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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 MemberServices@iehp.org。 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 MemberServices@iehp.org。 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 ProviderServices@iehp.org。 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： Human_Resources@iehp.org。 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：legal@iehp.org 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 press@iehp.org 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

獲得最佳照護和充滿活力，IEHP 會竭盡所能。結合州 Medi-Cal，您可以獲得當地數千位醫生的服務，以滿足您的醫療、牙科和視力需求。 請立即致電我們，以詳細瞭解 IEHP 和 Medi-Cal。 河濱郡的醫療服務 未投保的美國人在需要醫療保健時不太可能會主動尋求服務，而這可能會加劇已有的醫療問題。透過選擇 IEHP 並結合 Medi-Cal，您將獲得保護自己的健康和全家人健康的機會。 低收入或無收入不再是獲取優質醫療保健的阻礙。透過由 IEHP 管理的 Medi-Cal，享受您理應獲得的承保服務。 周全的醫療服務 Medi-Cal 不僅僅承保基礎醫療服務，例如門診服務、安寧照護、急診服務和住院治療。利用 IEHP 和 Medi-Cal 承保服務，會員還可以獲得： 戒癮治療 兒科照護 新生兒照護 跨性別支援服務 放射線治療承保服務 實驗室檢驗服務 透過 IEHP，您可以獲得網絡內 8,000 多名醫生和專家的服務。 請立即致電 IEHP，以瞭解 IEHP 會員享受的福利，以及申請 Medi-Cal 的方式。 視力服務 視力低下會影響生活品質。投保 IEHP 和 Medi-Cal 計畫後，獲取所需照護會變得輕而易舉。成為 IEHP 計畫會員後，您每 24 個月便能免費進行一次視力檢查，如果在醫療上具有必要性（例如對於糖尿病患者），額外或更頻繁的眼部檢查也在承保範圍內。如果您獲得有效處方，您還能每 24 個月就獲得一副眼鏡（包含鏡框和鏡片）。  如果因為眼部疾病或醫療狀況（例如喪失一隻耳朵）而無法佩戴眼鏡，則隱形眼鏡檢查和隱形眼鏡可能也在承保範圍內。 透過河濱郡 Medi-Cal 獲取牙科服務 Medi-Cal（透過 Medi-Cal 牙科計畫）承保部分牙科服務，包括： 診斷和預防性牙科衛生（例如檢查、X 射線治療和牙齒清潔） 為止痛而提供的緊急服務 拔牙 根管治療（前／後） 刮牙術與牙周整平 牙冠（預製／實驗室製作） 符合條件的兒童齒顎矯正 全口義齒或部分義齒 局部塗氟 牙科照護與醫療照護同樣重要。如果您對於牙科服務有疑問或想瞭解更多資訊，請撥打 Medi-Cal 牙科計畫電話：1-800-322-6384（TTY 使用者請撥 1-800-735-2922 或 711）。您還可以造訪 Medi-Cal 牙科計畫網站：https://www.dental.dhcs.ca.gov 或 https://smilecalifornia.org/。 申請河濱郡的 Medi-Cal IEHP 治愈疾病和鼓舞心靈的使命之所以能夠實現，是因為其設立了一個願景 — 為了讓社區獲得最佳照護和充滿活力而竭盡所能。   每個人都應該獲得醫療保健，而且現在比以往都更容易獲得承保服務。 如何申請河濱郡的 Medi-Cal 申請 Medi-Cal 的方式有多種，其中包括： 致電 IEHP 於週一至週五上午 8 點至下午 5 點撥打 1-866-294-4347。TTY 使用者請撥 1-800-720-4347。您將與 IEHP 友善的雙語投保顧問進行交流。 郵寄 您可以將填妥並簽名的申請表郵寄至：   Covered California P.O.Box 989725 West Sacramento, CA 95798-9725 或郵寄至河濱郡 Medi-Cal 辦公室。 現場申請 按一下此處以查找河濱郡 Medi-Cal 辦公室的地點。 線上申請 按一下此處以在線上申請。   立即獲得健康承保服務 成為 IEHP 計畫會員，享受一流的加州醫療保險服務。在超過 25 年的時間裡，IEHP 為辛勤工作的市民及其家人提供服務並以此為傲。立即加入 IEHP，讓您的健康成為我們的重心。  

「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

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 www.fcc.gov/lifeline-consumers 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

參加時，您可能會收到不同的醫療保健通知，例如透過 IEHP 獲得護理的方式、重要的健康提醒，另外還將通知您有關健康教育和健康計畫的資訊 。短信頻率會有所不同。 本條款與條件有可能變更。 IEHP 保留隨時更新或修改本條款與條件的權利。 IEHP 或其服務提供者可自行決定因為任何原因終止、調整或暫停任何使用者使用本服務或本服務的任何一部分。 您亦可隨時終止或暫停服務，只需要您發送簡訊「STOP」至 90902 或發送電子郵件至 texthelp@iehp.org 以取消訂閱。如需協助，請發送簡訊 HELP 至 90902，也可致電 1-800-440-4347 聯絡 IEHP 會員服務中心 (IEHP Member Services)。 您必須至少年滿 13 歲，方符合使用本服務之資格。不過，如果您至少年滿 13 歲但未滿 18 歲，您可以在獲得家長或監護人事前准許的情況下使用本服務，而且只有在此情況下才能使用本服務。任何情況下，未滿 13 歲者皆不得使用本服務。  IEHP 不會因為本服務收費，不過可能會收取簡訊費用和資料費用。例如，您的呼叫器或行動電話的服務提供者可能會向您收取接收無線簡訊的費用。IEHP 及其承包商皆不對使用本服務的任何相關費用負責。 您同意您負責支付您的電信業者費用以使用本服務，或是如果您未滿 18 歲，您同意您已獲得負責支付電信業者費用的成年人准許，可使用本服務。運營商對延遲或未送達的訊息不承擔任何責任。 IEHP「依原樣」提供本服務，沒有任何形式的保證。IEHP 明確聲明不對本服務做任何明示或暗示的保證，包括對適售性、特定用途的適用性、不侵權的任何暗示保證，或是對服務一定安全、不受中斷或沒有錯誤、病毒或其他有害成分做任何保證。* 某些州不允許暗示保證的免責聲明，因此以上免責聲明對您可能不適用。 任何情況下，IEHP 或其員工、主管或董事皆不對您因為使用本服務而產生或是與使用本服務相關的任何間接、偶然、衍生性質、特殊或懲罰性質的損害負責，不論 IEHP 是否被告知上述損害的可能性。 如果您對本服務或任何 IEHP 網站上的任何內容不滿意，或對本條款與條件不滿意，您唯一的救濟方式是中止使用本服務。您若使用本服務，即承認您對本服務的使用自行承擔所有風險。 您同意賠償與保護 IEHP、其合作夥伴、客戶、員工、主管、董事，使他們免於承擔下列事項所產生的任何及所有索賠、責任、處罰、清算、判決、費用 (包括合理的律師費)：(i) 您或任何使用您帳戶的人可能提交、發布或傳輸至本網站的任何內容；(ii) 您對本服務的使用；(iii) 您違反本條款與條件的條款之情事；(iv) 任何您違反或未能遵守與本服務相關的所有法令與法規。 未獲得 IEHP 事前書面同意時，不論您是自願還是依據法令行事，您皆不得完全或部分讓與您在本文中的任何權利，或是完全或部分委託本文中的任何義務。未獲得 IEHP 適當的事前書面同意時，您進行上述的任何讓與或委託行為皆屬無效，不具任何效力及作用。 IEHP 致力於守護您的隱私。 您可以在此找到我們的隱私權政策 (Privacy Policy)。 聯絡資訊 10801 Sixth Street, Rancho Cucamonga, CA 91730 1-800-440-IEHP (4347) TTY 使用者請撥 1-800-718-IEHP (4347) 服務時間：太平洋標準時間上午 8 點至下午 5 點    

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 hello@skinnygeneproject.org 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 healthed@iehp.org 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.

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 PAVE@dhcs.ca.gov PED Policy Assistance PEDCORR@dhcs.ca.gov IEHP Provider Assistance ProviderNetwork@iehp.org

成 IEHP DualChoice (HMO D-SNP)。如您未更改計畫，IEHP DualChoice (HMO D-SNP) 將為您提供 Medicare 福利。您可以繼續領取 Medicare 及 Medi-Cal 的福利。您的保險不存在任何差價。 您將自動加入 IEHP DualChoice，並且可以無條件地繼續享受這些服務。IEHP DualChoice 與您目前的 Cal MediConnect 計畫十分相似。加入 IEHP DualChoice 後，IEHP DualChoice 會員服務團隊會繼續為您服務以幫助滿足您的需求。如果您在與我們健康計畫合作的提供者處看診，您將無需支付保費以及醫師看診或其他醫療護理的費用。如欲進一步瞭解處方藥費用，請致電 IEHP DualChoice 會員服務中心 (Member Services)。如欲詢問您的初級保健醫生 (Primary Care Physician, PCP) 或其他提供者是否於 2023 年加入我們的網路，請致電 IEHP DualChoice 會員服務中心。 按一按此處以瞭解 IEHP DualChoice 的更多資訊。 我的 Medicare Medi-Cal 計畫將承保哪些服務？ IEHP DualChoice 將承保您現在領取的 Medicare 和 Medi-Cal 以下多種福利： Medicare 承保的所有服務、醫生、醫院、實驗室和 X 光片 您有權造訪包含與您當前計畫相同的多位提供者的提供者網路 Medicare 承保的處方藥 整合您現在獲得或可能需要的服務 前往醫療服務處的交通費用 醫療用品 耐用醫療設備 (Durable Medical Equipment, DME) 護理之家照護 社區成人服務 (Community-Based Adult Services, CBAS) 您有權造訪包含與您當前計畫相同的多位提供者的提供者網路您的保險不存在任何差價。您將自動加入 IEHP DualChoice 提供的 Medicare Medi-Cal 計畫。您可以無條件加入此計畫（如有意願）。如欲更換計畫，請致電 IEHP DualChoice 會員服務中心。  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：1-800-718-4347。

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@iehp.org. 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: compliance@iehp.org. 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: compliance@iehp.org 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: Htips@oc.dhhs.gov Additional Hotlines DHCS Medi-Cal Fraud Hotline Phone: (800) 822-6222 E-mail: fraud@dhcs.ca.gov Web: https://apps.dhcs.ca.gov/stopfraud/Default.aspx  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.

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

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。   

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

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      

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

addresses the clinical and non-clinical needs of high-need, high-cost IEHP Members through systematic coordination of services and comprehensive care management. ECM is a collaborative and interdisciplinary approach to providing intensive and comprehensive care management services to individuals. It serves to build on the Health Homes Program (HHP) and Whole Person Care (WPC) pilots and transitions those pilots to one larger program to provide a broader platform to build on positive outcomes from each program. ECM provides these vulnerable Members an additional care team to help coordinate and manage their care. The care team consists of a Nurse Care Manager, a Behavioral Health Care Manager, a Care Coordinator, and a Community Health Worker. These specially trained professionals collaborate with IEHP Members' Primary Care Physicians, Specialists, and family support systems to create a personalized plan of care. Beginning January 1, 2022, please direct eligible IEHP Members who need the ECM services to call IEHP Member Services at (800) 440-4347, Monday - Friday, 8am - 5pm. TTY users should call (800) 718-4347. If you have programmatic questions, please submit them to ECM@iehp.org. IEHP Enhanced Care Management Member Brochure (PDF) CalAIM Enhanced Care Management Policy Guide (PDF)   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

page. What is CCS? CCS is a statewide program that enables children with qualifying conditions to receive specialized services related to that condition independent from IEHP. The CCS program provides diagnostic and treatment services, and medical case management for those who have qualifying conditions. CCS also provides occupational and physical therapy services through the Medical Therapy Program (MTP). The Medical Therapy Program (MTP) is a special program that provides physical therapy (PT), occupational therapy (OT), for children who have disabling conditions, generally due to neurological or musculoskeletal disorders Who Qualifies? The CCS program services children and young adults under the age of 21 who have eligible medical conditions. Examples of CCS-eligible conditions include, but are not limited to, chronic and acute medical conditions such as cystic fibrosis, hemophilia, cerebral palsy, heart disease, cancer, traumatic injuries, and infectious diseases producing major sequelae. For a more inclusive list of diagnoses and medical criteria of qualifying conditions please reference the below links: https://www.dhcs.ca.gov/services/ccs https://www.dhcs.ca.gov/services/ccs/Documents/CCSMedicalEligibility.pdf Provider Responsibilities Primary Care Physicians (PCPs), Specialty Providers, and IPA/Medical Groups are responsible for performing appropriate baseline health assessments and diagnostic evaluations sufficient to identify children and young adults with potential CCS-qualifying conditions and refer to CCS as needed. PCPs are responsible for all well child and pediatric preventative services as these services are not a covered benefit of CCS. PCPs are also responsible in assisting CCS members with transition from CCS to IEHP authorizations at the age of 21 when members age out of the CCS program. Benefits of CCS Enrollment CCS Clients are not restricted to in area providers but have access to any CCS paneled provider within the state of California when a need for the specialty care has been determined to be CCS eligible. Once a client is determined to be eligible for CCS, the client will continue to be medically eligible for CCS until treatment is complete or age 21 when the CCS program ends. Additional Resources To assist our valued Providers, every Member active with CCS has a distinct red “CCS” widget in the Provider Portal. Opening that widget enables you to view the diagnosis being treated and any Specialists and their treatment authorization range. For any questions about your Member’s CCS care or management, please do not hesitate to contact IEHP’s CCS Team at: (800) 706-4347 or by email at CCSCareManagement@iehp.org . (By clicking on the links below, you will be leaving the IEHP site) For additional CCS resources please reference the below links: CCS Program Overview: https://www.dhcs.ca.gov/services/ccs CCS Program Application: https://www.dhcs.ca.gov/formsandpubs/forms CCS Brochure (English/Spanish): https://www.dhcs.ca.gov/services/ccs/Pages/CCSBrochure.aspx How to become a CCS Provider: https://www.dhcs.ca.gov/services/ccs/Pages/ProviderEnroll.aspx You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

assist primary care providers in delivering care in accordance with IEHP standards. Resources are reviewed regularly and updated to reflect changes from a regulatory and clinical standpoint. Preventive Care Guidelines American College of Obstetricians and Gynecologists (ACOG) American Academy of Pediatricians (AAP) / Bright Futures Comprehensive Perinatal Services Program (CPSP) Clinical Practice Guidelines Library The guidelines contained on this page are recommended by IEHP with the intent to enhance Member care. IEHP’s Clinical Practice Guidelines topics are organized using the following categories: United States Preventive Services Task Force (USPSTF); IEHP Internal Library; Healthcare Effectiveness Data Information Set (HEDIS); and Managed Care Accountability Set (MCAS) Links or documents embedded within the Internal Library category indicate literature that has been published by leading, formal organizations and have been endorsed/approved by IEHP’s Medical Directors and Quality Committee. IEHP produced information relevant to the topic will also be listed in this category. We have also indicated any HEDIS/ MCAS measures that are pertinent to the topic. Additionally, IEHP accepts USPSTF guidelines to help primary care clinicians identify clinical preventive services that are appropriate for their patients. IF there is a USPSTF guideline relevant to the topic, we have identified it below.  Library Catalog Click on a letter to jump to that specific section: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z A Asthma USPSTF N/A IEHP Internal Library Global Strategy for Asthma Management and Prevention (PDF) HEDIS Asthma Medication Ratio (AMR) Medication Management for People with Asthma (MMA) MCAS Asthma Medication Ratio (AMR) (Back to Library Catalog) B Breast Cancer USPSTF Breast Cancer Screening Use of Medications to Prevent Breast Cancer BRCA Testing IEHP Internal Library N/A HEDIS Breast Cancer Screening (BCS) MCAS Breast Cancer Screening (BCS) (Back to Library Catalog) C Cervical Cancer USPSTF Cervical Cancer Screening IEHP Internal Library N/A HEDIS Cervical Cancer Screening (CCS) MCAS Cervical Cancer Screening (CCS) (Back to Library Catalog) Chlamydia USPSTF Chlamydia and Gonorrhea Screening IEHP Internal Library You may also refer to Sexually Transmitted Infections in this resource guide HEDIS Chlamydia Screening in Women (CHL) MCAS Chlamydia Screening in women (CHL) (Back to Library Catalog) Cholesterol USPSTF Statin Therapy for Primary Prevention of CVD Healthful Diet and Physical Activity for CVD Prevention in Adults with CVD Risks IEHP Internal Library American Heart Association – Blood Cholesterol Management (PDF) American Heart Association – Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults (PDF) HEDIS Statin Therapy for Patients with Cardiovascular Disease-Adherence (SPC) Statin Therapy for Patients with Cardiovascular Disease – Statin Therapy (SPC) MCAS N/A (Back to Library Catalog) Chronic Obstructive Pulmonary Disorder USPSTF N/A IEHP Internal Library Global Initiative for Chronic Obstructive Lung Disease – COPD (PDF) HEDIS Pharmacology Management of COPD Exacerbation – Systemic Corticosteroids (PCE) Pharmacology Management of COPD Exacerbations – Bronchodilators (PCE) Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR) MCAS N/A (Back to Library Catalog) Colorectal Cancer USPSTF Colorectal Cancer Screening IEHP Internal Library N/A HEDIS Colorectal Cancer Screening (COL) MCAS N/A (Back to Library Catalog) D Depression USPSTF Screening for Depression in Adolescents Screening for Depression in Adults including Pregnant Women Screening for Perinatal Depression IEHP Internal Library American Academy of Pediatrics – Adolescent Depression in Primary Care (PDF) American Psychiatric Association – Major Depressive Disorder (PDF) HEDIS Antidepressant Medication Management Acute Phase (AMM) Antidepressant Medication Management Continuation Phase (AMM) MCAS Antidepressant Medication Management Acute (AMM-Acute) Antidepressant Medication Management Continuation (AMM-Cont) (Back to Library Catalog) Diabetes USPSTF Gestational Diabetes Screening Prediabetes and Type 2 Diabetes: Screening IEHP Internal Library American Diabetes Association – Diabetes Care (PDF) National Kidney Foundation – Diabetes and Chronic Kidney Disease (PDF) HEDIS Statin Therapy for Patients with Diabetes – Adherence (SPD) Statin Therapy for Patients with Diabetes – Statin Therapy (SPD) Comprehensive Diabetes Care – HbA1C Testing (CDC) Comprehensive Diabetes Care - HbA1C Control (<=9) (CDC) Comprehensive Diabetes Care (<8) (CDC) Comprehensive Diabetes Care - Eye Exam (CDC) Comprehensive Diabetes Care – Monitoring for Nephropathy (CDC) Comprehensive Diabetes Care – Blood Pressure Control (<140/90) (CDC) MCAS Comprehensive Diabetes Care HbA1C Testing (CDC HT) Comprehensive Diabetes Care HbA1C Testing >9%) (CDC H9) (Back to Library Catalog) E (Back to Library Catalog)   F (Back to Library Catalog)   G Gonorrhea USPSTF Chlamydia and Gonorrhea Screening IEHP Internal Library You may also refer to Sexually Transmitted Infections in this resource guide HEDIS N/A MCAS N/A (Back to Library Catalog) H Hepatitis C USPSTF Hepatitis C Virus Infection in Adolescents and Adults: Screening IEHP Internal Library American Association for the Study of Liver Diseases – Hepatitis C (PDF) HEDIS N/A MCAS N/A (Back to Library Catalog) Human Immunodeficiency Virus (HIV) USPSTF HIV Screening in Pregnant Persons HIV Screening in Adults and Adolescents HIV Prevention – Preexposure Prophylaxis IEHP Internal Library You may also refer to Sexually Transmitted Infections in this resource guide HEDIS N/A MCAS N/A (Back to Library Catalog) Hypertension USPSTF Screening for Hypertension in Adults IEHP Internal Library Joint National Committee – Hypertension Guidelines (PDF) HEDIS Controlling high blood pressure (CBP) MCAS Controlling high blood pressure (CBP) (Back to Library Catalog) I (Back to Library Catalog)   J (Back to Library Catalog)   K (Back to Library Catalog) L (Back to Library Catalog)   M (Back to Library Catalog)   N (Back to Library Catalog)   O Obesity USPSTF Weight Loss to Prevent Obesity Related Morbidity and Mortality in Adults - Counseling Screening for Obesity in Children and Adolescents Behavioral Health Counseling for Adults that are Overweight or Obese and Have Other CVD Risk Factors IEHP Internal Library N/A HEDIS Weight Assessment and Counseling (WCC-BMI) Adult Body Mass Index (ABA) MCAS Weight Assessment and Counseling (WCC-BMI) Adult Body Mass Index (ABA) (Back to Library Catalog) Osteoporosis USPSTF Osteoporosis to Prevent Fractures: Screening IEHP Internal Library N/A HEDIS Osteoporosis management in women who have had a fracture (OMW) MCAS N/A (Back to Library Catalog) P (Back to Library Catalog) Q (Back to Library Catalog) R (Back to Library Catalog) S Sexually Transmitted Infections USPSTF Syphilis Screening in Pregnant Women Syphilis Screening for those at Increased Risk for Infection Chlamydia and Gonorrhea Screening HIV Screening in Pregnant Persons HIV Screening in Adults and Adolescents HIV Prevention – Preexposure Prophylaxis IEHP Internal Library Centers for Disease Control Public Health Media Library – STD Treatment You may also refer to individual topics as they appear in this library: Chlamydia Gonorrhea HIV Syphilis HEDIS Chlamydia Screening in women (CHL) MCAS Chlamydia Screening in women (CHL) (Back to Library Catalog) Skin Cancer Behavioral Counseling USPSTF Skin Cancer Prevention: Counseling IEHP Internal Library N/A HEDIS N/A MCAS N/A   (Back to Library Catalog) Smoking Cessation/Tobacco Usage USPSTF Smoking Cessation Smoking Cessation – Pharmacotherapy Lung Cancer Screening Tobacco Use in Children and Adolescents – Primary Care Interventions IEHP Internal Library N/A HEDIS N/A MCAS N/A (Back to Library Catalog) Syphilis USPSTF Syphilis Screening in Pregnant Women Syphilis Screening for Those at Increased Risk for Infection IEHP Internal Library You may also refer to Sexually Transmitted Infections in this resource guide HEDIS N/A MCAS N/A (Back to Library Catalog) T Tuberculosis USPSTF Latent Tuberculosis Screening IEHP Internal Library N/A HEDIS N/A MCAS N/A (Back to Library Catalog) U (Back to Library Catalog) V (Back to Library Catalog) W (Back to Library Catalog) X (Back to Library Catalog) Y (Back to Library Catalog) Z (Back to Library Catalog) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

備方面的協助 (例如輪椅、呼吸機、氧氣監測儀等)，可於週一至週五上午 8 點至下午 5 點 (太平洋標準時間) 致電 IEHP  會員服務中心，電話  1-800-440-IEHP (4347)。TTY 使用者請撥  1-800-718-4347。如果您需要續取藥物，請前往藥局申請續領。 如何為緊急情況預作準備。 公共安全停電警報 我們鼓勵您註冊警報，以便能夠掌握「公共安全停電」可能發生的時間，以及電力何時能夠恢復。  按一下此處進行註冊。  用藥安全 有些藥物可能需要存放於冰箱中才能維持其藥效，包括許多藥水。如果停電一天或更長時間，除非藥物標籤另有指示，否則請丟棄應該冷藏的任何藥物。如果需要依賴冷藏藥物 (例如胰島素) 維繫生命，請僅在取得新藥品前使用。請儘快更換所有冷藏藥物。 資源 冷藏藥物儲存 (PDF) 緊急情況下的胰島素儲存與藥物轉換 (PDF) 胰島素比較 (PDF) 耐用醫療設備安全性 使用下面的核對清單以便為停電預作準備。 經常檢查您的備用電力設備，確保其在緊急情況期間能夠正常運作。 事先打電話給電力與自來水公司說明您在維生設備方面的需要 (居家透析、抽痰機、呼吸機等) 以免災難發生時措手不及。 將氧氣設備的關閉開關放在您手邊，以便在發生緊急情況時可以快速操作。 發電機使用者應在開闊區域操作發電機，以確保良好的空氣循環。 經常測試發電機以確保它在需要時能夠運作。 制定在停電時如何為電池充電的計畫。 當電力恢復時，請確定醫療設備的設定沒有被更改。 資源 耐用醫療設備的緊急電力規劃核對清單 (PDF) 如何為需要電力的醫療設備做好停電時的準備和處理 - FDA 心理健康 如果您受到火災的影響並且需要與壓力或悲傷有關的心理健康照護，可於週一至週五上午 8 點至下午 5 點 (太平洋標準時間) 致電 IEHP 會員服務中心，電話  1-800-440-IEHP (4347)。TTY 使用者請撥  1-800-718-4347。 其他提示 準備或補充您的緊急補給箱，裡面放置的物品包括食物、飲用水、手電筒、收音機、全新電池、急救用品以及現金。 確定手機的備用充電方法。 學會如何手動打開車庫門。 如果您擁有備用發電機，請確保它能夠安全運作。 擬定火災行動計畫，包括住家、家人與寵物的疏散規劃。 資源 https://protect-us.mimecast.com/s/4RDSCPNEZQi0nDJUWM25sW?domain=sce.com https://protect-us.mimecast.com/s/wMaTCQWG07tXLDJhOEH8ax?domain=sce.com https://protect-us.mimecast.com/s/GR-kCR6Jo1CGXKycW3MoLf?domain=prepareforpowerdown.com/ https://protect-us.mimecast.com/s/Yh7hCVOjPQT284zfMY-QBf?domain=readyforwildfire.org/ 緊急疏散準備：為您的安全負責，身心障礙以及其他活動受限者的指南 緊急健康資訊：Savvy Health Care Consumer 系列 身心障礙以及活動受限者的緊急補給箱 需要過夜的緊急旅遊安全提示 行動裝置緊急使用提示 針對使用依賴電力和電池輔助技術與醫療設備人員進行的緊急電力規劃  

88) 244-4347，TTY 使用者請撥 711。 1.與我們的護士通話  我們的護士可透過電話為您提供醫療建議，或指導您取得所需照護。  致電我們的護士的常見原因：   咳嗽 輕微胃痛 輕微發燒 喉嚨痛 感冒或流感 藥物相關問題  耳痛  護士諮詢影片 2.與醫師通話 我們的護士可能會決定您需要與醫師通話。在這種情況下，我們的護士會將電話轉給醫師，由醫師與您線上對話，或安排透過應用程式進行視訊診療。 3.造訪 IEHP 緊急照護診所 我們的護士可能會為您轉介緊急照護診所，讓您能夠在同一天內獲得醫師看診。許多診所在夜間、週末及假日都可以看診。部分診所擁有 X 光與實驗室檢測設施。我們的網路內擁有超過 90 家緊急照護診所。如欲找尋您附近的緊急照護診所，請造訪 IEHP 提供者搜尋部分。 造訪緊急照護診所的常見原因：  輕微喉嚨痛 輕微發燒 皮疹 流鼻血 輕微外傷 動物咬傷或蟲咬 哮喘 (非緊急情況) 割傷與撕裂傷 請致電 911 或前往附近的急診室 (ER) 取得緊急醫療與行為健康照護。不要猶豫！   緊急照護影片

使命始終是幫助會員取得 高品質的醫療、行為健康和保健服務。 IEHP 簡介 IEHP 是管理式照護健保計畫。我們成立於 1996 年，當時有 62,000 位 Medi-Cal 會員。 時至今日，我們已擴大為前 10 大 Medi-Cal 健保計畫。IEHP 的網絡有超過 8,000 個醫 療服務提供者以及超過 2,000 位員工，為 Riverside 和 San Bernardino 郡逾 140 萬居民 服務。我們與您當地的醫師、醫院和其他健 康照護服務提供者合作，向會員提供更理想 的健康照護協調及高品質照護。 身為 IEHP 會員， 我可以取得哪些福利？ 加入 IEHP，您也可以使用： 由超過 8,000 個醫師、專科醫師和其 他健康照護服務提供者組成的網絡 照護協調  24 小時護士諮詢專線 視力服務 緊急照護中心 養成健康生活習慣的課程和方案 還有更多其他福利！ 如需更多關於 IEHP 福利和服務的資訊， 請前往我們的網站，網址 www.iehp.org， 或聯絡 IEHP 會員服務部。 我成為 IEHP 會員後還 可以保有 MEDI-CAL 嗎？ 可以的，您仍可保有 Medi-Cal 以及您原本 即有的全部福利和服務，例如無月費及醫 生看診、藥物和住院零費用。唯一的不同是 您的健康照護服務現在將透過 IEHP 協調。 其他 Medi-Cal 服務包括預防照護，例如疫 苗和精神健康、發展和物質濫用失調篩檢。 您可透過 Medi-Cal 牙科方案取得按服務收 費的 Medi-Cal 牙科服務。 我加入 IEHP 後還可以繼續去看 同樣的醫師嗎？ 只要醫師在 IEHP 的醫療服務提供者網絡 中，您就可以繼續向同一位醫師接受照護。 您可以致電 IEHP 會員服務部查詢，電話 1-800-440-IEHP (4347)，週一至週五，太 平洋標準時間 (PST) 上午 8 時至下午 5 時。 聽語障專線使用者請撥 1-800-718-4347。 如果您也有 Medicare，只要醫師服務是由 Medicare 提供，您便能繼續去看這些醫師。 認識我們 我們的使命 我們要療癒和鼓舞人心。 我們的期許 我們的努力永不停止，因為我們要讓服務的 社區都享有最佳照護，讓民眾活躍而健康。 我們的價值 我們做正確的事，例如： 將會員視為我們的核心利益。 揮灑創意、發揮勇氣以增進民眾健康與 福址。 始終以負責的態度專注於我們的工作。 對於我們與會員、醫療服務提供者、合作 夥伴及彼此間的承諾，絕不妥協。 我們很樂意回答您的問題，幫助您開始踏出 邁向健康的旅程！