benefits with Other Health Coverage (OHC) – Medi-Medi Coverage Added to Provider Portal 03/11 All IEHP Providers & IPAs Notice of Dismissal of Coverage Letter Updates & Attestation Form 03/11 All Medicare IPAs Process for IEHP Medi-Cal Members: Continuous Glucose Monitors (CGM) 03/10 All Medi-Cal PCPs UPDATED Integrated Denial Notice Medicare Letter Templates 03/08 All Medicare IPAs Process for IEHP Medi-Cal Members: Blood Pressure Monitors and Nebulizers 03/07 All Medi-Cal PCPs Recalls, Withdrawals & Safety Alerts 03/07 All IEHP Providers & Pharmacies IEHP’s Quarterly BH Provider Training 03/04 All Behavioral Health Providers Update: Enhanced Care Management Roster Available on Provider Portal 03/01 All Medi-Cal PCPs & IPAs February 2022     New Facility Site Review and Medical Record Review Tools and Standards effective March 1, 2022 – DHCS APL 20-006 02/28 All PCPs & IPAs 2022 OB P4P Kickoff Meeting – March 31, 2022 02/28 Medi-Cal OB/GYNs Community Supports Services Referral Process Now Available Online 02/25 BH & BHT Providers American Rescue Act Plan – Extension of Postpartum Care Coverage 02/25 Medi-Cal PCPs, OBs & IPAs PHA Gonococcal Infections 02/24 All Riverside County PCPs Vision Authorization Process – Please Do Not Submit Duplicate Requests 02/23 All Vision Providers COVID-19 Oral Antiviral Drugs – Coverage and Dispensing Pharmacies 02/23 All Medicare PCPs, Specialists & IPAs 2022 Global Quality P4P Program – PCP CAIR2 Participation Requirement 02/22 All Medi-Cal IPAs UPDATED LAUNCH DATE: Pyx Health Mobile Application: Pilot Program 02/22 All PCPs & IPAs Global Quality P4P Programs - 2022 ROSTER UPDATE -IPA 02/22 All Medi-Cal IPAs Global Quality P4P Programs – 2022 ROSTER UPDATE - PCP 02/22 All Medi-Cal PCPs RETRACTION - Medi-Cal Rx Transition: Continuous Glucose Monitors (CGM) 02/17 All Medi-Cal PCPs RETRACTION - Medi-Cal Rx Transition: Continuous Glucose Monitors (CGM) 02/17 All Medi-Cal IPAs Health Access License Surrender Update: Revised Effective Date 02/17 IEHP Direct Providers & IPAs UPDATE: Post-Service/Retrospective Auth Decision Notification Requirements 02/17 Medi-Cal IPA Administrators, UM Medical Directors & UM Staff Revised/Retired/Reviewed With No Changes UM Authorization Guidelines 02/16 IPA Administrators & Medical Directors Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM) UPDATE 02/14 All Medi-Cal PCPs Medi-Cal Rx Transition Survey – Your Response is Important! 02/14 All Medi-Cal PCPs and Specialists Presidents’ Day Holiday 02/14 All IEHP Providers LTSS Roster: IHSS County Social Worker and Caregiver Info 02/14 All Medicare IPAs Important Notice: Insulin Misutilization 02/14 All IEHP Providers & Pharmacies Updated - Medi-Cal Rx Transition: Implantable and Injectable Contraceptives FAQs 02/11 All Medi-Cal PCPs and OBs 2022 IEHP DualChoice Cal MediConnect Plan Benefits 02/10 All Dual Choice IPAs & Providers Medi-Cal Rx Transition: Continuous Glucose Monitors (CGM) UPDATE 02/10 All Medi-Cal IPAs Medi-Cal Rx Transition: Hyaluronic Acid Knee Injections 02/09 All Orthopedic Specialists Medi-Cal Rx UPDATE: Revised Prior Auth Policy for Prescribers and Emergency Fill Quantity Limit 02/07 All Medi-Cal PCPs & Specialists Medi-Cal Rx Transition - How To Assist IEHP Members 02/07 All Medi-Cal PCPs Recalls, Withdrawals & Safety Alerts 02/07 All IEHP Providers & Pharmacies Global Quality P4P IPA Program - 2022 Program Guide Release 02/04 All Medi-Cal IPAs Medi-Cal Letter Templates 02/03 All Medi-Cal IPAs Vaccines for Children: Webinar This Week! 02/02 All IEHP Peds REMINDER: 2022 Global Quality P4P Program – CAIR2 Participation Requirement 02/01 All Medi-Cal IPAs Upcoming CHDP Trainings 02/01 All Medi-Cal PCPs OB/GYN P4P Program Guide- UPDATE 02/01 All Medi-Cal OBs January 2022     2022 Global Quality P4P IPA Kickoff Meeting 01/31 All Medi-Cal IPAs 2022 Global Quality P4P PCP Kickoff Meeting 01/31 All Medi-Cal PCPs Free OTC COVID-19 Antigen Kits Available 01/28 All Medi-Cal PCPs Provider Manual Acknowledgement of Receipt (AOR) Winners! 01/28 All IEHP Providers Home Dialysis Codes S9335 and S9339 01/27 All Dialysis Providers PATH Program Design Webinar 01/26 All Medi-Cal PCPs Free At-Home COVID-19 Tests Available by Request 01/26 All Medi-Cal PCPs Fluoride Application Training Flyer 01/26 All PCPs SB County Black Infant Health Program 01/25 All San Bernardino County PCPs, OBs & BH Providers Medi-Cal Rx Transition - Implantable and Injectable Contraceptives FAQs 01/24 All Medi-Cal PCPs and OBs SAVE THE DATE - Care Management Medi-Cal IPA Training 01/24 All Medi-Cal IPAs COMING SOON - Pyx Health Mobile Application - Pilot Program 01/24 All PCPs and IPAs Participation Required - 2022 Global Quality P4P Program- CAIR2 01/24 All Medi-Cal PCPs Access Standards – Appointment Availability For Specialists 01/20 All Specialists Access Standards – Appointment Availability For PCPs and OBs 01/20 All PCPs & OBs Access Standards – Appointment Availability For Behavioral Health Providers 01/20 All Behavioral Health Providers Clarification! - Individualized Care Plan (ICP) Attestation Process 01/19 All DualChoice Providers Non-Contracted Hospitals Required to Obtain PA for Post-Stabilization Care of IEHP Members 01/19 California Non-Contracted Hospitals Misdirected Claim Outreach Letter V3 01/18 All IEHP Trading Partners Medi-Cal Rx Transition - Implantable and Injectable Contraceptives 01/18 All Medi-Cal PCPs and OBs Medi-Cal Rx (Magellan) Customer Service 01/18 All Medi-Cal PCPs & Specialists Medi-Cal Rx Transition - Continuous Glucose Monitors (CGM) 01/18 All Medi-Cal PCPs & Specialists UPDATE: Community Supports Referral Process 01/14 All Behavioral Health Providers IEHP HOLIDAY - Martin Luther King Jr. Day 01/14 All IEHP Providers & IPAs UPDATE: CDC Quarantine Guidelines 01/12 Skilled Nursing Facilities Last Chance to Win a $50 Gift Card – Submit 2022 Provider Manual Acknowledgement of Receipt (AOR) Today! 01/12 All IEHP Providers REMINDER! Major Organ Transplant (MOT) Authorization Process 01/11 All PCPs, Specialists, IPAs & Hospitals UPDATE: Community Supports Services UM Authorization Guidelines 01/11 IPAs & Behavioral Health Providers NEW: Riverside County Public Health: Protocol for Isolation and Quarantine for the General Public 01/06 All Riverside County PCPs & Specialists Extending SNF COVID-19 Per Diem Rate 01/05 Skilled Nursing Facilities Recalls, Withdrawals & Safety Alerts 01/05 All IEHP Providers & Pharmacies CORRECTION! Medi-Cal Rx: Mail Order for Blood Pressure Monitors and Nebulizers 01/04 All Medi-Cal PCPs & Specialists NEW BENEFIT: Enhanced Care Management 01/02 All Medi-Cal PCPs & IPAs December 2021     Community Supports- Coming January 1, 2022! 12/30 All PCPs, Specialists & Behavioral Health Providers Global Quality P4P Programs- NEW 2022 Program Guide Release 12/30 All Medi-Cal PCPs NEW: Major Organ Transplant (MOT) Authorization Process 12/30 All Hospitals & COEs NEW: Major Organ Transplant (MOT) Authorization Process 12/30 All PCPs, Specialists & IPAs Medi-Cal Rx: Mail Order for Blood Pressure Monitors and Nebulizers 12/30 All Medi-Cal PCPs & Specialists REMINDER: Medi-Cal Rx launches this weekend - January 1, 2022! 12/29 All Medi-Cal PCPs, Specialists and IPAs NEW IEHP Video – Immunity: Why Vaccines Matter 12/29 All IEHP Providers & IPAs CalAIM Expansion to Zip Codes now in IEHP’s Service Area –January 1, 2022 12/22  All Medi-Cal PCPs & IPAs COVID-19 Vaccine Billing for Medicare Advantage Enrollees Effective DOS January 1, 2022 12/22 Direct DualChoice Providers DHCS Retro Hospice Rates 12/22 Hospice Providers IEHP Formulary Changes: Nov P&T Update 12/21 All IEHP Providers & Pharmacies Revised/Retired UM Authorization Guidelines 12/20 IPA Administrators & Medical Directors IEHP 2021 - 2022 Holiday Hours 12/17 All IEHP Providers & IPAs DHCS Medi-Cal Rx (Carve Out) and Members’ Preferred Pharmacy 12/17 All Medi-Cal PCPs, Specialists & IPAs COVID-19 Vaccine Incentive Program – Program Guide 12/16 All Medi-Cal PCPs REMINDER: COVID Vaccine Enrollment Survey - Your Response is Requested 12/16 All Medi-Cal PCPs Early Start Eligibility Criteria and Referral Process 12/14 All Medi-Cal PCPs Inland Regional Center Eligibility Criteria and Referral Process 12/14 All Medi-Cal PCPs 2021 Global Quality P4P Program- Data Submission Deadlines - PCPs 12/14 All Medi-Cal PCPs 2021 Global Quality P4P Program- Data Submission Deadlines - IPAs 12/14 All Medi-Cal IPAs SBC Children’s Network Safe Sleep Video 12/13 All San Bernardino County Peds, OBs, Family Planning & Community Clinics REMINDER: Medi-Cal Rx launches January 1, 2022! 12/10 All Medi-Cal PCPs, Specialists & IPAs REMINDER: COVID Vaccine Enrollment Survey - Your Response is Requested 12/10 All Medi-Cal PCPs COVID-19 Vaccine Billing for Medicare Advantage Enrollees 12/10 All Medicare IPAs Medi-Cal Rx Transition: Blood Pressure Monitors and Nebulizers 12/10 All IEHP Providers & Pharmacies Notice of High-Risk Medications Drug Alternative(s) Reference Guide – New 2019 Update to the AGS Beers Criteria 12/10 All IEHP Providers & Pharmacies IEHP Recognized for Innovation Five Years in a Row 12/08 All PCPs, Specialists & IPAs Recalls, Withdrawals & Safety Alerts 12/08 All IEHP Providers & Pharmacies Retraction: IEHP’s Quarterly BHT Provider Training 12/03 All Behavioral Health Providers COVID Vaccine Enrollment Survey 12/03 All Medi-Cal PCPs New! Healthy Heart Health Education Classes 12/03 All IEHP PCPs IEHP’s Quarterly BHT Provider Training 12/03 Behavioral Health Treatment Providers New ID Cards for ALL IEHP Members due to Medi-Cal Rx 12/02 All PCPs, Specialists & IPAs IEHP Clean Claim Rules Implementation 12/02 IEHP Trading Partners CDC Encourages COVID Booster Due to Omicron Variant 12/01 All IEHP PCPs COMING SOON - Enhanced Care Management 12/01 All Medi-Cal PCPs 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 Communications - Pharmacy Communications

or later to view the PDF files. You can download a free copy by clicking here. By clicking on this link, you will be leaving the IEHP website. TITLE DATE RECIPIENTS December 2022     CoverMyMeds - Prior Authorization Submission Method for DualChoice Members (Effective January 1, 2023) 12/01 All IEHP Pharmacy Providers November 2022     Recalls, Withdrawals & Safety Alerts - October 2022 11/14 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts - September 2022 11/02 All IEHP Pharmacy Providers COVID-19: Test to Treat Monoclonal Antibodies 11/01 All IEHP Pharmacy Providers October 2022     Cal MediConnect to Medi-Cal Rx Transition (D-SNP) 10/28 All IEHP Pharmacy Providers September 2022     Recalls, Withdrawals & Safety Alerts 09/08 All IEHP Pharmacy Providers August 2022     2022-2023 Flu Vaccination for IEHP Members 08/31 All IEHP Pharmacy Providers Reminder: Medi-Cal Rx Gradual Reinstatement of PAs - Phase 1 08/31 All IEHP Pharmacy Providers 30-Day Countdown: Reinstatement of PA Requirements for 11 Drug Classes 08/18 All IEHP Pharmacy Providers 30-Day Countdown: Reinstatement of PA Requirements for 11 Drug Classes 08/17 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 08/10 All IEHP Pharmacy Providers July 2022     Academic Detailing Services Now Offered 07/15 All IEHP Pharmacy Providers DHCS Medi-Cal Rx Update: Postponement of Implementation of NCPDP Reject Code 80 07/13 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 07/07 All IEHP Pharmacy Providers June 2022     New DHCS DUR Board Educational Article 06/22 All IEHP Pharmacy Providers MTM Medicare Pharmacy Mailing Campaign 06/08 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 06/05 All IEHP Pharmacy Providers Academic Detailing Services Now Offered 06/04 All IEHP Pharmacy Providers Medi-Cal Rx Transition: Blood Pressure Monitors and Cuffs 06/03 All IEHP Pharmacy Providers Important Notice: COVID-19 Oral Antivirals Billing 06/01 All IEHP Pharmacy Providers May 2022     Recalls, Withdrawals & Safety Alerts 05/05 All IEHP Pharmacy Providers April 2022     Rejected Claims Due To Prescriber Error Codes 04/06 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 04/05 All IEHP Pharmacy Providers MTM COVID-19: Test to Treat 04/04 All IEHP Pharmacy Providers March 2022     MTM Medicare Pharmacy Mailing Campaign 03/29 All IEHP Pharmacy Providers New DHCS DUR Board Educational Article 03/16 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 03/28-03/31 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 03/21-03/25 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 03/14-03/18 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 03/07-03/11 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 03/07 All IEHP Pharmacy Providers IEHP Contracted DME Pharmacies: CGM, BP Monitor, Nebulizer 03/02 All IEHP Pharmacy Providers February 2022     Medi-Cal Rx Transition: How To Assist IEHP Members 02/28-03/04 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 02/22-02/25 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 02/14-02/18 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 02/10-02/11 All IEHP Pharmacy Providers Pharmacy Empowerment Program 02/08 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 02/07 All IEHP Pharmacy Providers New DHCS DUR Board Educational Article 02/02 All IEHP Pharmacy Providers January 2022     Free OTC COVID-19 Antigen Test Kits Available 01/31 All IEHP Pharmacy Providers Medi-Cal Rx Transition Implementation 01/17-01/21 All IEHP Pharmacy Providers Medi-Cal Rx Transition Implementation 01/10-01/14 All IEHP Pharmacy Providers Medi-Cal Rx Transition Implementation 01/07 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 01/05 All IEHP Pharmacy Providers December 2021     Medi-Cal Rx Transition Implementation 12/27-12/30 All IEHP Pharmacy Providers Medi-Cal Rx Transition Implementation 12/20-12/23 All IEHP Pharmacy Providers IMPORTANT NOTICE: COVID-19 Vaccine Billing 12/20 All IEHP Pharmacy Providers Medi-Cal Rx Transition Implementation 12/13-12/17 All IEHP Pharmacy Providers Notice of High-Risk Medications Drug Alternative(s) Reference Guide- New 2019 Update to the AGS Beers Criteria 12/10 All IEHP Pharmacy Providers Medi-Cal Rx Transition: Blood Pressure Monitors and Nebulizers 12/10 All IEHP Pharmacy Providers Medi-Cal Rx Transition Implementation 12/09-12/10 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 12/08 All IEHP Pharmacy Providers November 2021     Furnishing Narcan (naloxone) 11/09 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 11/03 All IEHP Pharmacy Providers Reporting Opioid Claim Related Safety Edit Errors 11/01 All IEHP Pharmacy Providers October 2021     Recalls, Withdrawals & Safety Alerts 10/28 All IEHP Pharmacy Providers New DHCS DUR Board Educational Article 10/13 All IEHP Pharmacy Providers Rejected Claims due to Member Eligibility Issues to be Reprocessed 10/05 All IEHP Pharmacy Providers  

Provider Manuals - General Information

EHP's contracted Providers understand how IEHP functions and understand the rules and regulations IEHP must comply with, as governed by the California Department of Health Care Services (DHCS), California Department of Managed Health Care (DMHC), the Centers for Medicare and Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA). The Delegate or Provider has the responsibility to ensure review, understanding, and attestation of the information contained in the Manual. Acknowledgement of Receipt (AOR) 2023 Providers: 2023 Provider eAOR Providers are encouraged to attest electronically using the following recommended browsers: Google Chrome, Microsoft Edge, Mozilla Firefox 2023 Hospital & IPA AORs For more information regarding 2023 Manuals, click here. 2022 Providers: 2022 Provider eAOR Providers are encouraged to attest electronically using the following recommended browsers: Google Chrome, Microsoft Edge, Mozilla Firefox 2022 Hospital & IPA AORs For more information regarding 2022 Manuals, click here.

Ủy Ban Cố Vấn Hội Viên - Nhóm Làm Việc về Người Khuyết Tật

iến phản hồi của họ hướng dẫn các dịch vụ của chúng tôi. Do đó, chúng tôi có thể cải thiện cách chúng tôi cung cấp dịch vụ và dịch vụ chăm sóc. Nếu quý vị là Hội Viên IEHP bị khuyết tật, thì quý vị có thể yêu cầu trở thành Hội Viên PDW của chúng tôi.  PDW họp ba tháng một lần tại IEHP. Trong các cuộc họp, Hội Viên sẽ có cơ hội đưa ra phản hồi về các tài liệu của hội iên và kinh nghiệm tổng thể của họ khi nhân dịch vụ chăm sóc với IEHP. Chúng tôi cũng thảo luận về bất kỳ nhu cầu giao tiếp và các vấn đề về khả năng tiếp cận mà các Hội Viên có thể có. Để đăng ký làm thành viên trong nhóm làm việc này, vui lòng gọi cho Dịch Vụ Hội Viên của IEHP theo số (800) 440-4347, TTY (800) 718-4347. Lịch Họp 2022 Ngày 31 tháng 3 năm 2022 Ngày 23 tháng 6 năm 2022 Ngày 22 tháng 9 năm 2022 Ngày 15 tháng 12 năm 2022

Ủy Ban Cố Vấn Hội Viên - Ủy Ban Tham Gia Chính Sách Công

kinh nghiệm và ý kiến phản hồi của họ hướng dẫn các dịch vụ của chúng tôi. Do đó, chúng tôi có thể cải thiện cách chúng tôi cung cấp dịch vụ và dịch vụ chăm sóc. PPPC họp ba tháng một lần. Chúng tôi tập hợp các nhân viên và Hội Viên IEHP lại với nhau để cung cấp cho Hội Viên một nền tảng để thảo luận cởi mở. Trong các cuộc họp, Hội Viên sẽ có cơ hội đưa ra phản hồi về các tài liệu của hội iên và kinh nghiệm tổng thể của họ khi nhân dịch vụ chăm sóc với IEHP. Chúng tôi cũng thảo luận về chương trình dịch vụ Văn Hóa và Ngôn Ngữ (C&L) của IEHP. Hội Viên được chọn tham gia sẽ nhận được $75 cho mỗi cuộc họp mà họ tham dự.  Nhấp vào đây nếu quý vị muốn phục vụ trong Ủy Ban Chính Sách Công.  Lịch Họp 2022:  Ngày 16 tháng 3 năm 2022 Ngày 15 tháng 6 năm 2022 Ngày 21 tháng 9 năm 2022 Ngày 21, tháng 12 năm 2022  

Cuộc Họp của Ban Quản Trị - Chương Trình Cuộc Họp và Báo Cáo

will now be held at the following address: Dr. Bradley P. Gilbert Center for Learning & Innovation 9500 Cleveland Ave. Rancho Cucamonga, CA 91730 Click here to view the meeting room map. Any Member of the public may observe the scheduled proceedings by using the link listed below. September 12, 2022 - 9 a.m. Click here to join the virtual meeting. November 2022 Agenda Board Report Under $200k Summary Report October 2022 Agenda Board Report Under $200k Summary Report

Plan Updates - Updates

alifornia Specific Quality Withhold Technical Notes for DY 2 to 8 (PDF) Core Quality Withhold Technical Notes for DY 2 to 9 (PDF) Riverside University Health System - Health Advisory Influenza (PDF) A Message From IEHP Medical Director, Dr. Takashi Wada The 2022-2023 influenza season continues to coincide with circulation of COVID-19 virus (SARS-CoV-2). As of August 2022, approximately 94.2 million cases of COVID-19 had been reported in the United States. Influenza vaccination remains an important tool for the prevention of potentially severe respiratory illness, which helps decrease the stress on the U.S. health care system. IEHP DualChoice members who are 18 years of age or older may obtain flu vaccines through the IEHP Pharmacy Vaccine Network. Flu Vaccine Notice: Access to Pharmacy Vaccine Network (PDF) Frequently Asked Influenza (Flu) Questions: 2022-2023 Season (CDC Recommendations) What’s New for 2022-2023  By clicking on these links, you will be leaving the IEHP website. The composition of flu vaccines has been updated. For the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. The recommended timing of vaccination is similar to last season. For most people who need only one dose for the season, September and October are generally good times to get vaccinated. Vaccination in July and August is not recommended for most adults but can be considered for some groups. While ideally it’s recommended to get vaccinated by the end of October, it’s important to know that vaccination after October can still provide protection during the peak of flu season. The age indication for the cell culture-based inactivated flu vaccine, Flucelvax Quadrivalent (ccIIV4), changed from 2 years and older to 6 months and older. Pre-filled Afluria Quadrivalent flu shots for children are not expected to be available this season. However, children can receive this vaccine from a multidose vial at the recommended dose. Preventive Services Immunizations  By clicking on these links, you will be leaving the IEHP website. CDC ACIP Vaccine Recommendations and Guidelines: https://www.cdc.gov/vaccines/hcp/acip-recs/index.html CDC ACIP Immunization Schedule for Children: https://www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html CDC ACIP Immunization Schedule for Adults: https://www.cdc.gov/vaccines/schedules/hcp/adult.html USPSTF Task Force's Immunization Recommendations: https://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=immunization California Immunization Registry Portal (CAIR): https://cair.cdph.ca.gov/CAPRD/portalInfoManager.do Immunization Timing 2022 (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.

P4P - Proposition 56 - GEMT - Prop 56 - Value Based Payment

OS June 30, 2022, payments will run out through June 2023. The Proposition 56 VBP Program provided direct payments incentivizing Providers to meet specific measures aimed at delivering key quality healthcare services that improve the quality of care to Medi-Cal beneficiaries. Targeted areas were behavioral health integration, chronic disease management, prenatal/post-partum care and early childhood prevention. For more information about the VBP Program, please visit the DHCS website at https://www.dhcs.ca.gov/provgovpart/Pages/VBP_Measures_19.aspx. By clicking on this link, you will be leaving the IEHP website.  Value Based Payments Program Guide Value Based Payments (VBP) Program Guide (PDF) - Published: January 01, 2022 Value Based Payments Dispute Forms Value Based Payments Program - Paid Claims Dispute Request (PDF) Published: January 19, 2022 Value Based Payments Program - Encounter Dispute Request (PDF) Published: January 19, 2022 Please e-mail completed forms to ValueBasedPaymentsProgram@iehp.org At-Risk Condition Codes The At-Risk Condition Codes list includes diagnosis codes to identify Serious Mental Illness, Substance Use Disorder or Homelessness Conditions for the VBP Program. These conditions qualify Providers for an additional payment amount for VBP services. Please refer to page 4 of the VBP Program Guide for additional details. At-Risk Condition Codes (PDF) Published: March 25, 2020 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 - Coronavirus (COVID-19) Advisory

e Control and Prevention (CDC) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China and which has now been detected in almost 70 locations internationally, including in the United States. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19"). IEHP will continually update you on the latest recommendations, news, and resources on COVID-19 as it becomes available. COVID-19 Therapeutics Available for Members In an effort to provide the most up-to-date treatments against COVID-19, IEHP continues to maintain a list of providers, including but not limited to infusion clinics, ancillary, hospital and non-hospital based infusion centers offering COVID-19 infusion therapy treatment. Under all Member coverage, outpatient COVID therapeutics will be offered immediately after a Member is determined to be clinically eligible under and Emergency Use Authorization (EUA). List of Infusion Sites COVID-19 Infusion Treatments by Organization (PDF) Test-To-Treat COVID-19 Vaccine Reimbursement for Medi-Cal Providers DHCS has carved out the COVID-19 vaccine from Medi-Cal managed care health plans and will reimburse providers under the Fee-for-Service (FFS) delivery system for both medical and pharmacy claims. Medi-Cal will reimburse the associated COVID-19 vaccine administration fee at the allowable Medicare rate for all claims (medical, outpatient, and pharmacy), based on the number of required doses for all Medi-Cal beneficiaries. For further information: June 13, 2022 - DHCS COVID-19 Vaccine Administration Provider FAQs   How Vaccines Build Immunity While the COVID-19 vaccines are relatively new - the technology and science behind the vaccines have been in development for decades. In the video below, we demonstrate how years of vaccine research and advanced technology allowed researchers and scientists worldwide to be prepared to develop an mRNA vaccine that could help fight the spread of a global infectious disease. FIND A TESTING AND VACCINATION SITE NEAR YOU TODAY! RIVERSIDE Riverside County Public Health COVID Testing Site Vaccine Information Vaccine Locations & Registration Registrations encouraged but not required for: The CDC recommends everyone ages 6 months and older get vaccinated against COVID-19 as well as a booster for everyone 5 years and older, if eligible. For more information, visit the Riverside Country Vaccine webpage. Teenagers 5 to 17 years old must register for a vaccination clinic that offers the Pfizer vaccine and be accompanied by a parent/legal guardian or present a signed written consent from a parent/legal guardian and be accompanied by an adult. Pfizer Minor Consent Form (PDF) | Spanish  The Moderna and Johnson & Johnson vaccines can only be given to individuals age 18 years and older. Johnson & Johnson Fact Sheet (PDF) | Spanish - Published April 26, 2021  SAN BERNARDINO San Bernardino County Public Health COVID Testing Site Vaccine Locations & Registration Additional Dose and Boosters Information COVID-19 Vaccine Consent Form (PDF) | Spanish   The CDC recommends everyone ages 6 months and older get vaccinated against COVID-19 as well as a booster for everyone 5 years and older, if eligible. For more information, visit the San Bernardino County Pediatric COVID-19 Vaccination web page Walk-ins are now available at County-operated vaccination sites. Walk-in individuals will not need to bring any additional information to the site, however be prepared to register on site, which will include answering health screening questions. Walk-ins may experience longer wait times and availability may vary based on site demand.  Centers for Disease Control and Prevention (CDC) Clinical Care Guidance Vaccines Vaccination Plans January 10, 2022 - Continued Coverage of COVID-19 Diagnostic Testing (PDF) CalVax CalVax is a state-wide centralized system for health care Providers enrolled or interested in participating in the California COVID-19 Vaccination Program, developed by the California Department of Public Health (CDPH). The new CalVax platform will provide a system to manage vaccine enrollment, ordering, inventory, administration, reporting and data analytics. Training materials such as job aids, videos, and recorded demos will be available to support all system users as they navigate through the new CalVax platform (mycavax.cdph.ca.gov).  CA Notify • CA Notify Flyer in English (PDF) and Spanish(PDF) • CA Notify Shareable Tools for web and social media • CA Notify Website  Financial Assistance Resources Riverside County Medical Association - COVID-19 Financial Toolkit for Medical Practice U.S. Department of Health & Human Services (HHS) CARES Provider Relief Fund Learn more about the Provider Relief Fund (PRF) Provider Relief Fund (PRF) Portal U.S. Small Business Administration. Borrowers may be eligible for Paycheck Protection Program (PPP) loan forgiveness. See if you're eligible here. Guidance Regarding Monoclonal Antibody Treatment for COVID-19 Even with decreasing cases and hospitalizations, those with high-risk conditions who have tested positive for COVID-19 are encouraged to get monoclonal antibody treatment at Riverside University Health System (RUHS) – Medical Center. In January, the U.S. Food and Drug Administration (FDA) limited the use of certain monoclonal antibody therapies that were ineffective against the omicron variant. In response, RUHS – Medical Center is administering sotrovimab, an IV infusion shown to be effective against omicron and other variants. January 14, 2022 - RUHS-Medical Center Offers Monoclonal Antibodies Treatment Quest Diagnostic For more information, please visit Quest Diagnostics FAQs COVID-19 Specimen Collection Instructions (Watch Video Here)                        Fact Sheet for Healthcare Providers for COVID-19 Testing (View PDF Here)   LabCorp For more information, please visit LabCorp's COVID-19 page. Which COVID-19 Test is Right For You? COVID-19 FAQs If you do not have the ability to collect specimens for COVID-19, please refer to your County Public Health resources for guidance on directing Members for testing.   Telehealth IEHP is strongly encouraging the utilization of telehealth for visits that can be conducted over the phone or via other audiovisual telecommunications.  IEHP has published a telehealth FAQ which is available here: Telehealth Services Due to Limiting Exposure to COVID-19 (PDF)- October 17, 2022 Remember: IEHP Provider Telehealth Information (PDF) IEHP expects that Providers will offer telehealth services and support to their Members during their published business hours.  Existing authorizations are valid and do not need to be changed even if services are being provided via telehealth You can request a POS 02 or POS 10 on your authorization however if you do not, you can still utilize the authorization for telehealth services even if a different POS was approved. When billing the claim for the service, you will utilize a POS 02 or POS 10. ONLY Services that are deemed clinically appropriate to provide via telehealth should be provided via telehealth. If there are treatments, exams, procedures or other services that cannot be provided via telehealth, those are not eligible to be provided via telehealth.  Provider Resources for Combatting COVID-19 Fatigue ACEs Aware - Support for those on the front lines as California addresses stress and anxiety related to COVID-19   Department of Health Care Services (DHCS) and California Department of Public Health (CDPH) COVID 19 Response Department of Health Care Services (DHCS) California Department of Public Health (CDPH)   The California Department of HealthCare Services (DHCS) has published a COVID-19 response page with guidance for Providers and Partners, Home and Community Based Services and Behavioral Health. Found Here: DHCS COVID‑19 Response | DHCS COVID-19 Medi-Cal FAQs The California Department of Public Health (CDPH) also has a page with new guidance documents and additional resources and news releases. Found Here: CDHP COVID-19 Updates Centers for Medicare & Medicaid Services (CMS) CMS Health Care Provider Toolkit - Help link to COVID-19 related questions   San Bernardino Medical Society The San Bernardino County Medical Society promotes the science and art of medicine, the care and well-being of patients, the protection of the public health and to promote the betterment of the medical profession. The latest news, research and developments on the COVID-19 outbreak for physicians can be found here: SBCMS COVID-19. January 07, 2021 - COVID-19 Vaccines For All Practicing Physicians and Staff – San Bernardino County (PDF) 2-1-1 San Bernardino County Resource & Information Guide   2-1-1 San Bernardino County has curated a COVID-19 Resource & Information Guide and will update this page regularly as the situation changes. For more information, please click here.   Correspondences May 2, 2022 - Webinar - IWIN COVID and the Community April 13, 2022 - COVID-19 “Test to Treat” Initiative April 8, 2022 - 2nd Round of Free At-Home COVID-19 Test Kits Available February 23, 2022 - COVID-19 Oral Antiviral Drugs – Coverage and Dispensing Pharmacies  January 28, 2022 - Free OTC COVID-19 Antigen Kits Available January 26, 2022 - Free At-Home COVID-19 Tests Available by Request January 5, 2022 - Extending SNF COVID-19 Per Diem Rate December 22, 2021 - COVID-19 Vaccine Billing for Medicare Advantage Enrollees Effective DOS January 1, 2022 December 16, 2021- COVID-19 Vaccine Incentive Program – Program Guide December 16, 2021 - REMINDER: COVID Vaccine Enrollment Survey - Your Response is Requested December 10, 2021 - REMINDER: COVID Vaccine Enrollment Survey - Your Response is Requested December 10, 2021 - COVID-19 Vaccine Billing for Medicare Advantage Enrollees December 3, 2021- COVID-19 Vaccine Enrollment Survey December 1, 2021- CDC Encourages COVID Booster Due to Omicron Variant November 17, 2021- UPDATE! COVID-19 Vaccine FQHC, RHC and IHF Incentive Program November 9, 2021- Three Upcoming Webinars on Building COVID-19 Vaccine Trust October 22, 2021- 2021 COVID-19 Vaccination Member Incentive October 22, 2021- NEW!!! COVID-19 Vaccine FQHC and RHC Incentive Program October 19, 2021- COVID-19 Treatment – RUHS Monoclonal Antibody Treatment Center October 12, 2021- Reminder - NEW COVID-19 Vaccine PCP Incentive Program - Kickoff Meeting October 6, 2021- NEW COVID-19 Vaccine PCP Incentive Program- Kickoff Meetings October 4, 2021- New COVID-19 Vaccine PCP Incentive Program September 8, 2021- CDPH Webinar: How to Have Crucial Conversations About COVID-19 Vaccines – Thursday, September 9th August 18, 2021 - Riverside County Public Townhall on COVID-19 Vaccines For additional resources regarding COVID-19, please visit: Centers for Disease Control and Prevention (CDC) Riverside County Public Health San Bernardino Public Health 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 - 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.

Pharmacy Services - Pharmacy Network Lists

here to download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website.   To view IEHP’s current Pharmacy Network under IEHP DualChoice CalMediConnect Plan (Medicare-Medicaid Plan), please use this link: Under “How to Access Care” tab, click on “2022 IEHP DualChoice Provider and Pharmacy Directory (PDF)".   To view IEHP’s future Pharmacy Network under IEHP DualChoice (HMO D-SNP), please use this link: Under “How to Access Care” tab, click on “2023 IEHP DualChoice Provider and Pharmacy Directory (PDF)".   Information on this page is current as of November 02, 2022.

Chuyển Đổi Medi-Cal Rx

i phúc lợi nhà thuốc cho các Hội Viên IEHP. Thuốc kê toa của các Hội Viên IEHP sẽ được bao trả bởi “Medi-Cal Rx”. Hãy đem theo Thẻ ID Medi-Cal và thẻ ID IEHP của quý vị đến nhà thuốc khi quý vị lấy thuốc để tránh bị chậm trễ.  Điều gì đang thay đổi với phúc lợi nhà thuốc của tôi? Bắt đầu vào ngày 1 tháng 1 năm 2022, quý vị sẽ nhận được các loại thuốc theo toa được Medi-Cal bao trả của mình thông qua Medi-Cal Rx thay vì IEHP. DHCS sẽ hợp tác với một nhà thầu mới là Magellan Medicaid Administration, Inc. để cung cấp dịch vụ nhà thuốc. Chi phí thuốc của tôi có thay đổi không? Sẽ không có sự thay đổi về cách quý vị thanh toán cho các loại thuốc của mình. Tôi cần làm gì? Hầu hết mọi người không cần làm gì. Bác Sĩ của quý vị sẽ được thông báo về sự thay đổi này. Tôi có cần thay đổi thuốc của mình không? Hầu hết mọi người sẽ không phải thay đổi thuốc. Quý vị cần kiểm tra danh sách thuốc được Magellan chi trả. Danh sách thuốc yêu cầu phải có sự chấp thuận trước có thể khác với danh sách mà IEHP sử dụng. Bác Sĩ của quý vị có thể cần được chấp thuận để mua thêm toa thuốc. Họ có thể trao đổi với quý vị về việc thay đổi thuốc không yêu cầu sự chấp thuận trước. Nhà thuốc của tôi có thay đổi không? Đa phần các nhà thuốc sẽ chấp nhận chương trình bảo hiểm mới của quý vị. Quý vị có thể gọi đến Đường Dây Hỗ Trợ Hội Viên Medi-Cal (1-800-541-5555, TTY 1-800-430-7077) để hỏi xem nhà thuốc của quý vị có chấp nhận Medi-Cal Rx không. Nếu nhà thuốc của quý vị không hợp tác với Medi-Cal Rx, quý vị có thể cần chọn một nhà thuốc khác. Tôi nên làm gì nếu tôi cần giúp tìm một nhà thuốc? Công Cụ Tìm Nhà Thuốc Medi-Cal Rx trực tuyến trên trang www.Medi-CalRx.dhcs.ca.gov sẽ có hiệu lực vào tháng 12 năm 2021. Hoặc bắt đầu vào ngày 1 tháng 1 năm 2022, quý vị có thể gọi Dịch Vụ Khách Hàng theo số 1-800-977-2273, 24 giờ một ngày, bảy ngày một tuần hoặc 711 đối với TTY từ thứ Hai đến thứ Sáu, 8 giờ sáng đến 5 giờ chiều. Điều gì xảy ra ngay lúc này? Quý vị sẽ nhận được Thẻ Hội Viên IEHP mới với số điện thoại của Magellan. Luôn đem theo Thẻ Hội Viên IEHP và Thẻ Nhận Dạng Phúc Lợi Medi-Cal (BIC) cùng với quý vị đến nhà thuốc. Tôi nên làm gì nếu có thắc mắc? Vào hoặc trước ngày 31 tháng 12 năm 2021 Nếu quý vị có thắc mắc về thông báo này hoặc có các thắc mắc chung về Medi-Cal Rx, hãy liên hệ với Đường Dây Hỗ Trợ Hội Viên Medi-Cal (1-800-541-5555, TTY 1-800-430-7077), Thứ Hai đến Thứ Sáu, 8 giờ sáng đến 5 giờ chiều.  Vào hoặc sau ngày 1 tháng 1 năm 2022 Quý vị có thể gọi Đường Dây Trung Tâm Dịch Vụ Khách Hàng Medi-Cal Rx (1-800-977-2273), 24 giờ một ngày, bảy ngày một tuần hoặc 711 đối với TTY từ thứ Hai đến thứ Sáu, 8 giờ sáng đến 5 giờ chiều. Điều gì sẽ xảy ra nếu tôi có khiếu nại? Magellan sẽ tiếp nhận và giải quyết khiếu nại của quý vị. Quý vị có thể nộp đơn khiếu nại bằng văn bản hoặc qua điện thoại. Quý vị chỉ có thể sử dụng trang web này và số điện thoại để nộp đơn khiếu nại vào hoặc sau ngày 1 tháng 1 năm 2022. Truy cập trang www.Medi-CalRx.dhcs.ca.gov hoặc gọi đến Dịch Vụ Khách Hàng theo số 1-800-977-2273. Tôi vẫn có thể gọi đến IEHP để được trợ giúp với các khiếu nại về nhà thuốc của tôi không? IEHP không còn xử lý các khiếu nại về dịch vụ nhà thuốc đã nhận vào hoặc sau ngày 1 tháng 1 năm 2022. Sự thay đổi ảnh hưởng đến Hội Viên Kaiser Permanente như thế nào? Các hội viên có Kaiser Permanente vẫn có thể nhận thuốc theo toa thông qua các nhà thuốc có liên kết với Kaiser.