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Interoperability API Terms Of Use

IEHP GOVERNING YOUR USE OF THE DEVELOPER PORTAL AND THE IEHP APIS (DEFINED BELOW). BY CLICKING “I AGREE” OR ACCESSING THE DEVELOPER PORTAL OR USING IEHPS APIS YOU ARE AGREEING TO BE BOUND BY THE TERMS OF THIS DEVELOPER AGREEMENT AND ANY OTHER APPLICABLE TERMS AND CONDITIONS POSTED ON IEHPS WEBSITE LOCATED AT WWW.IEHP.ORG/EN/ABOUT/PRIVACY-POLICY. IF YOU DO NOT AGREE TO THE TERMS OF THIS AGREEMENT, YOU MAY NOT ACCESS THE DEVELOPER PORTAL OR USE THE IEHP APIs. By entering into this Agreement, you affirm that you are at least 13 years old and of legal age to enter into this Agreement and are authorized to enter into this Agreement on behalf of your Company. No legal partnership or agency relationship is created between IEHP and you or your Company by virtue of this Agreement. We may update this Agreement by posting the updated version(s) on this Website. Updated versions of the Agreement will apply to your use of the IEHP APIs occurring on or after the date of the last update. The "Last Updated" legend above indicates when this Agreement was last changed. You should periodically review this page to determine if this Agreement has been updated. Your continued use of the IEHP APIs following any updates to this Agreement shall constitute notice and acceptance of any such updates. PERMISSIBLE USE OF IEHP APIS We provide access to Our application programming interfaces (“APIs”), including Our Patient Access API, Provider Directory API and Promoting Interoperability API, and their associated documentation and sandbox (collectively, the “IEHP APIs”) on the Developer Portal. We may update, change, discontinue or add IEHP APIs or functionality or features to the IEHP APIs in Our discretion with or without providing notice to you. Subject to the terms of this Agreement, IEHP grants you a limited, non-sublicensable, non-assignable, non- transferable, royalty-free, non-exclusive license only to use: (a) the Patient Access API to retrieve certain health plan information maintained by Inland Empire Health Plan, a local public entity of the State of California, and its subsidiary health plans with the approval and at the direction of the applicable member or their personal representative consistent with applicable law; (b) the Provider Directory API to retrieve certain provider and pharmacy directory information; and (c) the Promoting Interoperability API to retrieve certain health care information with the consent of the applicable patient or their personal representative consistent with applicable law. You may only access the Patient Access API and Promoting Interoperability API by means of an application that has been registered with IEHP to access them. You agree to comply with all applicable laws, regulations, and governmental issuances. RESTRICTIONS You may not: (a) decompile, disassemble, reverse engineer, or otherwise attempt to derive, reconstruct, identify, or discover any source code, underlying ideas, or algorithms of the IEHP APIs by any means, except to the extent that the foregoing restriction is prohibited by applicable law; (b) remove any proprietary notices, labels, or marks from the IEHP APIs; (c) interrupt or attempt to interrupt the operation of the IEHP APIs in any way, including, without limitation, by restricting, inhibiting, or interfering with the ability of any other user to use the IEHP APIs (including by means of hacking or defacing any portion of the IEHP APIs, or by engaging in spamming, flooding, or other disruptive activities); (d) disrupt, interfere with, modify, bypass, or otherwise circumvent IEHP APIs functionality or features, limitations, security measures, technical processes, availability, integrity, or performance (or attempt the same); (e) transmit or attempt to transmit data over a IEHP APIs unless such transmission is authorized and formatted in accordance with applicable specifications in the IEHP APIs implementation guide; (f) transmit or otherwise make available through or in connection with the IEHP APIs any malicious, harmful or invasive code; (g) attempt to exceed IEHP APIs rate limits; (h) conduct security research on or testing against IEHP APIs, services, applications, systems, devices, or networks without prior written approval from IEHP; or (i) use the IEHP APIs (1) for any unlawful purpose or in any manner not authorized or intended in the IEHP APIs implementation guide, (2) in any way that could pose a threat to, disrupt, interfere with, harm, or impair the IEHP APIs, IEHP or other IEHP services, applications, systems, devices, or networks, or Inland Empire Health Plan members’, patients’, customers’, or other users’ use of IEHP APIs, (3) in any manner that, in IEHP’s reasonable determination, constitutes excessive or abusive usage, (4) to gain unauthorized access to any IEHP service, application, system, device, or network, or (5) to transmit malicious code or exploit security flaws, vulnerabilities, or deficiencies. MONITORING Your use of this Website and the IEHP APIs may be monitored by IEHP to ensure compliance with this Agreement. You consent to such monitoring. REPORTING SECURITY ISSUES You agree to promptly report to IEHP any security flaws, vulnerabilities, or deficiencies identified through normal use of IEHP APIs by calling the Inland Empire Compliance Hotline at 1-866-355-9038. You may not publicly disclose security flaws, vulnerabilities, or deficiencies in the IEHP APIs or other IEHP applications, systems, devices, or networks of which you become aware. ACCOUNTS/REGISTRATION You agree to promptly report to IEHP any security flaws, vulnerabilities, or deficiencies identified through normal use of IEHP APIs by calling the Inland Empire Health Plan Compliance Hotline at 1-866-355-9038. You may not publicly disclose security flaws, vulnerabilities, or deficiencies in the IEHP APIs or other IEHP applications, systems, devices, or networks of which you become aware. PROPRIETARY RIGHTS IEHP or its licensors own the IEHP APIs and the content on this Website and all intellectual property rights therein. You may not use any Inland Empire Health Plan entity’s name, trademarks, service marks, tradenames, logos or other distinctive brand features except as necessary to comply with your obligation, above, and agree not to remove any proprietary notices, labels, or marks from the IEHP APIs, and, in any case, you may not use those notices, labels or marks to imply affiliation with or endorsement by Inland Empire Health Plan. You have only those rights to access and use the IEHP APIs as are expressly granted by IEHP under this Agreement and all other rights in the IEHP APIs are reserved to IEHP or its licensors. You acknowledge that these rights are valid and protected in all forms, media, and technologies existing now or hereinafter developed. “Inland Empire Health Plan, a local public entity of the State of California,” means the health care organization doing business as Inland Empire Health Plan including, without limitation, Inland Empire Health Plan, and the subsidiaries, partners, and successors of the foregoing. PUBLIC ENTITY STATUS; BROWN ACT/PUBLIC RECORDS ACT The parties hereby acknowledge and agree that IEHP is a local public entity of the State of California subject to the Brown Act, California Government Code Sections 54950 et seq., and the Public Records Act, California Government Code Sections 6250 et seq. PRIVACY Your submission of information through the Website is governed by our Privacy Policy. RESPONSIBILITY FOR HARDWARE, SOFTWARE, TELECOMMUNICATIONS AND OTHER SERVICES You are responsible for obtaining, maintaining, and paying for all hardware, software, and all telecommunications and other services, needed for you to use the IEHP APIs. DISCLAIMER OF WARRANTY IEHP AND ITS SERVICE PROVIDERS DISCLAIM ALL EXPRESS OR IMPLIED REPRESENTATIONS OR WARRANTIES REGARDING THE IEHP APIS, INFORMATION, CONTENT, SERVICES, FUNCTIONALITY, AND ANY OTHER RESOURCES AVAILABLE ON OR ACCESSIBLE THROUGH THIS WEBSITE, INCLUDING, WITHOUT LIMITATION, ANY IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NON- INFRINGEMENT. ALL SUCH IEHP APIS, INFORMATION, CONTENT, SERVICES, FUNCTIONALITY AND RESOURCES ARE MADE AVAILABLE "AS IS" AND "AS AVAILABLE", AT YOUR SOLE RISK, WITHOUT WARRANTY OF ANY KIND. IEHP DOES NOT WARRANT THAT THE WEBSITE OR IEHP APIS WILL BE ACCURATE OR OPERATE WITHOUT INTERRUPTION OR ERROR. LIMITATION OF LIABILITY TO THE MAXIMUM EXTENT PERMITTED BY APPLICABLE LAW, IN NO EVENT SHALL IEHP, INLAND EMPRIE HEALTH PLAN OR THEIR SERVICE PROVIDERS, LICENSORS OR RESPECTIVE EMPLOYEES, OFFICERS, DIRECTORS, AGENTS, AFFILIATES, SUPPLIERS, VENDORS, LICENSORS, CO-BRANDERS OR PARTNERS (COLLECTIVELY, THE “INLAND EMPRIE HEALTH PLAN PARTIES") BE LIABLE FOR ANY DIRECT, INDIRECT, SPECIAL, PUNITIVE, INCIDENTAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES, OR ANY DAMAGES WHATSOEVER RESULTING FROM ANY LOSS OF USE, LOSS OF DATA, LOSS OF PROFITS, BUSINESS INTERRUPTION, LITIGATION, OR ANY OTHER PECUNIARY LOSS, WHETHER BASED ON BREACH OF CONTRACT, TORT (INCLUDING NEGLIGENCE), PRODUCT LIABILITY, OR OTHERWISE ARISING OUT OF OR IN ANY WAY CONNECTED WITH THE USE, OPERATION OR PERFORMANCE OF THE IEHP APIS, WITH THE DELAY OR INABILITY TO USE THE IEHP APIS, ANY DEFECTS IN THE IEHP APIS, OR WITH THE PROVISION OF, OR FAILURE TO MAKE AVAILABLE, ANY INFORMATION, SERVICES, PRODUCTS, MATERIALS, OR OTHER RESOURCES AVAILABLE ON OR ACCESSIBLE THROUGH THE IEHP APIS, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. You acknowledge and agree that the limitations set forth above are fundamental elements of this Agreement. INDEMNIFICATION You agree to indemnify, defend, and hold the Inland Empire Health Plan Parties harmless from any liability, loss, claim, and expense (including reasonable attorneys' fees) actually or allegedly related to or arising out of your use of the IEHP APIs or this Website, your use or disclosure of information obtained through the IEHP APIs, your violation of this Agreement, and/or your violation of the rights of any other person. TERM, TERMINATION, SUSPENSION AND REVOCATION This Agreement is effective until terminated by either party. If you no longer agree to be bound by this Agreement, you must cease your use of the IEHP APIs. If you breach any provision of this Agreement, then you may no longer use the IEHP APIs. IEHP may suspend or revoke your Credentials or access to the IEHP APIs without prior notice for your failure to comply with this Agreement or if IEHP determines that your access to the IEHP APIs would present an unacceptable level of risk to the security of IEHP’s systems. IEHP may terminate this Agreement if you fail to comply with its terms and, to the extent permitted by law, for any or no reason. If this Agreement is terminated for any reason, then: (a) this Agreement will continue to apply and be binding upon you in respect of your prior use of the IEHP APIs (and any unauthorized further use of the IEHP APIs); and (b) any rights granted to us under this Agreement will survive such termination. GENERAL LEGAL TERMS This Agreement constitutes the entire agreement between you and IEHP with respect to its subject matter IEHP’s failure to exercise or enforce any right or provision of this Agreement shall not constitute a waiver of such right or provision. If a court of competent jurisdiction rules that any provision of the Agreement is invalid, then that provision will be removed from the Agreement without affecting the rest of the Agreement and the remaining provisions will continue to be valid and enforceable. There are no third- party beneficiaries to this Agreement. The rights granted in this Agreement may not be assigned or transferred by You without the prior written approval of IEHP. You may not delegate your responsibilities or obligations under this Agreement without the prior written approval of IEHP. This Agreement shall be governed by the laws of the State of California without regard to its conflict of laws provisions. You agree to submit to the exclusive jurisdiction of the courts located within the county of San Bernardino, California to resolve any legal matter arising from this Agreement. IEHP may, notwithstanding this, seek injunctive remedies in any jurisdiction.

兒童與青少年 - 兒童健康

的家庭所設計。 此課程採用參與遊戲及社交互動的方式,提倡健康的成長與養育技巧。我們鼓勵父母們運用各種健康照護資源,並與兒科醫師合作進行發育篩檢和早期干預。瞭解健康素養,包括健兒門診、餵食、語言發育、安全、體能活動與疫苗接種。發育篩檢服務可應要求提供。   點選此處確認小組上課時間並報名。 如欲為您的子女申請發育篩檢服務,請寄電子郵件至 與我們聯絡 亦可參閱: 點選下列任何連結,您將會離開 IEHP 網站。 發育里程碑 健兒門診時程表 疫苗接種時程表 健康兒童之旅


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建議書徵求文件 (RFP) 與標案 - 採購

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


中心,電話 1-800-440-IEHP (4347)。TTY 使用者請致電 1-800-718-4347。您也可以發送電子郵件至。 Medicare/Medi-Cal 會員:  如有任何疑問,請於上午 8 點 至晚上 8 點(太平洋標準時間)致電 IEHP DualChoice,電話:1-877-273-IEHP (4347),每週七天(包括節假日)均提供服務。TTY 使用者請致電 1-800-718-4347。您也可以發送電子郵件至。 若您是提供者: 如需任何資訊,請於週一至週五上午 8 點至下午 5 點致電提供者關係團隊 (Provider Relations Team),電話 (909) 890-2054。您也可以發送電子郵件至。 如欲投保 IEHP: 如需投保醫療保健保險,請於週一至週五上午 8 點至下午 5 點致電  1-866-294-4347。TTY 使用者請致電  1-800-720-4347。我們會有親切友善的雙語投保顧問 (Enrollment Advisors) 與您洽談。 如需驗證 IEHP 員工的就業狀況  ,請向 IEHP 人力資源部門 (IEHP Human Resources Department) 提交請求:  電子郵件:。 傳真:909-477-8544 電話:909-890-2000(轉接人力資源部門) 我們的社區 如欲洽詢一般事務,請於週一至週五上午 8 點至下午 5 點致電 (909) 890-2000。TTY 使用者請致電 (909) 890-0731。 潛在供應商  若您有意成為 IEHP 的供應商,請造訪我們的「Procurement」(採購) 頁面。 對於所有記錄處理 請聯絡 IEHP 法務部門 (IEHP Legal Department)。法務部門負責處理牽涉受保護健康資訊 (Protected Health Information) (“PHI”)、傳票、監護權、公共記錄法 (Public Records Act) (“PRA”),以及加州政府理賠申請的各項事宜。法務部門也是 IEHP 的傳票送達指定代收人。 Inland Empire Health Plan Attn:Legal Department 10801 Sixth Street Rancho Cucamonga, CA 91730 電子郵件 傳真:(909) 477-8578 授權書 (Authorization of Release) (PDF) - 本表授權 IEHP 使用及披露受保護的健康資訊。 若您是媒體/新聞記者  請致電我們的媒體聯絡人: 傳播策略專家 Chelsea Galvez (909) 727-5263 我們的地址 10801 Sixth Street Rancho Cucamonga, CA 91730  郵寄地址 P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 傳真:(909) 890-2003 IEHP 直接會員的索賠郵寄地址 Inland Empire Health Plan - Claims P.O. Box 4349 Rancho Cucamonga, CA 91729-4349 IEHP 直接會員的索賠上訴和爭議郵寄地址 Inland Empire Health Plan - Claims Appeals and Disputes P.O. Box 4319 Rancho Cucamonga, CA 91729-4319

心理健康 - 心理健康與保健

「發瘋」或是「發狂」的人們一直被社會所排斥。這是由於對心理健康的無知所致。 很遺憾,目前社會對心理健康仍然存在太多的恐懼和誤解。許多人都患有心理健康疾病。鑑於目前 COVID-19 帶來的危機,遭受心理疾病所苦的人變得更多。 太多人默默地承受著心理疾病的折磨 根據 COVID 爆發前的最新統計資料,美國 5 人當中就有 1 人被診斷患有心理疾病 這一數字在 COVID-19 危機期間將會呈現增長趨勢 心理健康包括保健、自我照護、情緒管理、關係問題以及育兒等日常生活的各方面 心理健康對每一個人來說都很重要 每個人都有可能罹患心理疾病 每個人都應獲得心理健康治療。 您可以做些什麼以瞭解更多資訊或獲得協助 瞭解心理健康保健的重要性以及什麼是心理疾病。 請按這裡以瞭解更多資訊。 從頸部快速檢查。 請按此處進行線上篩查。  在 COVID-19 期間維持心理健康的秘訣 自我照護非常重要:聆聽您的情緒掙扎警示訊號,並透過做一些基本的事情來緩和,如洗澡、吃飯、睡覺與運動 每天做一些能夠讓您保持心情愉悅的事:與您的子女或配偶一起玩遊戲、散步、讀書以及其他可激發創造力的活動 每天透過電話或其他影像技術,與家人以外的他人聯絡 營養飲食,不要暴飲暴食或吃太多甜食 避免喝酒 繼續透過遠距醫療接受治療師的治療 持續照顧您的身體、財務與精神需求 對自己與他人保持耐心 隨時寬恕自己 運動、瑜珈、散步。  保持活力,但是不要過度 必要時,尋求心理健康治療 IEHP 行為健康服務不僅重視您的心理健康,也看重您的身體健康。您的心理健康包括情緒、精神與社會福祉的平衡。 它不但影響您思考,也影響您的感受以及您的行為模式。  您的心理與身體是相連的,兩者會互相影響。當您的心理承受痛苦時,您的身體也會感受到苦痛。IEHP 行為健康服務的目標是協助您活出最棒且最健康的人生,包括心理與生理。   心理疾病比您想像的還要普遍,IEHP 可隨時為您提供協助與支援。您是否知道,美國每五個人就有一人患有心理疾病,而心理疾病是可以治療的?這些人都在與心理疾病做鬥爭,如沮喪、焦慮,甚至是藥品或酒精濫用。   若您認為您可能遭受行為或心理健康問題,並且希望獲得治療,請預約您的醫師。若您沒有醫師,可以在您所在區域 尋找行為健康專科醫師 ,請致電 1-800-440-IEHP (4347) 聯絡 IEHP 會員服務中心 (Member Services),服務時間為週一至週五上午 7 點 至晚上 7 點 以及週六至週日上午 8 點 至下午 5 點。TTY 使用者請致電 1-800-718-4347,要求與行為健康部門 (Behavioral Health Department) 通話。 若您出現自我傷害或傷害他人的想法,請前往您附近的急診室、致電 911 或聯繫 全國自殺預防熱線 ,電話 1-800-273-8255。 請記住,您並不孤單。   許多人在這段期間都在或是即將面臨情緒和焦慮方面的問題。求助他人。  有一些心理健康的求助管道,而我們也希望您尋求幫助。 可用資源 聖貝納迪諾郡行為健康 河濱郡行為健康 聖貝納迪諾郡藥物使用 河濱郡藥物使用 精神疾病治療免預約診所 (Montclair) 精神疾病治療免預約診所 (Palm Desert) 精神疾病治療免預約診所 (Victorville) 青少年心理健康指南 COVID-19 孕期心理健康常見問答集 物質濫用與心理健康服務管理局 尋找提供者 孕期心理健康與保健資源  National Postpartum Support International 本地 Inland Empire 孕產婦心理健康合作資源


HP 臨床藥師團隊負責生產您的藥物,確保您所使用的藥物劑量符合您的健康狀況。若您是符合 MTM 計畫資格的會員,我們將會發送一封信函給您。除非您選擇不加入,否則您將自動投保計畫。符合資格的會員投保計畫無需花費任何費用。 誰可能符合資格?  本計畫的部分合格會員可能僅享有 IEHP 的 Medi-Cal 給付,   或者可能已經投保 IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid 計畫)。該等會員必須符合相關條件,且將會獲得 Medicare MTM 計畫的服務。(請參閱下列說明。)  MTM 服務包括哪些?  IEHP 的  MTM 服務包括 下列核心要素: 藥物治療審查 藥物教育 - 包括藥物行動計畫 疾病管理 我們的 IEHP 臨床藥師團隊會審查會員的藥物、家族病史、疾病狀態與藥物治療目標。該團隊會依據完整審查結果,為會員與提供者提供建議。  持照藥劑師與技師團隊將會與您的醫師 (或其他提供者) 及藥局合作提供完整照護。我們也會與照護管理團隊合作,為會員提供「全方位健康」照護。 Medicare MTM 計畫 IEHP 臨床藥師團隊為符合下列條件的 IEHP DualChoice 會員提供 MTM 服務,不另收取費用: 患有多種疾病; 使用許多處方藥; 需支付高額藥物費用 加入此計畫後,您將收到一份包含詳細資訊的郵寄資料包。此資料包也會提供如何退出計畫的相關資訊,以便您選擇不加入計畫時使用。若您決定不參與計畫,您獲得 IEHP DualChoice 給付的狀態及相關資格將不會有任何變化。誠摯希望您在符合資格時能夠加入,此計畫完全免費,還可協助您更好地管理您的藥物。  MTM 計畫包括年度綜合用藥審查 (CMR) 及針對性用藥審查 (TMR)。以下為 MTM 服務的部分內容: 綜合用藥審查  (CMR) IEHP 臨床藥劑師將透過電話為您提供年度綜合用藥審查服務。藥劑師會逐一確認您的藥物,以確保您所使用的藥物符合您的健康狀況,並協助您避免藥物相互作用等。  在完成您的 CMR 後,我們會將您的藥物行動計畫 (Medication Action Plan, MAP) 及個人藥物清單 (Personal Medication List, PML) 郵寄給您。您可致電會員服務中心並要求與臨床藥師團隊通話,以取得相關 MTM 服務文件及個人藥物清單的副本。 針對性用藥審查  (TMR) IEHP 臨床藥師團隊也會在一年當中提供 TMR 服務,審查參與計畫之 IEHP DualChoice 會員的藥物。該團隊會每三個月為所有保險受益人進行一次 TMR。保險受益人會透過郵件收到 TMR 建議,其初級照護提供者則可能會透過傳真收到相關建議 (若 IEHP 臨床藥師團隊認定有必要)。 符合 CMR 或 TMR 服務資格的 IEHP DualChoice 會員如需瞭解詳細資訊,可致電 1-877-273-IEHP (4347),服務時間為 (太平洋標準時間) 每天早上 8 點至下午 5 點,假日亦提供服務。TTY 使用者請撥 1-800-718-4347。  按一下此處獲取空白個人藥物清單。 資格條件 該等 MTM 計畫服務可能有一些適用的資格條件,且不屬於福利。MTM 計畫服務適用於符合下列條件的會員: 1.會員罹患至少三 (3) 種下列疾病: 骨骼疾病 - 關節炎 - 骨質疏鬆症 骨骼疾病 - 關節炎 - 類風濕性關節炎 慢性心臟衰竭 (Chronic Heart Failure, CHF) 糖尿病 血脂異常 末期腎臟病 (End-Stage Renal Disease, ESRD) 高血壓 心理健康慢性疾病/殘障心理健康疾病 呼吸系統疾病 – 哮喘 呼吸系統疾病 – 慢性阻塞性肺病 (Chronic Obstructive Pulmonary Disease, COPD) 2. 醫師為會員開立至少五 (5) 種不同的處方藥,以治療下列疾病: 血管緊張素 I 型轉化酶抑制劑 血管緊張素 II 型受體阻斷劑 (Angiotensin II Receptor Blocker, ARB) 抗憂鬱劑 降血脂藥 降血壓藥 抗精神病藥物 乙型阻斷劑 支氣管擴張劑 鈣通道阻斷劑 疾病調節抗風濕藥物 (Disease-Modifying Anti-Rheumatic Drug, DMARD) 利尿劑 胰島素 口服降血糖藥 選擇性血清素再吸收抑制劑 (Selective Serotonin Reuptake Inhibitor, SSRI) 腫瘤壞死因子 (Tumor Necrosis Factor, TNF) 吸入式皮質類固醇 擬鈣製劑 強心配糖體 聚落刺激因子 昇糖素類似胜肽 糖皮質激素 腦啡肽酶抑制劑 非類固醇消炎止痛藥 (NSAID) 磷酸鹽結合劑 維生素 D 類似物  3.前三個月可能須支付 1,174 美元 (4,696 美元的四分之一) 的藥物費用。 如欲進一步瞭解 MTM,請致電  IEHP DualChoice 會員服務中心,電話:1-877-273-IEHP (4347)。服務時間為 (太平洋標準時間) 每天早上 8 點至晚上 8 點,假日亦提供服務。TTY 使用者 請 撥 1-800-718-4347。 此頁面資訊為截至 2021 年 10 月 8 日的資訊。 H5355_CMC_22_2246727 已接受  

心理健康 - 988 自殺和危機熱線

好記,便於陷入危機中的人致電。該熱線會將他們轉至全國自殺預防熱線(現稱為 988 自殺和危機熱線 (988 Suicide & Crisis Lifeline))。 對於處於危機中的人士來說,這是一個拯救生命的資源。 此號碼的接聽對象是受過訓練的危機顧問,並非警察。 當人們致電或發簡訊至 988 時,會將其轉至受過訓練的顧問,這些顧問是現有熱線網絡的成員。他們會做人們的聆聽者,瞭解來電者的問題如何對其造成了影響,並為其提供支持和在必要時將他們與資源建立聯絡。 988 和 911 有何區別? 988 不是一種新的服務,只是一個新號碼。設立 988 區號的目的是改善獲取危機服務的機會,以滿足我國日益增長的自殺和心理健康相關危機護理需求。它可以讓人們更輕鬆地存取熱線網絡和相關的危機資源,這與 911 的公共安全用途(其重點是根據需要派遣緊急醫療服務、消防和警察)不同。 988 是否可以處理藥物濫用危機? 任何需要自殺、心理健康和/或藥物濫用危機方面等幫助的人都可以致電此熱線。 988 熱線是免費服務嗎? 是的,熱線會以多種語言提供全天候接聽服務。988 服務還可以回覆簡訊或訊息(僅限英文)。移動運營商的標準數據速率可能適用於向此熱線發送簡訊的人員。如果在通訊需求方面需要資金援助,請造訪 以瞭解詳細資訊。任何需要心理健康相關或自殺危機幫助的人員皆可致電、發送簡訊和訊息。  每個人都可以致電此熱線嗎?  所有美國民眾都可以致電此熱線,它可以為陷入自殺危機或情緒困擾的人提供全天候的免費支持並確保私密性。988 熱線每天幫助無數人同自殺念頭和健康問題作鬥爭。 如果您或認識的人處於危機之中,請致電下方的當地危機電話號碼。全國 988 服務持續在線,請根據需要利用當地資源。  Riverside 1-800-273-TALK (951) 686-HELP (4357) 1-877-727-4747 和危機簡訊熱線:741-741 San Bernardino 24 小時危機熱線:(760) 365-6558 East Valley:(909) 421-9233 West Valley:(909) 458-9628 High Desert:(760) 956-2345 心理健康緊急照護診所 Riverside 緊急照護診所 Riverside(年滿 18 歲的成年人) 9990 County Farm Rd. Bldg. 2, Riverside, CA 92503 (951) 509-2499 Perris(年滿 13 歲的青少年及成年人) 85 Ramona Expressway, Suites 1-3, Perris, CA 92571 (951) 349-4195 San Bernardino 緊急照護診所 Victorville(免預約危機中心) 12240 Hesperia Rd., Ste.A, Victorville, CA 92395 (760) 245-8837 Yucca Valley(免預約危機中心) 7293 Dumosa Ave., Ste.2, Yucca Valley, CA 92284 (760) 365-2233 Merrill 中心 - Fontana(危機平息部門) 14677 Merrill Ave., Fontana, CA 92335 (951) 643-2340 Windsor 中心 - San Bernardino(危機平息部門) 1481 N. Windsor Dr., San Bernardino, CA 92404 (909) 361-6470 其他資源 Take My Hand,一個心理健康支持聊天熱線 Medi-Cal 心理健康服務護理熱線 1-800-499-3008

Special Programs - Major Organ Transplant (MOT)

nd Empire Health Plan (IEHP) is now responsible for coverage of the Major Organ Transplant (MOT) benefit for adult and pediatric transplant recipients and donors, including related services such as organ procurement and living donor care.   What Transplant Services are Available for Members? Autologous Islet Cell Bone Marrow Cornea Heart Heart-Lung Liver Liver-Heart Liver-Intestinal Liver -Lung Lung Kidney Kidney-Liver Kidney - Pancreas Pancreas (after Kidney)   Centers of Excellence (COE) For transplant care, IEHP has partnered with various, local, Centers of Excellence (COE). A COE is a recognized program within an existing healthcare center that provides a concentration of specialized care,  delivered in a comprehensive, interdisciplinary manner. Their focused care in distinct areas provides exceptional, integrated care that can lead to better Member outcomes.   Bone Marrow - CHLA, City of Hope, LLUMC, UCSD, USC (Norris) Heart - USC (Keck), LLUMC, Rady's Children, Sharp Memorial, UCSD Intestinal - CHLA Kidney-Pancreas - LLUMC, UCI Liver- CHLA, LLUMC, USD, USC (Keck) Lung - UCSD      You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here  

Provider Resources - Health and Wellness

and achieve health goals. IEHP’s Health & Wellness Programs help Members learn how to manage their health and make healthy lifestyle changes. You can refer your IEHP Members to these programs anytime by logging into the Secure Provider Website and completing the Health Education Program Request Form. Health Resources Kids and Teens Managing Your Illness Pregnancy and Postpartum Senior Health Weight Management Health & Wellness Brochures and Handouts Inland Empire Health Plan (IEHP) offers many Wellness Programs that focus on the health and well-being of our Members. All of our programs are free, join us at our next session and learn ways to stay healthy.  Get information on important health topics through our health education brochures and handouts: Controlling Asthma (PDF) Diabetes. What's next? (PDF) Eat Healthy, Feel Better (PDF) Fever in Children (PDF) Flu Decision Guide (PDF) Flu Shot (PDF) High Blood Pressure (PDF) Immunizations - English (PDF) Immunizations - Spanish (PDF) Immunizations - Chinese (PDF) Immunizations - Vietnamese (PDF) PAP and HPV Tests: What to Expect (PDF) Diabetes Prevention Program (DPP) - Live the Life You Love Format: Online (small group) Duration: One year Ages: 18 years and over This online year-long lifestyle change program helps you make real changes that last.  During the first 6 months, you will meet weekly with a small online group to learn how to make healthy choices into your life. In the second 6 months, you will meet monthly to practice what you have learned. No person is alike, so the program will be tailored to meet your needs and honor your customs and values. You will also be paired with a health coach for one year to help you set your goals, such as how to: Eat healthier Add physical activity into your daily life Reduce stress Improve problem-solving and coping skills Studies have shown that those who finish the program can lose weight and prevent Type 2 Diabetes. Small changes can have big results! Let's start living the best version of you and living the life you love. Find out if you qualify! Click here to visit the Skinny Gene Project online, or Call Skinny Gene Project at (909) 922- 0022, Monday - Friday 8am – 5pm., or Email For Providers DPP Rx Pad (PDF) Educational Resources 2021 Population Needs Assessment (PNA) Report IEHP’s Population Needs Assessment (PNA) identifies Member health status and behaviors, Member health education priorities, cultural/linguistics needs, health disparities, and gaps in service related to these issues. The findings of the PNA may help Providers better understand and serve our Members. For questions, please contact IEHP Health Education Department at 2021 Population Needs Assessment (PNA) Report Loving Support Program IEHP supports and sponsors the Loving Support Program that is run by Riverside University Health System (RUHS). Loving Support is a program committed to helping mothers achieve their breastfeeding goals. This service offers help and support with the first days at home, return to work, support groups, and timely answers to challenges nursing mothers face. Members can directly contact the Loving Support 24/7 Helpline at 888-451-2499. No referral is necessary. English and Spanish-speaking certified lactation specialists and Internationally Board Certified Lactation Consultants (IBCLCs) are available 24 hours a day, 7 days a week to answer questions. Messages are recorded after hours and promptly addressed. Member Education Resources The following websites are good sources of easy-to-read patient information that can be downloaded, printed, or ordered. By clicking on these links, you will be leaving the IEHP website.  RESOURCE  DESCRIPTION Medline Plus A service of the US National Library of Medicine and the National Institutes of Health. Easy to read information and audio tutorials on many health topics in English and Spanish. Topics are available in multiple languages. Food and Drug Administration - Office of Women's Health Easy-to-read handouts in English, Spanish and other languages on nutrition, diabetes, depression, and other topics related to women’s health. Learning About Diabetes, Inc. Easy to read “Handouts and Visual Aids” in color on diabetes care and nutrition to help patients eat the right foods to control blood sugar. Weight Control Information Network An extensive list of health education materials about healthy weight and physical activity in English and Spanish. Materials can be printed or ordered. Health Information Translations Easy-to-read educational handouts on many health topics and in multiple languages.   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Join Our Network - Screening & Enrollment

d by APL 19-004, all Providers currently in IEHP's network and those looking to join the network are mandated to enroll in the Medi-Cal Program. This requirement to enroll in the Medi-Cal Program applies to all IEHP Providers, including those participating through an IPA. If a Provider currently active with IEHP fails or declines to complete their enrollment in the Medi-Cal Program, IEHP will be required to terminate their participation from the network.  How to Enroll The Provider Enrollment Division (PED), a unit within the Department of Health Care Services (DHCS), is responsible for the timely enrollment of Providers into the Medi-Cal Program. PED now offers an improved web-based application via their Provider Application and Validation Enrollment (PAVE) portal. Please note the current PAVE release may not support specific Provider types or submissions from new out-of-state Providers. PAVE is being implemented in a series of releases to include Provider types and enrollment actions. Here is a current list of Provider types supported in PAVE. Provider Resources All Plan Letter 19-004 This APL supersedes 17-019, the APL mandating Providers to enroll in the Medi-Cal Program. All Plan Letter 17-019 Access the APL on DHCS's website regarding the screening and enrollment of all Providers rendering services to Medi-Cal beneficiaries.  California Health & Human Services (CHHS) Agency Open Data Portal Utilize the Open Data Portal to identify Providers who have successfully enrolled in the Medi-Cal Program through DHCS. The portal is maintained and updated by PED monthly. Frequently Asked Questions (FAQ) The document contains responses from DHCS to frequently asked questions regarding screening and enrollment requirements. Provider Resources from DHCS Access to PAVE Provider Types, PAVE 101 Training Slides, Provider Job Aides, FAQs, PAVE Support Resources Contact Information Department of Healthcare Services Attn:  Provider Enrollment Division MS4704 PO BOX 997412 Sacramento, CA 95899-7412 PED Message Center (916) 323-1945 After reaching the welcome message, please select Option 4, then Option 1 to speak with a live agent. PAVE Technical Assistance (866) 252-1949 PED Policy Assistance IEHP Provider Assistance

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 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 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.

Provider Resources - Compliance

h plan operations in compliance with ethical standards, contractual obligations under State and Federal programs, laws, and regulations applicable to Medi-Cal and IEHP DualChoice. This commitment extends to our business associates and delegated entities that support IEHP’s mission to organize and improve the delivery of quality, accessible, and wellness based healthcare services for our community.   Our Compliance Program is designed to: Ensure we comply with applicable laws, rules, and regulations Reduce or eliminate Fraud, Waste, and Abuse (FWA) Prevent, detect, and correct non-compliance Reinforce our commitment to culture of compliance for which we strive Establish and implement our shared commitment to honesty, integrity, transparency, and accountability Code of Business Conduct and Ethics Inland Empire Health Plan (IEHP) expects Team Members and business entities doing business with IEHP to conduct business activities in an ethical and professional manner that promotes public trust and confidence in the integrity of IEHP. The Code is meant to provide guidance about the compliance culture at IEHP and the role that each Team Member, including management, Chief Officers and the Governing Board, plays in building and preserving that culture. IEHP Code of Business Conduct and Ethics (PDF) Compliance, Fraud, Waste, and Abuse (FWA), and Privacy Program Training The IEHP Compliance, FWA, and Privacy Training Program focuses on the elements of an effective Compliance Program, conduct & ethics, and the Fraud, Waste and Abuse and Privacy Programs. IEHP requires delegated entities to provide Compliance Training to their employees, Providers, downstream entities, Board of Directors, and Contractors within 90 days of hire/start, and annually thereafter. IEHP is committed to a culture of compliance, ethics, and integrity. The goal of Compliance Training is to provide all associated parties the ability to demonstrate awareness of IEHP’s requirements, including regulations and policies & procedures associated with Compliance as it relates to daily work. If you have questions or additional suggestions, please e-mail the IEHP Compliance Department at Compliance Training FWA HIPAA Privacy and Security (PDF) Eligibility to Participate in Federal and State Health Care Programs Inland Empire Health Plan (IEHP) is prohibited from issuing payment for services provided, ordered, or prescribed by an individual or entity that is excluded, ineligible, or terminated from participation in State and Federal health care programs in accordance with regulatory and contractual requirements. IEHP conducts regular reviews of Federal and State exclusionary databases and lists, including but not limited to: Office of Inspector General (OIG) List of Excluded Individuals and Entities (LEIE list) GSA Excluded Parties List System (EPLS) DHCS Medi-Cal Suspended and Ineligible Provider List CMS Preclusion List Restricted Provider Database (RPD) Exclusion Screening IEHP has implemented a screening process to identify individuals and entities that appear on the DHHS OIG LEIE, the GSA EPLS, the CMS Preclusion List and the DHCS Medi-Cal Suspended and Ineligible Provider List prior to appointment, contracting, and/or employment and monthly thereafter to ensure that none of these individuals or entities are excluded, ineligible or terminated from participation in State and Federal health care programs. Delegated entities must implement a screening program for employees, Board Members, contractors, and business partners to avoid relationships with individuals and/or entities that tend toward inappropriate conduct. This program includes but is not limited to: Prior to contract and monthly thereafter, review of the GSA System for Award Management (SAM), the Department of Health Care Services Medi-Cal Suspended and Ineligible list, and the Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) that are excluded from participation in government health care programs (42 CFR §10011901). A monthly review of the Department of Health Care Services Medi-Cal Suspended and Ineligible list. Criminal record checks when appropriate or as required by law. Review of the National Practitioner Databank (NPDB). Review of professional license status for sanctions and/or adverse actions. Reporting results to Compliance Committee, Governing Body, and IEHP as necessary. Fraud, Waste, and Abuse (FWA) IEHP has established a Fraud, Waste, and Abuse Program to detect, correct, and prevent fraud, waste, and abuse on part of Team Members, IEHP Members, Providers, Vendors, delegated entities and any other entity doing business with IEHP. Fraud Prevention Fraud Prevention, it’s a Team Effort In an effort to prevent fraud and abuse, IEHP encourages Providers and their staff to report any suspicious circumstances when they arise. You may want to ask for another form of identification in addition to the IEHP Member identification card. Identification with both a picture and a signature, such as a valid driver’s license or State identification card, are suggested. We are informing Members of this concern and are requesting that they have additional identification available when they come to you. To obtain more compliance guidelines, the Department of Health and Human Services (HHS) offers assistance (by clicking on this link you will be leaving the IEHP website). Fraud is knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program, or to obtain, by means of false or fraudulent pretenses, representations, or promises, any of the money or property owned by, or under the custody or control of, any health care benefit program. Examples include: Knowingly billing for services or prescriptions not furnished or supplies not provided Knowingly altering claim forms for a higher payment Selling medicine, medical equipment, or other things received through IEHP Waste includes overuse of services, or other practices that, directly or indirectly, result in unnecessary costs. Waste is generally not considered to be caused by criminally negligent actions but rather by the misuse of resources. Examples include: Conducting excessive office visits Writing excessive prescriptions or ordering excessive tests Prescribing more medications than necessary for the treatment of a specific condition Abuse includes actions that may, directly or indirectly, result in unnecessary costs and improper payment or services. Abuse involves payment for items or services when there is no legal entitlement to that payment and the provider has not knowingly and/or intentionally misrepresented facts to obtain payment. Examples include: Billing for unnecessary medical services or medical equipment Billing for brand name drugs when generics are dispensed Misusing codes on a claim, such as upcoding and unbundling codes. Report potential FWA Click Here (By clicking on this link, you will be leaving the IEHP website). Privacy Incident/Breach IEHP has established a HIPAA Privacy Program to ensure that Member’s health information is properly protected while allowing the flow of health information needed to provide and promote high-quality health care. A privacy breach is defined as unauthorized acquisition, access, use, or disclosure of protected health information (PHI) which compromises the security or privacy of such information. PHI is health information that relates to a Member’s past, present or future physical or mental health or condition, including the provision of his/her health care, or payment for that care and contains personally identifiable information (PII) such as name, SSN, DOB, Member ID, address, or any other unique identifier related to the Member. This generally means that a breach occurs when PHI is accessed, used, or disclosed to an individual or entity that does not have a business reason to know that information. The law does allow information to be accessed, used, or disclosed when it is related to treatment, payment, or healthcare operations directly associated with the work that we do at IEHP on behalf of our Members. Report a Privacy Incident/Breach Click Here (By clicking on this link, you will be leaving the IEHP website). Reporting Information IEHP has the following resources available for reporting fraud, waste or abuse, privacy issues, and other compliance issues: Compliance Hotline: (866) 355-9038 Fax: (909) 477-8536 E-mail: Mail: IEHP Compliance Officer P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Online: (By clicking on this link, you will be leaving the IEHP website) Report a Compliance Issue: Click Here Report a Privacy Incident/Breach: Click Here Report potential FWA: Click Here Frequently Asked Questions (FAQs) What are some common examples of fraud? Providers Billing for services not rendered Paying a "kickback" in exchange for a referral for medical services or goods Unbundling Overcharging for services or goods  Using false credentials Members Allowing unauthorized individuals to use ID card to obtain benefits Altering prescriptions Falsifying residence information to obtain benefits Drug seeking or doctor shopping to obtain narcotics What do I do if I suspect an IEHP Member is engaging in possible fraud, waste, or abuse? First, document your suspicions. Then, contact IEHP’s Compliance Department at (866) 355-9038 and make a report with one of our Representatives. At times, IEHP may request additional information that is necessary to investigate. IEHP also has the following resources available for reporting fraud, waste or abuse, privacy issues, and other compliance issues: Compliance Hotline: (866) 355-9038 Fax: (909) 477-8536 E-mail: Mail: IEHP Compliance Officer P.O. Box 1800 Rancho Cucamonga, CA 91729-1800 Online: (By clicking on the following links, you will be leaving the IEHP website) Report a Compliance Issue Click Here Report a Privacy Incident/Breach Click Here Report potential FWA Click Here What do I do if my facility has made some billing errors? If you suspect that errors in billing may have occurred, contact your IEHP Provider Services Representative at (909) 890-2054. What are some other things I can do as a Provider? Periodically perform internal audits of billing practices and compare billing records with payments received. Do not leave prescription pads, which include a Provider's identification and license number, out in the open. For example, do not store prescription pads in exam room cabinets or leave on office counters. IEHP DualChoice (HMO D-SNP) Model of Care Training The Centers for Medicare & Medicaid Services (CMS), the Department of Health Care Services (DHCS) and the National Committee for Quality Assurance (NCQA) require that IEHP staff and contracted consultants/vendors, our Medicare IPAs, Hospitals/SNFs, and Providers, receive training on the Plan’s Model of Care for our D-SNP Members: Interdisciplinary Care Team (ICT) Fact Sheet (PDF) IEHP DualChoice (HMO D-SNP) Model of Care Training (PDF) IEHP DualChoice (HMO D-SNP) Model of Care Training (HTML)   *We recommend opening file in: Mozilla Firefox, MS Edge or MS Internet Explorer Contact the OIG The Office of the Inspector General (OIG) is there to assist you and maintains a hotline, which offers a confidential means for reporting vital information. For information on confidentiality, please contact the hotline and ask about their confidential source program. Each caller is encouraged to assist the OIG by providing information on how they can be contacted for additional information but the caller may remain anonymous. Contacting the Office of the Inspector General Phone: (800) HHS-TIPS (447-8477) E-mail: Additional Hotlines DHCS Medi-Cal Fraud Hotline Phone: (800) 822-6222 E-mail: Web:  The recorded message may be heard in English and 10 other languages: Spanish, Vietnamese, Cantonese, Armenian, Hmong, Cambodian, Laotian, Farsi, Korean and Russian. The call is free and the caller may remain anonymous.    You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

IEHP DualChoice - IEHP DualChoice

計畫,讓您透過我們的計畫取得承保的 Medicare 和 Medi-Cal 福利。 我們的計畫包括醫師、醫院、藥局、長期服務與支援提供者、行為健康服務提供者與其他提供者。該計畫還設有照護協調人員與照護團隊,可協助您管理所有提供者與服務。他們會合作為您提供所需的照護。 IEHP DualChoice (HMO D-SNP) 有助於讓您的 Medicare 和 Medi-Cal 福利配合運作更順利,為您提供更好的服務。其中一些優點包括: 您可以透過與我們合作,滿足您所有的醫療保健需求。 您擁有一個由您協助建構的照護團隊。您的照護團隊可包括您自身、您的護理人員、醫師、護士、顧問或其他健康專業人員。 您可以聯繫照護協調員。照護協調員與您、我們的計畫以及您的照護團隊共同協助制定護理計畫。 您的照護團隊和照護協調員與您一起制定護理計畫,以滿足您的健康需求。照護團隊幫助協調您所需的服務。舉例來說,這表示您的護理團隊會確保: 您的醫師知悉您服用的所有藥物,因此他們可以確保您服用正確的藥物,並得以減少您可能因藥物而產生的任何副作用。 視情況而定,將與您全部的醫師和其他提供者共享您的檢驗結果。  哪些人符合 IEHP DualChoice 的資格? IEHP DualChoice 同時適用 Medicare (A 與 B 部分) 與 Medi-Cal 會員。下列資訊說明哪些人符合 IEHP DualChoice (HMO D-SNP) 的資格。 包含對象: 強制投保 Medi-Cal 福利,包括長期服務與支援 (LTSS) 福利,以及 Medicare 福利。  若您符合下列條件,則您可以加入我們的計畫: 居住在我們的服務區域內(被監禁者即使實際位於該地理服務區域,也不被視為居住於該服務區域),以及 投保時年滿 21 歲,且  擁有 Medicare A 部分和 Medicare B 部分;且 目前符合獲得 Medi-Cal 的資格,且  您是全福利的雙重合格受益人,並且為您的 Medicare 福利投保 IEHP DualChoice,為您的 Medi-Cal 福利投保 Inland Empire Health Plan (IEHP)。 這被稱為獨家一致投保 (Exclusively Aligned Enrollment),且 為美國公民或在美國合法居留 服務區域  只有居住在我們服務區域的民眾才能加入 IEHP DualChoice。我們的服務區域包括河濱郡與聖貝納迪諾郡所有地區。  如何投保 如需投保,請致電聯繫: 請於太平洋標準時間每天上午 8 點至晚上 8 點致電 (800) 741-IEHP (4347) 聯繫 IEHP DualChoice Medicare 團隊,假日亦提供服務;TTY 使用者請撥 (800) 718-4347 造訪我們的投保頁面以瞭解更多資訊。  IEHP DualChoice 是與 Medicare 簽約的 HMO 計畫,投保 IEHP DualChoice (HMO D-SNP) 取決於合約續訂。 此頁面資訊為截至 2022 年 10 月 1 日的最新資訊。 H8894_DSNP_23_3241532_M Pending Accepted

創新和品質績效 - 我們致力於創新

護的近用以及會員、提供者、社區為第一優先。  提供者招募 IEHP 創新的網路擴展基金 (NEF) 是加州同類型計畫的先驅。成立於 2014 年的 NEF 自特別指定基金中提撥了 3,000 萬美元,以吸引專科認證的初級照護提供者、專科醫師、中階提供者至內陸帝國地區,因應此地區長期缺少提供者的情況,並且為超過 120 萬名 IEHP 會員改善照護近用。至今,本計畫的直接成果之一是招募了超過 280 個提供者。 行為健康整合複合式照護計畫 行為健康整合複合式照護計畫 (BHICCI) 是一項 2019 年 1 月 1 日開始的合作計畫,參與者為 IEHP 以及內陸帝國地區中替加州醫療保健服務部 (California Department of Health Care Services, DHCS) 的健康之家計畫提供服務據點的 30 多間診所。該計畫旨在改善會員的健康狀況,方法是組織提供全面照護管理的複合式照護團隊,以及在河濱郡與聖貝納迪諾郡的多個提供者與健康照護系統之間協調複雜的生理與行為健康需求。BHICCI 照護團隊目前正在轉型為提供健康之家服務的社區照護管理實體 (community-based care management entity, CB-CME),為健康之家上線做準備。 健康之家計畫 健康之家計畫 (HHP) 是以擁有複雜需求的病患為對象的綜合照護管理計畫,基礎為 IEHP 的行為健康整合複合式照護計畫 (BHICCI),依照醫療保健服務部 (DHCS) 的立法進行。HHP 會協助擁有嚴重慢性生理與/或心理健康問題的會員,協調生理、行為、社區上的長期服務與支援 (Long-Term Services and Supports, LTSS) 需求。HHP 的主要目標是透過照護協調與複合式照護管理,改善會員的整體健康狀況。自從計畫於 2019 年 1 月啟動以來,已有超過 9,000 名會員在血壓、糖尿病、憂鬱的相關臨床健康狀況上獲得極為正向的結果。按一下這裡進一步瞭解健康之家計畫。  EHR 與健康資訊交換所 IEHP 與聖貝納迪諾郡醫學會 (San Bernardino County Medical Society) 及河濱郡醫學會 (Riverside County Medical Association) 合作,組建了 Inland Empire EHR 資源中心,在選擇及採用電子病歷系統方面協助提供者與診所。此外,IEHP 也是 Inland Empire 健康資訊交換所的一部分,日前已與 CalIndex 健康資訊交換所合併為 Manifest Medex (MX)。MX 是涵蓋加州的健康資訊交換所,在內陸帝國地區的普及率及使用率顯著,透過所有的內陸帝國急症照護醫院與許多醫療團體及醫師提供病患的臨床資料與管理資料。MX 為存取及安全分享病患的電子病歷提供必要技術,造福內陸帝國 440 萬名居民中的絕大多數人。MX 讓醫師、診所、醫院、其他健康照護提供者能用電子方式檢查及存取醫療記錄,為我們社區中的病患提供及時且高品質的健康照護。 線上醫師 (DocOnline) 這項創新計畫為會員提供了另一個選擇,能在下班時間取得醫師的醫療建議。IEHP 會員能透過電話或視訊聊天,輕鬆快速地與專科認證醫師通話。醫師可以存取 IEHP 處方集與 IEHP 網路內藥局,在需要時為 IEHP 會員以電子方式開立處方藥。全面實施之後,本服務將提升會員的近用性與便利性,同時減少不必要的急診室或緊急照護就醫次數。 遠程醫療 IEHP 支持在內陸帝國地區拓展遠程醫療服務,促進有迫切需要的專科照護之近用,在快速診斷及治療方面提供協助。遠程醫療能消除內陸帝國長期存在的一項照護障礙 – 取得健康照護資源的地理距離。有了遠程醫療的資源通訊技術,就能遠程推動疾病或傷害的治療及預防,消除地理距離這項阻礙照護的重大因素。遠程醫療也能用來協助訓練提供者及教育會員。IEHP 目前支援以下特定服務的遠程醫療:行為健康、視網膜檢查、皮膚科、骨科諮詢。未來還將推出多項計畫,根據會員需求拓展至其他服務。 電子諮詢 (eConsult) 電子諮詢是 IEHP、Arrowhead Regional Medical Center、河濱大學保健系統之間的合作計畫,讓 PCP 在病患可能需要專科醫師轉介時,能以電子方式直接聯繫專科醫師。透過隱密安全的系統,PCP 能及時取得專科醫師的臨床建議,得以在初級照護環境中管理大多數病患 (某些病患可能需要親自前往專科醫師處就診)。IEHP 目前為該計畫前 24 個月提供贊助,未來將在河濱郡與聖貝納迪諾郡超過 70 處診所設計、實施、評估電子諮詢。 安全線上會員入口網站與應用程式 IEHP 會員可以在全天候管理自身健康方面扮演積極角色,方法是使用透過 IEHP 網站或行動應用程式存取的安全線上帳戶。會員可以檢視及列印自己的 IEHP 會員卡;檢視檢測內容、疫苗接種卡與授權書;尋找或變更醫師;搜尋提供者目錄;參加健康教育課程;確認資格;以及更多服務。獨立的 Baby-N-Me 產前護理應用程式有助改善孕期的健康狀況,讓孕婦更容易追蹤孕期里程碑,辨識健康問題,利用提醒與有用工具保持健康。 簡訊發送與警示 IEHP 採用雙向簡訊發送與簡訊服務 (SMS) 警示,向會員說明計畫福利以及健康照護系統的操作方式。這些具有針對性的警示會傳達季節性的健康資訊,涵蓋疫苗接種、預防性照護、服藥遵從性、新健康計畫的特色等主題。 長期護理服務與支援 (LTSS) IEHP 長期護理服務與支援 (LTSS) 計畫讓老年人及殘障人士得以在家中以安全可行的方式長時間獨立生活,無法獨立生活時則提供專業護理機構 (SNF) 照護。LTSS 包括 Multipurpose Senior Services Program (MSSP) 與社區成人服務 (CBAS),以及必要時的 SNF 服務。IEHP 也會幫助協調任何居家支援服務 (IHSS) 的福利。2018 年 5 月以來,IEHP 已幫助 750 名會員轉離長期照護機構,返回社區。與河濱郡社會服務部合作制定的 24 小時居家緊急照護者計畫及個案管理計畫獲得了全國郡縣協會 (National Association of Counties) 頒發的 2017 年與 2018 年成就獎。IEHP 還與加州大學洛杉磯分校合作投入 Geriatric Workforce Enhancement Program,提供病患、家屬、照護者需要的知識與技能,改善健康狀況並提升老年人的照護品質。   

COVID-19 - 檢測地點

檢測以治療」站點完成。  如果您的醫療狀況使您更有可能因 COVID-19 加重病情,您可能有資格接受治療。 成人和年滿 12 歲的兒童可以接受治療,但必須在出現症狀後 5 天內盡快開始治療。 按一下此處以進一步瞭解 COVID-19「檢測以治療」計畫的相關資訊。  免費的居家 COVID-19 檢測 美國境內的每個家庭都有資格訂購一個免費的 COVID-19 檢測試劑盒,其中包括四個居家檢測試劑。這些檢測完全免費。按一下此處以訂購由美國郵政管理局 (United States Postal Service, USPS) 提供的免費居家檢測。  自 2022 年 2 月 1 日起,Medi-Cal 會員可接受 Medi-Cal 網絡內藥局提供的居家 COVID-19 檢測服務。加州衛生保健服務局 (California Department of Health Care Services, DHCS) 每月可為每名會員報銷最多 8 份檢測試劑盒。如需瞭解哪些檢測試劑盒在承保範圍內,或者如果您需要處方相關協助,請諮詢您的醫生或您的藥劑師。 如果 Medi-Cal 會員在 2021 年 3 月 11 日至 2022 年 1 月 31 日期間購買居家檢測試劑盒,則可以透過此處列出的程序由 DHCS 報銷費用(須提供收據)。 San Bernardino 郡支援的檢測點將為在 San Bernardino 郡生活、工作或上學的人士提供免費的居家 COVID-19 檢測試劑盒(需要提供居住或就業證明)。按一下此處以尋找郡級協助檢測點的清單。 檢測 如果您認為您有感染 COVID-19 的風險,您可以在以下地點進行 COVID-19 篩檢與檢測。   IEHP 會承保提供者安排進行的檢測,包括 PCR、快速檢測、居家檢測等。如果您的醫生為您安排檢測,IEHP 將承擔檢測費用。您的提供者需要為這些檢測直接向 IEHP 請款。  如會員選擇支付並非由提供者要求進行的 COVID 檢測,IEHP 不會予以報銷。  Riverside 郡 COVID-19 檢測點 Banning Banning Family Care Center 3055 W. Ramsey, Banning 預約 Beaumont Beaumont Women's Club 306 E 6th St., Beaumont, 92223 致電 (888) 634-1123 預約 Borrego Health 多個地點可供選擇 按一下此處以瞭解有關您所在區域 COVID-19 檢測點的資訊。 Cathedral 市 Plaza Rio Vista Kiosk 67908 Vista Chino, Cathedral City 預約 Coachella Our Lady of Soledad 52525 Oasis Palm Ave., Coachella 預約 Coachella TODEC Legal Center COVID 檢測點 1560 6th St., Coachella 預約 Corona Corona Community Health Center 2813 S. Main St., Corona 預約 Corona Unicare Community Health Center 107 N. MicKinley St., Corona 電話 (909) 457-3603 CVS MinuteClinic 多個地點可供選擇* 預約 服務時間因地點而異 Desert Hot Springs Henry V. Lozano Community Center 12800 West Arroyo, Desert Hot Springs 預約 Indio Indio Fleet Services 82775 Plaza Ave., Indio 預約 Indio Old Amistad High School 44801 Golf Center Pkwy, Indio 預約 Jurupa Avalon Park Community Center 2500 Avalon St., Jurupa 預約 La Quinta La Quinta Wellness Center 78450 Avenida La Fonda, La Quinta 預約 Lake Elsinore Outlets at Lake Elsinore 檢測點 17600 Collier Ave., Suite J-195 Parking Lot, Lake Elsinore 預約 Moreno Valley Moreno Valley Family Care Center 23520 Cactus Ave., Moreno Valley 預約 Moreno Valley Cottonwood Golf Center 13671 Frederick St., Moreno Valley 預約 Moreno Valley Moreno Valley 檢測亭 14075 Frederick St., Moreno Valley 週一至週五上午 10:00 至下午 6:30 預約 Moreno Valley Riverside University Health System Medical Center 26520 Cactus Ave., Moreno Valley 週一至週五上午 10:00 至下午 6:30 預約 Murrieta California Oaks Center Trailer 40565 California Oaks Rd., Murrieta 預約 Palm Desert UCR Palm Desert Campus 75080 Frank Sinatra Dr., Palm Desert 預約 Palm Springs Palm Springs Convention Center 277 N. Avenida Caballeros, Palm Springs 預約 Perris Perris' City Council Chamber 101 N D St., Perris 預約 Perris Perris Community Health Center 308 E. San Jacinto Ave., Perris 預約 Perris Rapid Care Enterprises 126 Avocado Ave.Ste 102, Perris 致電 (951) 490-4910 週一至週五 | 上午 9:00 至晚上 9:00 週六至週日 | 中午 12:00 至下午 5:00 此站點可能會產生費用 Rite Aid Pharmacy 多個地點可供選擇* 預約 週一至週五 | 上午 10:00 至晚上 8:00 週六至週日 | 上午 10:00 至下午 5:00 Riverside Jurupa Valley Family Care Center 8876 Mission Blvd., Riverside 預約 Riverside Riverside City Hall 檢測亭(僅可檢測) 3900 Main St., Riverside 預約 Riverside Riverside Neighborhood Health Clinic 7140 Indiana Ave., Riverside 預約 Riverside La Sierra Park 免下車檢測點(僅可檢測) 5272 Mitchell Ave., Riverside 預約 Temecula Vail Ranch Center 檢測亭 31699 Temecula Pkwy., Temecula 預約 如需更多有關 Riverside 郡 COVID-19 檢測點的資訊,請造訪 Riverside 郡公共衛生處 網站。 San Bernardino 郡 COVID-19 檢測點 Adelanto Adelanto Health Center 11336 Bartlett Ave., Ste.11, Adelanto 電話 (800) 722-4777 Apple Valley James A. Woody Community Center 13467 Navajo Rd., Apple Valley 預約 Barstow Barstow Adult School 720 E. Main St., Barstow 預約 Big Bear Big Bear Health Center 477 Summit Blvd., Big Bear Lake 預約 Barstow Barstow Health Center 303 E. Mountain View St., Barstow 電話 (800) 722-4777 Bloomington Kessler Park COVID-19 檢測巴士 18401 Jurupa Ave., Bloomington 預約 Borrego Health 多個地點可供選擇 按一下此處以瞭解有關您所在區域 COVID-19 檢測點的資訊。 Chino CVUSD Chino Valley Adult School 12970 3rd St., Chino 預約 Chino Lani City Medical 4036 Grand Ave., Suite A, Chino (909) 465-5000 預約 Colton Arrowhead Regional Medical Center 400 N. Pepper Ave., Colton 電話 (855) 422-8029 Colton Colton Urgent Care Center 1181 N. Mt. Vernon Ave., Colton Colton Urgent Care Center 線上登記 Colton Gonzales Community Center 670 Colton Ave., Colton 預約 Colton Unicare Community Health Center 308 N. La Cadena Dr., Colton 致電 (909) 457-3603 CVS 多個地點可供選擇 預約 Fontana Jessie Turner Health & Fitness Community Center 15556 Summit Ave., Fontana 預約 Fontana West Point Medical Center 7774 Cherry Ave., Fontana 致電 (909) 355-1296,按 1 Hesperia Hesperia Health Center 16453 Bear Valley Rd., Hesperia 致電 (800) 722-4777 Joshua Tree Community Center 6171 Sunburst St., Joshua Tree 預約 Loma Linda Loma Linda Senior Center 25571 Barton Rd., Loma Linda 預約 Montclair Montclair Kid's Station - COVID 檢測巴士 4985 Richton St., Montclair 預約 Montclair Montclair Place - Moreno St. Market Food Court 5060 N. Montclair Plaza Ln., 2nd Floor, Ste.2138 預約 Ontario 免下車 COVID 診所 2500 E. Airport Dr., Ontario 預約 Ontario 免下車 COVID 檢測診所 1 Mills Circle, Ontario 預約 Ontario Ontario Health Center 150 E. Holt Blvd., Ontario 致電 (800) 722-4777 Ontario Parktree Community Health Center 2680 E. Riverside Dr., Ontario 致電 (909) 630-7927 Ontario Unicare Community Health Center 437 N. Euclid Ave., Ontario 致電 (909) 988-2555 Rancho Cucamonga Lani City Medical 1398 Kenyon Way, Suite J, Rancho Cucamonga (909) 727-3911 預約 Rancho Cucamonga RC Family Resource Center 9791 Arrow Rte., Rancho Cucamonga 預約 Rancho Cucamonga Terra Vista Town Center - 劇院停車場 COVID 檢測巴士 10701 Town Center Dr., Rancho Cucamonga 預約 Rancho Cucamonga West Point Medical Center 8520 Archibald Ave., St B., Rancho Cucamonga 致電 (909) 481-3909,按 1 Redlands Redlands Urgent Care Center 301 W. Redlands Blvd., Redlands Redlands Urgent Care Center 線上登記 Rialto Carl Johnson Center 214 N. Palm Ave., Rialto 預約 Rite-Aid Pharmacy 多個地點可供選擇 預約 San Bernardino Court Street Square 349 N East St., San Bernardino 活動日期:5 月 3 日、17 日及 31 日 預約 San Bernardino 公共衛生部 COVID-19 檢測巴士 172 W. 3rd St., San Bernardino 預約 San Bernardino 免下車 COVID 檢測診所 500 Inland Center Dr, San Bernardino 預約 San Bernardino Premier Urgent Care Centers of California 284 E. Highland Ave., San Bernardino 每日 | 上午 9:00 至晚上 9:00 San Bernardino SAC Health System 250 S. G St., San Bernardino 電話 (909) 771-2911 週二/週三/週五 | 下午 3:00 至下午 5:00 San Bernardino San Bernardino Health Center 606 E. Mill St., San Bernardino 電話 (800) 722-4777 San Bernardino West Point Medical Center 1800 Medical Center Dr., St. 99, San Bernardino 致電 (909) 880-6400,按 1 Twentynine Palms Twentynine Palms - Patriotic Hall 5885 Luckie Ave., Twentynine Palms 預約 Upland Advanced Medical & Urgent Care Center 974 W. Foothill., Upland 致電 (909) 981-2273 週一至週五 | 上午 8:00 至下午 2:30 Upland Landecena Community Building 1325 San Bernardino Rd., Upland 預約 Victorville 免下車 COVID 檢測診所 14400 Bear Valley Dr., Victorville 預約 Victorville Green Tree Golf Course 宴會廳 14144 Green Tree Blvd., Victorville 預約 Victorville Victor Valley College 65 Mojave Fish Hatchery Rd., Victorville 位於 Construction Technology Building 65 後方的貨櫃屋 預約 Walgreens 多個地點可供選擇 預約 Yucaipa 7th Street Pool 12385 7th St., Yucaipa 預約 Yucca Valley Yucca Valley Community Center COVID-19 檢測巴士 57090 Twentynine Palms Highway, Yucca Valley 預約 Yucaipa Yucaipa Urgent Care Center 33494 Oak Glen Rd., Yucaipa Yucaipa Urgent Care Center 線上登記 如需更多有關 San Bernardino 郡 COVID-19 檢測點的資訊,請造訪 San Bernardino 郡 COVID-19 檢測點。

CalAIM - Pay for Performance (P4P)

th Care Services (DHCS), California Advancing and Innovating Medi‐Cal (CalAIM) is a long‐term commitment to transform and strengthen Medi‐Cal, offering Californians a more equitable, coordinated, and person‐centered approach to maximizing their health and life trajectory.1 DHCS Goals For CalAIM 2 Identify and manage comprehensive needs through whole person care approaches and social drivers of health. Improve quality outcomes, reduce health disparities, and transform the delivery system through value-based initiatives, modernization, and payment reform. Make Medi‐Cal a more consistent and seamless system for enrollees to navigate by reducing complexity and increasing flexibility. Resource Links DHCS CalAIM page DHCS CalAIM Transformation Infographic (PDF) DHCS Medi-Cal Alignment Primer (PDF) IEHP Enhanced Care Management IEHP Enhanced Care Management (Member Page) IEHP Community Support Services IEHP Community Support Services (Member Page)   1,2 You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Medicare DSNP Formulary Search Tool - IEHP DualChoice (HMO D-SNP) Formulary Search Tool

h Plan by searching for the exact name of the medication or by browsing our formulary database. You can also view the IEHP Medicare Formulary (PDF)  Additional resources to help you understand drug coverage information are available via your desktop at or download the free mobile app from or, If the prescription is not in IEHP's Formulary, providers may print and submit a new Prescription Drug Prior Authorization (Rx PA) Request Form or submit the Prescription Drug Prior Authorization Online.

Pharmacy Services - Pharmacy Quality Ratings

ated to help IEHP Members to find high-quality local pharmacies for your pharmacy services. This searchable system will display the rating of each participating pharmacy. The ratings range from 1 to 5 stars (with 1 being the lowest and 5 being the highest). What does the rating scale mean? The rating is on a scale of 1 to 5 stars (with 1 being the lowest and 5 being the highest).    Star Ratings Performance Description 1 Star Well below average 2 Stars Below average 3 Stars Average 4 Stars Good 5 Stars Exceptional No Star No information is available for this pharmacy Please keep in mind that Pharmacy Quality Star Rating is currently under development and may not reflect the most recent ratings of your Pharmacy at this time. IEHP Pharmacy Quality Rating is visible with IEHP "Find a Doctor, Urgent Care, or Pharmacy" webpage (select “Pharmacies” and put in your zip code or city, then hit “Find”). The quality rating information is displayed on the right side of each pharmacy. Information on this page is current as of January 1, 2022      

Pharmacy Services - Provider Communications

otices from most recent P&T Formulary changes to current PER processing changes, and even CME event invitations.  The published notifications are grouped respectively for: Provider Communication - Pharmacy Provider Communication - Physician