搜尋結果： : " MAKE FREEDHARDEMAN UNIVERSITY "

most appropriate, high quality and cost-effective drug therapies.   The Inland Empire Health Plan Pharmacy and Therapeutics (P & T) Subcommittee develops and monitors the Formulary. The P & T is composed of the IEHP Chief Medical Officer, Medical Directors, Director of Pharmaceutical Services, physicians from various medical specialties, local communities, and clinical pharmacists. This panel reviews the medications in all therapeutic categories based on safety, clinical efficacy, and cost-effectiveness and selects the most appropriate drugs in each class.   Formulary development and maintenance is a dynamic process. The IEHP P & T Subcommittee is responsible for developing, managing, updating and administering the Formulary. The Subcommittee also ensures that the IEHP Formulary remains responsive to the needs of our members and providers.   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Click here to download a free copy by clicking Adobe Acrobat Reader. By clicking on this link, you will be leaving the IEHP website.   IEHP Medi-Cal Formulary Items: DHCS Noncapitated Physician Administered Drugs (PADs) Medi-Cal Medical Benefit PA (PDF) Medi-Cal Medical Benefit Formulary (PDF) Referral Form for Medi-Cal Benefit (PDF) Exceptions to criteria or requests for coverage of drugs not on the Medi-Cal Drug Benefit Formulary may be submitted by prescribers on the Referral Form for Medi-Cal Benefit. Starting January 1, 2022, all IEHP Medi-Cal pharmacy services will be transitioned from managed care (MC) to fee for service (FFS). The Medi-Cal pharmacy benefits and services administered by the Department of Health Care Services (DHCS) will be identified collectively as "Medi-Cal Rx." Magellan Medicaid Administration, Inc. (MMA) will assume operations for Medi-Cal Rx on behalf of DHCS. For further information on Medi-Cal Rx, please visit: https://www.iehp.org/en/providers/pharmacy-services?target=medi-cal-rx For more information on the Medi-Cal Rx Covered Drug List (CDL), please visit: https://medi-calrx.dhcs.ca.gov/home/cdl   IEHP DualChoice (HMO D-SNP) - Medicare-Medicaid Plan Items: IEHP DualChoice (HMO D-SNP) Formulary Book (PDF) Grievance Coverage Determination and Appeals Process IEHP DualChoice (HMO D-SNP) Formulary Search Tool        10 Reasons Why You Should Be E-prescribing Brochure (PDF) E-prescribing Tips (PDF)   Information on this page is current as of May 31, 2023

alChoice 網路內提供者須遵守加州政府所規定藥局實務之最低標準。 IEHP DualChoice 給付哪些處方藥？ IEHP DualChoice (HMO D-SNP) 訂有給付藥品清單（處方集）。處方集說明 IEHP DualChoice 給付哪些 D 部分處方藥。這份清單上的藥品為本計畫在醫師及藥劑師協助下選定的。清單項目必須符合 Medicare 的規定。Medicare 已核准 IEHP DualChoice 處方集。  您可自下列資料找尋給付藥品： 2023 年處方集 (PDF) 處方集變更 (PDF) 2023 年分階段療法 (PDF) 2023 年須事先授權之藥品 (PDF) IEHP DualChoice 與哪些藥局簽約？ 我們的 IEHP DualChoice (HMO D-SNP) 提供者與藥局目錄列出完整的網絡內藥局清單 – 亦即清單上註明同意為本計畫會員提供給付處方藥的所有藥局。 通常情況下，您必須向計畫提供者取得所有例行性照護，並使用網路內藥局獲得您的處方藥福利，除非在非常規的情況下，而且有數量上限和使用限制。  此清單並非完整清單。相關福利資訊僅為概要資料，並非福利的完整說明。可能適用限制條款、共付額和限制條件。處方藥的共付額可能依您取得的「額外協助」等級而異。福利與共付額可能在每年的 1 月 1 日改動。給付藥品清單以及藥局與提供者網路在年度期間可能有所變化。在進行對您有影響的變更之前，我們會向您發送通知。如需詳細資訊，請致電 IEHP DualChoice 會員服務中心或參閱 IEHP DualChoice 會員手冊。  2023 年 IEHP DualChoice 提供者與藥局目錄 (PDF) 您需使用 Adobe Acrobat Reader 6.0 或更高版本，才能檢視 PDF 檔案。點選此處下載免費版本。點選此連結，您將會離開 IEHP DualChoice 網站。  若您沒有 IEHP DualChoice 提供者與藥局目錄，可向 IEHP DualChoice 會員服務中心索取副本。您可隨時致電 IEHP DualChoice 會員服務中心，取得網路內藥局變更事項的最新資訊。致電 1-877-273-IEHP (4347) 聯繫 IEHP DualChoice，服務時間為太平洋標準時間每天上午 8 點至晚上 8 點，假日亦提供服務。TTY 使用者請致電 1-800-718-4347。 網路外給付 通常，IEHP DualChoice (HMO D-SNP) 只在您無法使用網絡內藥局時，方會給付在網絡外藥局領取的藥品。在下列情況於網路外藥局領取的處方藥均屬給付範圍： 如果我因為緊急醫療情況而需要處方藥，應該怎麼辦？ 若處方藥是為了緊急醫療情況或急症照護，而於網路外藥局領取，我們將給付該等處方藥的費用。在此情況下，您在領取處方藥時須付清全額費用 (而非僅支付共付額部分)。您可提交書面理賠表，要求我們將我們應付的分攤費用退款給您。如欲進一步瞭解如何提交書面理賠，請參閱下面的書面理賠程序。 在您旅遊或不在計畫服務區域內時取得給付 若您定期領取處方藥，而且您即將外出旅行，請記得在出發前檢查您的藥品數量。只要可行，請隨身攜帶您需要的所有藥品。您可以透過我們的網路內郵購藥局服務，或透過提供「延長藥量」的零售網路藥局，事先訂購您的處方藥。 若您是在美國境內旅行，但不在計畫服務區域內，並且您生病、遺失處方藥或處方藥用完了，則若您遵守本文規定的所有其他給付規定，且附近無法找到網路內藥局，我們將會給付由網路外藥局提供的處方藥。在此情況下，您在領取處方藥時須付清全額費用 (而非僅支付共付額部分)。您可提交理賠表，要求我們將我們應付的分攤費用退款給您。如欲進一步瞭解如何提交書面理賠，請參閱下面的書面理賠程序。 在向網路外藥局領取處方藥之前，請致電 IEHP DualChoice 會員服務中心，瞭解您旅行所在區域是否有網路內藥局。若當地沒有網路內藥局，IEHP DualChoice 會員服務中心可以安排您向網路外藥局領取處方藥。 我們不支付由美國境外藥局所提供的任何處方藥，即使是基於緊急醫療情況而提供。 需要急症所需照護時，若您身處本計畫服務區域外該怎麼辦？ 身處服務區域外且無法取得網路內提供者提供的照護時，本計畫會給付任何提供者為您提供的急症所需照護。若您在美國以外地區接受照護，本計畫將無法給付該等急症所需服務或任何其他照護。 我們給付您向網路外藥局取得之處方藥的情況 在至少符合下列任一條件時，我們將會給付您向網路外藥局取得之處方藥： 若您因在合理交通範圍內無法找到提供 24 小時服務之網路內藥局，而無法在我們的服務區域內及時取得給付藥品。 若您試圖取得的給付處方藥並非合格網路內零售藥局或郵購藥局定期會進貨的藥品 (此等藥品包括孤兒藥或其他專科醫師用藥)。如有上述情況，請先向 IEHP DualChoice 會員服務中心確認附近是否有網路內藥局。  如何向本計畫申請退款？  如果您必須使用網路外藥局，通常必須在領取處方藥時付清全額費用 (而非平常所付的分攤費用)。您可以要求我們退還 IEHP DualChoice 應付的分攤費用。請將您的付款要求及帳單和所有付款單據郵寄給我們。建議您影印帳單及收據作為記錄。請將您的付款要求附上帳單或收據郵寄給我們，地址為：  IEHP DualChoice P.O. Box 4259 Rancho Cucamonga, CA 91729-4259  您必須在取得服務、用品或藥品之日起 1 年內提出理賠。如有任何疑問，請聯繫 IEHP DualChoice 會員服務中心。如果您不知道您應付的款項，或者您收到了帳單但不知道該如何處理，我們可以提供協助。如果您已經將付款要求寄給我們，但想提供更多資訊，也歡迎您致電與我們聯絡。請參閱 IEHP DualChoice 會員手冊 第 7 章及第 9 章，瞭解如何向本計畫申請退款。 IEHP DualChoice 處方集變動 IEHP DualChoice 處方集包括多種被視為第一線治療的藥物 (應首先用於適應症的藥品)。IEHP DualChoice 會審核新藥的療效 (治療效果) 與安全性 (安全程度)、比較新藥與既有藥品以及依據臨床證據編制臨床實務指南，以持續編制與維護處方集。 IEHP DualChoice 會 (在福利年度內) 不定時依據新臨床證據及市場上產品的供應狀況，修改 (新增或移除藥品) 處方集。 所有變動皆係由目前執業之提供者與藥局所組成的專案小組，負責審閱與核准。 IEHP DualChoice 會在將 D 部分藥品自 D 部分處方集移除之前，通知 IEHP DualChoice 會員。若發生任何事先授權、數量限制、分階段療法變動，或任何藥品移往更高費用分攤層級之情況，我們也將通知會員。 若 IEHP DualChoice 移除給付的 D 部分藥品，或對 IEHP DualChoice 處方集進行任何變動，我們會在 IEHP DualChoice 處方集變動生效日期前至少三十 (30) 天，將處方集變動內容公佈在 IEHP DualChoice 網站，並將通知受影響的會員。然而，如果食品藥物管理局 (FDA) 認為我們處方集的藥品不安全，或是藥品的製造商從市場撤除該藥品，我們將立即將該藥品從處方集中移除。 藥品清單的部分變動將會立即生效。例如： 市場上可取得新學名藥。有時會出現全新且更便宜，但效果與藥品清單所列藥品一樣好的藥品。在這種情況下，我們可能會將既有藥品移除，不過您就新藥品所分攤的費用將維持不變或減少。我們在新增學名藥時，還可能決定保留清單上既有的藥品，但會變更其給付規定或限制。 我們可能不會在進行上述變更之前通知您，不過我們會將相關變動資訊發送給您。 您或您的提供者可以申請這些變更的「例外處理」。我們會發送通知給您，向您說明申請「例外處理」的步驟。有關「例外處理」的詳細資訊，請參閱會員手冊第 9 章 (若您有問題或欲提出申訴 [給付決定、上訴、申訴] 時的處理方式)。 藥品從市場下架。若食品藥物管理局 (FDA) 認定您所服用的藥品不安全，或藥品製造商將藥品從市場下架，我們會將藥品從藥品清單中移除。若您正在服用該藥品，我們將會通知您。您的提供者也會接到這項變動通知。他或她將與您合作尋找其他可治療您的病情的藥物。 我們可能會做出影響您所服藥品的其他變動。 我們會事先通知您有關藥品清單的所有其他變動。此等變動可能因下列情況而發生： FDA 發佈藥品的新指南，或藥品出現全新的臨床指南。 我們新增市場已有的學名藥，且： 取代藥品清單上已有的原廠藥；或 變更原廠藥的給付規定或限制。 在進行此等變動時，我們會在變更藥品清單前或在您再次領藥前至少 30 天通知您，如此您就有時間與您的醫師或其他開立處方者進行溝通。他或她能協助您判斷是否能改服藥品清單中的類似藥品，或是否需要申請例外處理。接著，您可以： 在藥品清單變更生效前領取 31 天的藥品；或 申請這些變更的例外處理。如需進一步瞭解如何申請例外處理，請參閱會員手冊第 9 章 (若您有問題或欲提出申訴 [給付決定、上訴、申訴] 時的處理方式)。 再次強調，如果藥品因不安全或其他原因而突然被召回，本計畫將立即將該藥品從處方集中移除。我們會立即告知您此變動。 您的醫師也將瞭解此變動，並與您合作尋找其他可治療您的病情的藥物。 如何查詢您的藥品給付是否發生變化？ 若 IEHP DualChoice 移除給付的 D 部分藥品，或對 IEHP DualChoice 處方集進行任何變動，IEHP DualChoice 會在 IEHP DualChoice 處方集變動生效日期前至少三十 (30) 天，將處方集變動內容公佈在 IEHP DualChoice 網站，並將通知受影響的會員。然而，如果食品藥物管理局 (FDA) 認為我們處方集的藥品不安全，或是藥品的製造商從市場撤除該藥品，我們將立即將該藥品從處方集中移除。 取得計畫核准 針對特定藥品，您或提供者必須先取得計畫核准，我們才會同意給付該藥品。這稱為「事先授權」。有時候，事先取得核准的要求有助於導引特定藥品的適當使用。如果您未取得事先授權，本計畫可能不會予以給付。如需進一步瞭解分階段療法與數量限制的相關資訊，請參閱   IEHP DualChoice 會員手冊第 5 章。使用 IEHP Medicare 處方藥給付裁決表單取得事先授權。 申請 Medicare 處方藥給付裁定 (PDF) 標準格式說明 此表單亦可透過 CMS 網站取得：  Medicare 處方藥裁定申請表 (適用於投保人與提供者)。  點選此連結，您將會離開 IEHP DualChoice 網站。 適用條件與限制 只要您遵守 IEHP DualChoice 會員手冊 第 6 章所列給付規定，且藥品具醫療必要性，亦即為治療您的傷害或疾病所合理必要，我們通常會給付本計畫的處方集藥品。另外還必須是獲允許可治療您的病況的藥品。 關於 Medicare 藥品計畫依 D 部分規定不予給付的藥品，請參閱下列三項一般規定： 本計畫的 D 部分藥品給付範圍不包括 Medicare A 部分或 B 部分所給付的藥品。 本計畫無法給付在美國領土境外購買的藥品。 我們的計畫通常不給付仿單標示外使用。「仿單標示外使用」係指將該藥品用於任何非食品藥物管理局核准的用途 (相關用途標示於藥品仿單上)。 詳細資訊請參閱  IEHP DualChoice 會員手冊第 6 章。 取得臨時藥量 在某些情況下，若藥品不在藥品清單上或受到某些規定限制，我們可能會為您提供臨時藥量。這樣一來您就有時間與提供者討論是否可以改用其他藥品，或要求我們給付藥品。 若要取得臨時藥量，您必須符合以下兩條規定： 您一直以來服用的藥品： 不再列於我們的藥品清單上；或 從來不曾列於我們的藥品清單上，或 現在受到某些規定限制。 您必須符合以下任一種情況： 您去年為本計畫會員。 您是本計畫的新會員。 您加入本計畫已超過 90 天，居住在長期照護機構且立刻需要藥品。 當您取得藥品的臨時藥量時，應與提供者討論這次藥量用盡時該怎麼做。以下為您的可選方案： 您可以更換其他藥品。 本計畫可能有適合您的其他給付藥品。您可以致電會員服務中心以索取可治療相同病症的給付藥品清單。該清單可協助您的提供者找到可能適合您的給付藥品。 或者 您可以提出例外申請。 您與您的提供者可要求我們做出例外處理。例如，您可以要求我們給付未列於藥品清單上的藥品。或可要求我們給付藥品，而不加諸任何限制。若您的提供者認為您有適用例外情況的合理醫療理由，則可協助您提出申請。 若明年您所服用的藥品將從藥品清單中移除，或受到某些規定限制，我們將允許您在明年之前申請例外處理。 我們將告訴您明年的藥品給付變動。您可以向我們申請例外處理，並且按照您所希望的方式給付該藥品。 我們將在接到您的申請 (或您的開立處方者的佐證聲明後) 72 小時內答覆您的申請。 Medicare 處方藥給付及您的權利通知 - 會員藥品給付權利公告： Medicare 要求藥局在每次會員的給付請求被駁回或不同意費用分攤資訊時，通知會員。 若您不同意藥劑師所提供之資訊，您有權上訴或提出處方集例外處理要求。 閱讀您的 Medicare 會員藥品給付權利。   藥品使用管理 我們會審查會員的藥品使用情況，協助確保會員獲得安全且適當的照護。此等審查對採用多個提供者開立處方藥品的會員來說特別重要。 IEHP DualChoice (HMO D-SNP) 設有辨識與降低用藥錯誤情況的流程。每次您調配處方藥時，我們都會進行審查。我們也會定期審查我們的記錄。審查時，我們會尋找潛在的問題，如： 可能的用藥錯誤。 藥品可能非必要，因為您正在服用另一種治療相同醫學病症的藥品。 因您的年齡或性別對您不安全或不適當的藥品。 若同時服用，可能危害您健康的特定藥品組合。 處方箋中的藥品含有您會過敏的成分。 可能的服用藥量 (劑量) 錯誤。 過量使用與用量不足 臨床濫用/不當使用 若我們認為您的藥品使用情況可能存在問題，我們會與您的醫師合作改正問題。IEHP DualChoice 還會向 Medicare 暨 Medicaid 服務中心 (CMS) 提供資訊，說明其依據 CMS 規定的準則所採取的品質保證措施。 此頁面資訊為截至 2022 年 10 月 1 日的最新資訊 DSNP_23_3241532_M Pending Accepted

當暴露於疾病中時，身體將會知道如何對抗與殺死病菌，以預防病菌造成健康問題。這稱為對疾病具免疫力。 為什麼疫苗有這麼多種？ 人生的所有階段都需要接種疫苗。許多疫苗是對嬰兒與幼童施打，以在成長過程中發育良好。疫苗可保護人體罹患下列疾病： 流感 麻疹、腮腺炎、風疹 小兒麻痺症 破傷風 水痘 百日咳 有關疫苗接種的完整清單，請參閱  0-18 歲疫苗接種建議時程表 (PDF) 及 疫苗接種手冊 (PDF)。 接種疫苗不須負擔任何費用 投保 IEHP，您就可以免費接種疫苗。您亦可參閱 IEHP 會員手冊，瞭解疫苗接種與檢查時程表。向您的醫師索取疫苗接種記錄卡，或登入您的  IEHP 健康帳戶 列印，並在每次檢查時隨身攜帶。  

will now be held at the following address: Dr. Bradley P. Gilbert Center for Learning & Innovation 9500 Cleveland Ave. Rancho Cucamonga, CA 91730 Click here to view the meeting room map. Any Member of the public may observe the scheduled proceedings by using the link listed below. March 6, 2023 - 9 a.m. Click here to join the virtual meeting. June 2023 Agenda Board Report Under $200k Summary Report May 2023 Agenda Board Report Under $200k Summary Report

疫情突發公共衛生事件期間，加州醫療補助 (Medi-Cal) 而需續保。隨著突發公共衛生事件結束，要想醫療保險不變，現在需要採取行動。 馬上填寫內附續保資料包，然後交回所在縣加州醫療補助 (Medi-Cal) 辦公室。 可線上、郵寄、親臨或電話辦理續保。 是否需助填表？請聯絡因恩健保 (IEHP) 資格小組，電話：1-888-860-1296，服務時間：週一至週五，上午 8 點至下午 5 點。 加州醫療補助 (Medi-Cal) 需要每年續保方能保留福利。 更新 每年都會收到縣府來信，告知加州醫療補助 (Medi-Cal) 是否已由縣府自動續保，或縣府需要更多資訊。 警告 務必細讀來信並按說明照做事。 縣府會要求提供什麼資訊？ 填妥的續保表 收入核實資料 聯絡資訊更新 如果縣府要求提供更多資訊，必須在截止日期前提供。 如果不在截止日期前回覆，加州醫療補助 (Medi-Cal) 福利即可能終止。 注意：加州領導人發出了加州醫療補助 (Medi-Cal) 詐騙警告各種騙子正在聯絡加州醫療補助 (Medi-Cal) 會員索要申請或續保費用。 重要： 加州醫療補助 (Medi-Cal) 絕不會收取申請或續保費用。如果有人冒充縣府、州府或社區合作夥伴聯絡要錢，切勿理會。 有疑問嗎？請聯絡因恩健保 (IEHP) 資格小組，電話： 1-888-860-1296，服務時間：週一至週五，上午 8 點至下午 5 點 資訊遞交方法？ 綫上、郵寄、親臨或電話。 1.綫上辦理： 馬上造訪 BenefitsCal.com，然後選擇「建立帳戶 (Create an Account)」連結建立線上帳戶。觀賞上面的影片。 如果已有 BenefitsCal.com 帳戶，可按上面影片中的步驟遞交： 2.將資料包寄給縣府 聖貝納迪諾縣：點擊查找附近的郵寄地點里弗賽德縣：點擊查找附近的郵寄地點*註：資料包中附帶一個寄回文件用的信封。 3.親臨縣府辦公室。 聖貝納迪諾縣：點擊查找附近的縣辦事處里弗賽德縣：點擊查找附近的縣辦事處 4.致電縣府辦公室： 聖貝納迪諾縣：1-877-410-8829週一至週五，上午 7 點至下午 5 點里弗賽德縣：1-877-410-8827週一至週五，上午 7 點至下午 5 點 常見問題解答：加州醫療補助 (Medi-Cal) 續保問答 access_time 錯過了截止日期該怎麼辦？ 聯絡縣府詢問是否仍能遞交資料。 傳送 交表後會發生什麼？ 文件審查完後，縣府會寄一封信。 論壇 如有更多疑問，該問何人？ 如需更多幫助，請聯絡因恩健保 (IEHP)，電話：1-888-860-1296，服務時間：週一至週五，上午 8 點至下午 5 點，或所在縣加州醫療補助 (Medi-Cal) 辦公室： 里弗賽德縣：1-877-410-8827，週一至週五，上午 8 點至下午 5 點 聖貝納迪諾郡：1-877-410-8829，週一至週五，上午 7 點至下午 5 點 住家 搬家後应做之事？ 請聯絡縣府辦公室，確保已有您和您家人的最新資訊。 姓名 地址 電話號碼 電子郵件 縣府需要用於聯絡您，並提供您的加州醫療補助 (Medi-Cal) 相關重要資訊。 在此處查看更多常見問題解答

ness. Any pricing disputes, whether it be brand or generic, are to be handled by MedImpact. MedImpact also addresses pharmacy provider appeals on drug pricing. Please direct related inquiries and pricing appeals to MedImpact Pharmacy Provider line at 1-888-495-3147, with a 24/7/365 availability. Information on this page is current as of January 01, 2023

or later to view the PDF files. You can download a free copy by clicking here. By clicking on this link, you will be leaving the IEHP website. TITLE DATE RECIPIENTS June 2023     New DHCS Drug Use Review (DUR) Board Educational Articles 06/02 All Medi-Cal PCPs & Specialists May 2023     Pharmacy Recalls, Market Withdrawals Safety Alerts - April 2023 05/10 All IEHP PCP's, All IEHP Pharmacy Providers April 2023     Pharmacy Recalls Withdrawals Safety Alerts - January to March 2023 04/10 All IEHP PCP's & Pharmacy Providers March 2023     IEHP DualChoice (HMO D-SNP): Known Billing Issue 03/31 All IEHP Pharmacy Providers Pharmacy Recalls - Withdrawals - Safety Alerts - March 1-15, 2023 03/31 All IEHP PCPs & Pharmacy Providers Pharmacy Recalls - Withdrawals - Safety Alerts - Dec 2022 to Feb 2023 03/31 All IEHP PCPs & Pharmacy Providers DualChoice Medicare Billing for Non-FDA Approved Medications 03/21 All IEHP Pharmacy Providers Claim Processing during State of Emergency due to Snowstorm 03/03 All IEHP Pharmacy Providers February 2023     Transition to 30-day Coverage Determination Backdating 02/02 All LTC & SNF Providers January 2023     IEHP DualChoice (HMO D-SNP): Over-the-Counter Drugs 01/09-01/30 All IEHP Pharmacy Providers IEHP DualChoice (HMO D-SNP): Medicare Part B Coinsurance Billing 01/05-01/13 All IEHP Pharmacy Providers IEHP DualChoice (HMO D-SNP): PBM Update and Medicare Part B Coinsurance 01/02-01/20 All IEHP Pharmacy Providers IEHP DualChoice (HMO D-SNP) Members - Medication Overrides 01/02 All IEHP Pharmacy Providers December 2022     Cal MediConnect (CMC) to Medi-Cal Rx/HMO D-SNP Transition 12/22 All IEHP Pharmacy Providers Claims Rejected in Error 12/19 All IEHP Pharmacy Providers PBM Change & Prior Authorization Submission Method - for DualChoice (HMO D-SNP) Members (Effective January 1, 2023) 12/13-12/29 All IEHP Pharmacy Providers Pharmacy Recalls, Withdrawals & Safety Alerts - November 2022 12/07 All IEHP Pharmacy Providers CoverMyMeds - Prior Authorization Submission Method for DualChoice Members (Effective January 1, 2023) 12/01-12/12 All IEHP Pharmacy Providers November 2022     Recalls, Withdrawals & Safety Alerts - October 2022 11/14 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts - September 2022 11/02 All IEHP Pharmacy Providers COVID-19: Test to Treat Monoclonal Antibodies 11/01 All IEHP Pharmacy Providers October 2022     Cal MediConnect to Medi-Cal Rx Transition (D-SNP) 10/28 All IEHP Pharmacy Providers September 2022     Recalls, Withdrawals & Safety Alerts 09/08 All IEHP Pharmacy Providers August 2022     2022-2023 Flu Vaccination for IEHP Members 08/31 All IEHP Pharmacy Providers Reminder: Medi-Cal Rx Gradual Reinstatement of PAs - Phase 1 08/31 All IEHP Pharmacy Providers 30-Day Countdown: Reinstatement of PA Requirements for 11 Drug Classes 08/18 All IEHP Pharmacy Providers 30-Day Countdown: Reinstatement of PA Requirements for 11 Drug Classes 08/17 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 08/10 All IEHP Pharmacy Providers July 2022     Academic Detailing Services Now Offered 07/15 All IEHP Pharmacy Providers DHCS Medi-Cal Rx Update: Postponement of Implementation of NCPDP Reject Code 80 07/13 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 07/07 All IEHP Pharmacy Providers June 2022     New DHCS DUR Board Educational Article 06/22 All IEHP Pharmacy Providers MTM Medicare Pharmacy Mailing Campaign 06/08 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 06/05 All IEHP Pharmacy Providers Academic Detailing Services Now Offered 06/04 All IEHP Pharmacy Providers Medi-Cal Rx Transition: Blood Pressure Monitors and Cuffs 06/03 All IEHP Pharmacy Providers Important Notice: COVID-19 Oral Antivirals Billing 06/01 All IEHP Pharmacy Providers May 2022     Recalls, Withdrawals & Safety Alerts 05/05 All IEHP Pharmacy Providers April 2022     Rejected Claims Due To Prescriber Error Codes 04/06 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 04/05 All IEHP Pharmacy Providers MTM COVID-19: Test to Treat 04/04 All IEHP Pharmacy Providers March 2022     MTM Medicare Pharmacy Mailing Campaign 03/29 All IEHP Pharmacy Providers New DHCS DUR Board Educational Article 03/16 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 03/28-03/31 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 03/21-03/25 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 03/14-03/18 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 03/07-03/11 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 03/07 All IEHP Pharmacy Providers IEHP Contracted DME Pharmacies: CGM, BP Monitor, Nebulizer 03/02 All IEHP Pharmacy Providers February 2022     Medi-Cal Rx Transition: How To Assist IEHP Members 02/28-03/04 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 02/22-02/25 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 02/14-02/18 All IEHP Pharmacy Providers Medi-Cal Rx Transition: How To Assist IEHP Members 02/10-02/11 All IEHP Pharmacy Providers Pharmacy Empowerment Program 02/08 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 02/07 All IEHP Pharmacy Providers New DHCS DUR Board Educational Article 02/02 All IEHP Pharmacy Providers January 2022     Free OTC COVID-19 Antigen Test Kits Available 01/31 All IEHP Pharmacy Providers Medi-Cal Rx Transition Implementation 01/17-01/21 All IEHP Pharmacy Providers Medi-Cal Rx Transition Implementation 01/10-01/14 All IEHP Pharmacy Providers Medi-Cal Rx Transition Implementation 01/07 All IEHP Pharmacy Providers Recalls, Withdrawals & Safety Alerts 01/05 All IEHP Pharmacy Providers  

liance Delegation Oversight Audit (DOA) Grievance Growth Chart Health and Wellness  Historical Data Form Inland Regional Center Medi-Cal Letter Templates Medicare-Medicaid Plan Letter Templates D-SNP Letter Templates Medicare Non-Contracted Providers Perinatal Pharmacy Provider Preventable Conditions (PPC) UM/CM Vision Other Behavioral Health ABA 6 Month and Exit Progress Report Template (Word) ABA Exit Letter Template (Word) ABA Service Hour Log (Word) ABA School BHT Services Request Form (Word) Authorization Release of Information Form - English (PDF) Authorization Release of Information Form - Spanish (PDF) Behavioral Health Authorization Request Form (PDF) BHT Social Skills Template (Word) Coordination of Care Treatment Plan Form (PDF) No Further Treatment Request Form (PDF) Psych Testing Battery Plan (for Psychologist use only) (PDF)  (For BH Providers Only) Transition of Care Tool (PDF) Claims For Integrated Denial Notices please click here. Please select on the links below to obtain the revised CMS 1500 form (version 02/12) and the CMS 1500 Reference Instruction Manual. Provider Identified Overpayment Form (PDF) Provider Identified Overpayment Form (Multiple) (PDF) Provider Dispute Resolution (PDR) (PDF) Claims Project Spreadsheet (Excel) Clean Claim Tool Guide - UB04 Inpatient Form (PDF) Clean Claim Tool Guide - UB04 Outpatient Form (PDF) Waiver of Liability Statement - IEHP Dual Choice (HMO D-SNP) - effective January 2023 (PDF) Revised CMS 1500 Health Insurance Claim Form (PDF) CMS 1500 Reference Instruction Manual (PDF) (Back to top) Compliance Member Incentive Forms Focus Group Incentive (FGI) - Request for Approval Form (PDF) Focus Group Incentive (FGI) - Evaluation Form (PDF) Member Incentive (MI) Program - Request for Approval (PDF) Member Incentive (MI) Program - Annual Update/End of Program Evaluation (PDF) Survey Incentive (SI) - Request for Approval Form (PDF) Survey Incentive (SI) - Evaluation Form (PDF) Nondiscrimination Language Nondiscrimination Language Access Notice: Medi-Cal (PDF) Medicare (PDF) (Back to top) Delegation Oversight Audit (DOA) Biographical Information Sheet Credentialing DOA Audit Tool HIPAA Security - Medi-Cal DOA HIPAA Security - Medicare Medi-Cal DOA Tool UM/CM/QI Medicare DOA Tool UM/CM/QI Medi-Cal UM Referral Template Sub-Contracted Facility/Agency Services and Delegated Functions (Back to top) Grievance The Grievance Forms below are for your Member's use when filing a complaint, or has an appeal regarding any aspect of care or service provided by you. Please select the Appeal and Grievance form appropriate for their use: Medi-Cal Form      English (PDF)      Spanish (PDF)      Chinese (PDF)      Vietnamese (PDF) Medicare Form      English (PDF)      Spanish (PDF)      Chinese (PDF)      Vietnamese (PDF) The following IEHP DualChoice (HMO D-SNP) Letters will be effective January 1, 2023:      English (PDF)      Spanish (PDF)      Chinese (PDF)      Vietnamese (PDF) (Back to top) Growth Chart Inland Empire Health Plan (IEHP) offers you easy access to useful reference materials and forms you may need. It's just one click away. Select the growth chart form that you need by clicking on the link below: (0-36 months): Head Circumference-For-Age And Weight- For-Length Percentiles           Boys (PDF)          Girls (PDF) (0-36 months): Length and Weight-For-Age Percentiles           Boys (PDF)          Girls (PDF) (2-20 years): Stature and Weight-For-Age-Percentiles           Boys (PDF)         Girls (PDF) (2-20 years): Body Mass Index For-Age Percentiles           Boys (PDF)          Girls (PDF) (Back to top) Health and Wellness DPP Rx Pad (PDF) (Back to top)   Historical Data Form Historical Data Form (PDF) (Back to top) Inland Regional Center Early Start (0-36 months) Referral (PDF) Early Start Online Application Eligibility and Intake IRC Referrals (3-99+ years): San Bernardino County: For Providers - (909) 890-4711 // Intake - (909) 890-3148 Riverside County: For Providers - (909) 890-4763 // Intake - (951) 826-2648 (Back to top) Medi-Cal Letter Templates A complete template includes all documents listed under each template in the order specified listed. Changes can only be made to highlighted areas, any changes made outside of the highlighted areas are strictly prohibited by DHCS. Click on the title to expand the menu and download desired document. Member Authorization Letter English Last Updated: 09/20/2022 Spanish Last Updated: 09/20/2022   Chinese Last Updated: 09/20/2022   Vietnamese Last Updated: 09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Continuity of Care Authorization Letter English Last Updated: 09/20/2022   Spanish Last Updated: 09/20/2022   Chinese Last Updated: 09/20/2022   Vietnamese Last Updated: 09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Notice of Action – Carve Out English Last Updated: 12/29/2022   Spanish Last Updated: 12/29/2022   Chinese Last Updated: 12/29/2022   Vietnamese Last Updated: 12/29/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Independent Medical Review (IMR) Form - [English] [Spanish] [Chinese] [Vietnamese] Updated May 22, 2023 Notice of Action - Delay English Last Updated: 12/27/2022   Spanish Last Updated: 12/27/2022   Chinese Last Updated: 12/27/2022   Vietnamese Last Updated: 12/27/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Independent Medical Review (IMR) Form - [English] [Spanish] [Chinese] [Vietnamese] Updated May 22, 2023 Notice of Action - Deny English Last Updated: 12/27/2022   Spanish Last Updated: 12/27/2022   Chinese Last Updated: 12/27/2022   Vietnamese Last Updated: 12/27/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Independent Medical Review (IMR) Form - [English] [Spanish] [Chinese] [Vietnamese] Updated May 22, 2023 Notice of Action - Modify English Last Updated: 12/28/2022   Spanish Last Updated: 12/28/2022   Chinese Last Updated: 12/28/2022   Vietnamese Last Updated: 12/28/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Independent Medical Review (IMR) Form - [English] [Spanish] [Chinese] [Vietnamese] Updated May 22, 2023 Notice of Action - Terminate English Last Updated: 01/06/2023   Spanish Last Updated: 01/06/2023   Chinese Last Updated: 01/06/2023   Vietnamese Last Updated: 01/06/2023   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Independent Medical Review (IMR) Form - [English] [Spanish] [Chinese] [Vietnamese] Updated May 22, 2023 Other Health Care Coverage Requesting Provider Letter English Last Updated: 03/17/2021   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Continuity of Care Terminate Letter English Last Updated: 09/20/2022   Spanish Last Updated: 09/20/2022   Chinese Last Updated: 09/20/2022   Vietnamese Last Updated: 09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Specialist Termination Letter English Last Updated: 09/20/2022   Spanish Last Updated:09/20/2022   Chinese Last Updated:09/20/2022   Vietnamese Last Updated:09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 Prior Authorization Not Required English Last Updated: 09/20/2022   Spanish Last Updated:09/20/2022   Chinese Last Updated:09/20/2022   Vietnamese Last Updated:09/20/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated August 01, 2022 (Back to top) Medicare-Medicaid Plan Letter Templates A complete template includes all documents listed under each template in the order specified listed. Changes can only be made to highlighted areas, any changes made outside of the highlighted areas are strictly prohibited by CMS. Click on the title to expand the menu and download desired document. Carve-Out Information Letter English Last Updated: 11/12/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Denial Reason Matrix English Last Updated: 07/03/2018   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Detailed Explanation of Non-Coverage English Last Updated: 12/17/2021   Spanish Last Updated: 12/17/2021   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Detailed Notice of Discharge English Last Updated: 12/17/2021   Spanish Last Updated: 12/17/2021   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Expedited Criteria Not Met English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Extension Needed for Additional Information English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Integrated Denial Notice - Part B Drugs - 7 day appeal - IPA English Last Updated: 02/14/2022   Spanish Last Updated: 02/14/2022   Chinese Last Updated: 02/14/2022   Vietnamese Last Updated: 02/14/2022   Independent Medical Review - [English] [Spanish] [Chinese] [Vietnamese] Updated October 7, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Integrated Denial Notice - Part C - 30 day appeal - IPA English Last Updated: 03/08/2022   Spanish Last Updated: 02/14/2022   Chinese Last Updated: 02/14/2022   Vietnamese Last Updated: 02/14/2022   Independent Medical Review - [English] [Spanish] [Chinese] [Vietnamese] Updated October 7, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Integrated Denial of Payment Notice - 7 day appeal - IPA English Last Updated: 03/17/2021   Spanish Last Updated: 10/18/2021   Independent Medical Review - [English] [Spanish] [Chinese] [Vietnamese] Updated October 7, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Integrated Denial of Payment Notice - 30 day appeal - IPA English Last Updated: 03/17/2021   Spanish Last Updated: 04/12/2017   Independent Medical Review - [English] [Spanish] [Chinese] [Vietnamese] Updated October 7, 2022 Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Notice of Authorization of Services English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/17   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Notice of Dismissal of Coverage English Last Updated:03/10/2022   Spanish Last Updated:03/10/2022   Chinese Last Updated:03/10/2022   Vietnamese Last Updated:03/10/2022   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Notice of Medicare Non-Coverage English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 Notice of Reinstatement of Coverage English Last Updated: 10/31/2017   Spanish Last Updated: 10/31/2017   Nondiscrimination Notice & Taglines - [English] [Spanish] [Chinese] [Vietnamese] Updated October 27, 2022 (Back to top) NEW D-SNP Letter Templates These templates should not be used until the effective date of January 2, 2023. Please continue using the current Medicare DualChoice letter templates currently seen on this webpage for the remainder of 2022. A complete template includes all documents listed under each template in the order specified listed. Changes can only be made to highlighted areas, any changes made outside of the highlighted areas are strictly prohibited by CMS. Click on the title to expand the menu and download desired document. AOR Dismissal Letter English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 AOR Request Letter English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Continuity of Care - Notice of Authorization English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Continuity of Care – Notice of Termination English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Nondiscrimination Notice, Tagline, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Detailed Explanation of Non-Coverage English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Detailed Notice of Discharge English Last Updated: 12/20/2022   Spanish Last Updated:12/20/2022   Chinese Last Updated:12/20/2022   Vietnamese Last Updated:12/20/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Expedited Criteria Not Met English Last Updated: 09/26/2022   Spanish Last Updated: 09/26/2022   Chinese Last Updated: 09/26/2022   Vietnamese Last Updated: 09/26/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Extension Needed for Additional Information English Last Updated: 09/26/2022   Spanish Last Updated: 09/26/2022   Chinese Last Updated: 09/26/2022   Vietnamese Last Updated: 09/26/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Informational Letter to Beneficiary and PCP English Last Updated: 09/26/2022   Spanish Last Updated: 09/26/2022   Chinese Last Updated: 09/26/2022   Vietnamese Last Updated: 09/26/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Notice of Authorization of Services English Last Updated: 09/27/2022   Spanish Last Updated: 09/27/2022   Chinese Last Updated: 09/27/2022   Vietnamese Last Updated: 09/27/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Notice of Dismissal of Coverage Request English Last Updated: 09/26/2022   Spanish Last Updated: 09/26/2022   Chinese Last Updated: 09/26/2022   Vietnamese Last Updated: 09/26/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Notice of Medicare Non-Coverage English Last Updated:09/27/2022   Spanish Last Updated:09/27/2022   Chinese Last Updated:09/27/2022   Vietnamese Last Updated:09/27/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Cancelled Relocation Letter English Last Updated: 09/22/2022   Spanish Last Updated:09/22/2022   Chinese Last Updated:09/22/2022   Vietnamese Last Updated:09/22/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Long-Term Care IPA and PCP Change Letter English Last Updated: 09/26/2022   Spanish Last Updated:09/26/2022   Chinese Last Updated:09/26/2022   Vietnamese Last Updated:09/26/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Coverage Decision Letter Part B - 7 Day Appeal English Last Updated: 10/03/2022   Spanish Last Updated:10/03/2022   Chinese Last Updated:10/03/2022   Vietnamese Last Updated:10/03/2022   *Additional Information for IPAs: Please include the integrated Coverage Decision Letter, the most recent IMR form, application instructions, DMHC’s toll-free telephone number, and an envelope addressed to DMHC. Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Independent Medical Review (IMR) Form - [English] [Spanish] [Chinese] [Vietnamese] Updated January 01, 2023 State Fair Hearing Form - [English] [Spanish] [Chinese] [Vietnamese] Updated September 01, 2021 Coverage Decision Letter Medical – 30 Day Appeal English Last Updated: 10/03/2022   Spanish Last Updated:10/03/2022   Chinese Last Updated:10/03/2022   Vietnamese Last Updated:10/03/2022   *Additional Information for IPAs: Please include the integrated Coverage Decision Letter, the most recent IMR form, application instructions, DMHC’s toll-free telephone number, and an envelope addressed to DMHC. Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023 Independent Medical Review (IMR) Form - [English] [Spanish] [Chinese] [Vietnamese] Updated January 01, 2023 State Fair Hearing Form - [English] [Spanish] [Chinese] [Vietnamese] Updated September 01, 2021 Coverage Decision Letter - Claims English Last Updated: 11/22/2022   Spanish Last Updated:11/22/2022   Chinese Last Updated:11/22/2022   Vietnamese Last Updated:11/22/2022   Nondiscrimination Notice, Taglines, Language Insert - [English] [Spanish] [Chinese] [Vietnamese] Updated February 21, 2023   (Back to top) Medicare Certificates of Medical Necessity (CMN) & DME Information Forms (DIF) Positive Airway Pressure Devices for Obstructive Sleep Apnea (PDF) Enteral and Parenteral Nutrition (PDF) External Infusion Pump (PDF) Osteogenesis Stimulators (PDF) Oxygen (PDF) Seat Lift Mechanisms (PDF) Continuation Form (PDF) Transcutaneous Electrical Nerve Stimulator (TENS) (PDF) Pneumatic Compression Device (PDF) (Back to top) Non-Contracted Providers To submit a referral to IEHP, please fill out the referral form below, include all clinical notes and fax it to IEHP. If you are referring back to yourself, please indicate such. If you need IEHP to direct the referral, please indicate that on the form. Referral Authorization Request Form - Non-Contracted Providers (PDF) If you are interested in becoming a network Provider, please click here. (Back to top) Perinatal IEHP provides standard risk assessment forms that can be used by all Providers of obstetrical (OB) services. Please refer to IEHP Provider Policy 10D1, "Obstetrical Services, Guidelines for Obstetrical Services" for further detail. To obtain copies, simply click on the links below. Edinburgh Postnatal Depression Screening Tool - English (PDF) Edinburgh Postnatal Depression Screening Tool - Spanish (PDF) ACOG Antepartum Record (PDF) (Back to top) Pharmacy Click here for Pharmacy forms. (Back to top) Provider Preventable Conditions (PPC) By clicking on these links, you will be leaving the IEHP website. On May 23,2017, the Department of Healthcare Services (DHCS) released All Plan Letter (APL) 17-009, reporting requirements related to Provider Preventable Conditions. In conjunction, DHCS released Dual Plan Letter (DPL) 17-002. As part of these instructions, the Health Plan, Network Providers, Delegates, Contracted Hospitals, and ambulatory surgical centers must report using PPC Form on DHCS secure online portal for both Medicare and Medi-Cal lines of business. Further information is available on the following pages: Instructions for Completing Online Reporting of PPCs Medi-Cal Guidance on Reporting Provider-Preventable Conditions Frequently Asked Questions All Plan Letter (APL) 17-009 Duals Plan Letter (DPL) 17-002 PPC Form Medicare and Medi-Cal lines of business must follow the instructions below: Providers are REQUIRED to send a copy of the completed PPC submission from the DHCS secure online portal to IEHP by fax at (909) 890-5545 within five (5) business days of reporting to DHCS; IEHP does not pay Provider claims nor reimburse a Provider for a PPC, in accordance with 42 CFR Section 438.3(g) and IEHP's three-way Cal MediConnect contract. Per IEHP policy and the Coordinated Care Initiative 3-Way Contract, IEHP reserves the right to recover or recoup any claim related to a PPC; As outlined in both the APL/DPL - Reporting Requirements related to Provider Preventable Conditions, the following classify as PPCs and must be reported: Category 1 - HCACs (For Any Inpatient Hospital Setting in Medicaid) Any unintended foreign object retained after surgery A clinically significant air embolism An incidence of blood incompatibility A stage III or stage IV pressure ulcer that developed during the patient's stay in the hospital A significant fall or trauma that resulted in fracture, dislocation, intracranial injury, crushing injury, burn, or electric shock A catheter-associated urinary tract infection Vascular catheter-associated infection Any of the following manifestations of poor glycemic control: diabetic ketoacidosis; nonketotic hyperosmolar coma; hypoglycemic coma; secondary diabetes with ketoacidosis; or secondary diabetes with hyperosmolarity A surgical site infection following: Coronary artery bypass graft (CABG) - mediastinitis Bariatric surgery; including laparoscopic gastric bypass, gastroenterostomy, laparoscopic gastric restrictive surgery Orthopedic procedures; including spine, neck, shoulder, elbow Cardiac implantable electronic device procedures Deep vein thrombosis/pulmonary embolism following total knee replacement or hip replacement with pediatric and obstetric exceptions Latrogenic pneumothorax with venous catheterization A vascular catheter-associated infection Category 2 - Other Provider Preventable Conditions (For Any Health Care Setting) Wrong surgical or other invasive procedure performed on a patient Surgical or other invasive procedure performed on the wrong body part Surgical or other invasive procedure performed on the wrong patient (Back to top) UM/CM Acute Hospital Discharge Needs Request Form (PDF) Authorization for Use and/or Disclosure of Patient Health Information - English (PDF) Authorization for Use and/or Disclosure of Patient Health Information - Spanish (PDF) Care Management Referral Form (PDF) Consent for HIV Test - English (PDF) Consent for HIV Test - Spanish (PDF) Health Risk Assessment (HRA) - IEHP DualChoice (HMO D-SNP) - English (PDF) - effective 1/1/2023 Health Risk Assessment (HRA) - IEHP DualChoice (HMO D-SNP) - Spanish (PDF) - effective 1/1/2023 Health Risk Assessment (HRA) - IEHP DualChoice (HMO D-SNP) - Chinese (PDF) - effective 1/1/2023 Health Risk Assessment (HRA) - IEHP DualChoice (HMO D-SNP) - Vietnamese (PDF) - effective 1/1/2023 HIV Testing Sites - Riverside and San Bernardino (PDF) Home Health Check Off List (PDF) Home Modification Consent Form - English (PDF) - effective 04/01/2023 Home Modification Consent Form - Spanish (PDF) - effective 04/01/2023 Home Modification Consent Form - Chinese (PDF) - effective 04/01/2023 Home Modification Consent Form - Vietnamese (PDF) - effective 04/01/2023 Long Term Care (LTC) Data Sheet (PDF) Non-Emergency Medical Transportation (NEMT) Physician Certification Statement (PCS) (PDF) Referral Form (PDF) Service Request for Skilled Nursing Facilities (PDF) SNF Initial Review (PDF) SNF Follow-up Review (PDF) Standing Referral and Extended Access Referral to Specialty Care (PDF) Sterilization Consent Form PM-330 PM-330 Form - Tips and Example (PDF) PM-330 Form - English (PDF) PM-330 Form - Spanish (PDF) Transportation Requests Form (SNF & LTC) (PDF) Transportation Requests Form (Hospital) (PDF) Wound Assessment - Admission (PDF) Wound Assessment - Follow - Up (PDF) Wound Assessment - Addendum (PDF) (Back to top) Vision Ophthalmologist Referral Form (PDF) Vision Exception Request (VER) Form (PDF) PCP Vision Report Form (PDF) IEHP Lab Form (PDF) Medi-Cal Non-Covered Services/Materials Waiver Form-English (PDF) Medi-Cal Non-Covered Services/Materials Waiver Form-Spanish (PDF) Medi-Cal Non-Covered Services/Materials Waiver Form-Chinese (PDF) Medi-Cal Non-Covered Services/Materials Waiver Form-Vietnamese (PDF) The following IEHP DualChoice (HMO D-SNP) Letters will be effective January 1, 2023: IEHP DualChoice (HMO D-SNP) Non-Covered Services/Materials Waiver Form-English (PDF) IEHP DualChoice (HMO D-SNP) Non-Covered Services/Materials Waiver Form-Spanish (PDF) IEHP DualChoice (HMO D-SNP) Non-Covered Services/Materials Waiver Form-Chinese (PDF) IEHP DualChoice (HMO D-SNP) Non-Covered Services/Materials Waiver Form-Vietnamese (PDF) (Back to top) Other Authorization of Release - Use & Disclosure of PHI - English (PDF) Authorization of Release - Use & Disclosure of PHI - Spanish (PDF) CMS 1696 Appointment of Representative - English (PDF) CMS 1696 Appointment of Representative - Spanish (PDF) Contracts Maintenance Request Form (PDF) Provider Services Materials Request Form (PDF) 2017 Model Output Report (MOR) Data File Layout (PDF) (Back to top) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

s the Medi-Cal Renewal process, is currently underway across our state. This initiative is the biggest challenge facing the Medi-Cal program in its history. Up to 400,000 IEHP Members could potentially lose their Medi-Cal coverage if they don't complete the necessary renewal paperwork on time. The impact on Providers across the entire healthcare system will be significant, potentially resulting in: Increased use of the emergency department for primary care Decreased capacity of bed availability Delays in hospital discharges while awaiting coverage Increased length of stay for patients with delayed preventative or chronic care Increased cost of care Interruptions of ongoing care However, with every challenge comes opportunities to help our collective health care mission and partnership grow even stronger. IEHP takes this challenge seriously and we are committed to helping Members keep their Medi-Cal coverage and Providers keep their assigned Members without interruption. Resources to Help with the Medi-Cal Renewal Process The following resources for Providers offer more information about the Medi-Cal Renewal process and tools to help your office proactively engage and encourage Members to renew their Medi-Cal coverage on time. Medi-Cal Renewal Flyers and Provider Information IEHP Medi-Cal Renewal Flyer for Members PDF – (English, Spanish, Chinese, Vietnamese) Annual Eligibility Renewal (AER) FAQs Medi-Cal Redetermination PowerPoint presentation - (Providers and IPAs) Department of Health Care Services (DHCS) Toolkits – Medi-Cal Continuous Coverage Requirement IEHP Eligibility Renewal Support Team IEHP’s Eligibility Renewal Support team is here to answer calls from Members needing more one-on-one support during the Medical-Renewal process! We support: Application print outs Online submissions via BenefitsCal.com Assistance in connecting with the appropriate county department Serving as a centralized eligibility hub for all eligibility-related issues (on hold, disenrolled, out of area, etc.) Helping Members update contact information (national change of address, undeliverable address, etc.) Please let your patients and our Members know that additional application support is just a phone call away. IEHP Eligibility Renewal Support Team Hotline Phone and Hours of Operation: 1-888-860-1296, Monday-Friday, 8 am - 5 pm (PST) Additional information for IEHP Members Additional Communication from IEHP IEHP’s Medi-Cal Renewal specific Provider Communication is provided here for your convenience as well as here on our Correspondence page: May 04, 2023 - New: Annual Medi-Cal Eligibility Renewal (AER) Roster Now Available to Download Under CSV! (PDF) April 17, 2023 - Now Live! Annual Medi-Cal Eligibility Renewal (AER) Alerts and Roster! (PDF) April 06, 2023 - Phone Number CORRECTION: IEHP Eligibility Renewal Support Team First Round of Yellow Medi-Cal Renewal Packets Mailed to Members! (PDF) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

(IEHP) Pay for Performance program, also known as P4P. IEHP’s P4P was designed to increase the provision of preventive health services to IEHP Members as well as improve HEDIS® results to ensure that all IEHP Direct DualChoice Members receive timely annual assessment visits with an emphasis on review and management of chronic illnesses. IEHP Direct PCPs will be reimbursed directly by IEHP through the DualChoice Annual Visit program. PCPs participating in IEHP's network through an IPA only are not eligible for this program: Overview (PDF) DualChoice Annual Visit (PDF) To learn more about P4P IEHP DualChoice Annual Visit, contact a Provider Services Representative at (909) 890-2054. Click on the following links to jump to that specific section: Provider Quality Incentives Brochure Medicare P4P IEHP Direct IEHP Direct Stars Incentive Program D-SNP Model of Care Incentive Program Global Quality P4P Program OB/GYN P4P Program Hospital P4P Program Provider Quality Incentives Brochure Inland Empire Health Plan (IEHP) is pleased to announce the 2022 Provider Quality Incentive Brochure. 2022 Provider Quality Incentive Brochure (PDF) | June 22, 2022 (Back to P4P Menu) Medicare P4P IEHP Direct Program Inland Empire Health Plan (IEHP) is pleased to announce the Medicare P4P IEHP Direct Program.  The goal of the program is designed to reward IEHP Direct Primary Care Providers (PCPs) for providing quality care to IEHP DualChoice Members. Medicare P4P IEHP Direct Program Guide (PDF) Published: February 16, 2023 (Back to P4P Menu) IEHP Direct Stars Incentive Program Inland Empire Health Plan (IEHP) is pleased to announce the IEHP Direct Stars Incentive Program for Primary Care Physicians (PCPs). The goal of the program is to reward PCPs who provide high-quality care to IEHP DualChoice (HMO D-SNP) members. IEHP Direct Stars Incentive Program Guide (PDF) Updated: April 12, 2023 (Back to P4P Menu) D-SNP Model of Care Incentive Program Inland Empire Health Plan (IEHP) is pleased to announce the D-SNP Model of Care Incentive Program for Independent Physicians Associations (IPAs). The goal of the program is to reward IPAs who provide high-quality care to IEHP DualChoice (HMO D-SNP) members. D-SNP Model of Care Incentive Program (PDF) Published: March 24, 2023 Chronic Care Improvement Program Planning and Reporting Document The Chronic Care Improvement Program (CCIP) Planning and Reporting document can be used for the following D-SNP Model of Care Incentive Program activity: Chronic Care Improvement Program (CCIP) Activity. CCIP Planning and Reporting Document (Word Document) CCIP Planning and Reporting Document - Reference Guide (PDF) (Back to P4P Menu) Global Quality P4P Program If you would like more information about IEHP’s GQ P4P Program or best practices to help improve quality scores and outcomes, visit our Secure Provider Portal, email the Quality Team at QualityPrograms@iehp.org or call the IEHP Provider Relations Team at (909) 890-2054. 2023 IEHP Global Quality P4P Program Guide IPA (PDF) Published: April 21, 2023 2023 IEHP Global Quality P4P Program Guide PCP (PDF) Published: April 20, 2023 2022 IEHP Global Quality P4P Program Guide PCP (PDF) Published: April 20, 2023 2022 IEHP Global Quality P4P Program Guide IPA (PDF) Published: December 16, 2022 2022 Provider Quality Resource Guide (PDF) Published: July 14, 2022 (Back to P4P Menu) Quality Improvement Activity Strategy Forms The Quality Improvement Activity (QIA) Strategy Forms can be used for the following 2023 and 2022 Global Quality P4P QIA Activities: Reducing Health Disparities and Potentially Avoidable Emergency Department Visits or Potentially Preventable Admissions. 2023 Equity Quality Improvement Activity #1 - Strategy Form (PDF) 2023 Quality Improvement Activity #2 - Strategy Form (PDF) 2022 Equity Quality Improvement Activity #1 - Strategy Form (PDF) 2022 Quality Improvement Activity #2 - Strategy Form (PDF) (Back to P4P Menu) Potentially Avoidable Emergency Department (ED) Visits: Potentially Preventable Diagnosis Codes The Potentially Preventable Diagnosis Code List includes diagnosis codes for visits to an ED in which the condition could be treated by a Physician or other health care Provider in a non-emergency setting or conditions that are potentially preventable or are ambulatory care sensitive. Potentially Preventable Diagnosis List (PDF) Published: February 04, 2022 Patient Experience This toolkit is full of proven tips and successful strategies based on the kinds of questions your IEHP Members could be asked to answer regarding their Provider's service. Your Provider Relations Team has targeted nine specific topics in this toolkit to help Providers and their staff continue to achieve the highest marks in Patient experience from their IEHP Members. Serve Well Customer Service Toolkit (PDF) Well Child 2021 Recommendations for Preventive Pediatric Health Care from the American Academy of Pediatrics (PDF) Immunizations IEHP provides vaccine coverage based on the latest ACIP recommendation and guidelines. Please refer to the Immunization Update and "Summary of Recommendations" for both Child and Adolescents AND Adult Vaccines as follows: 2023 Immunization Timing Chart - English (PDF) 2023 Immunization Timing Chart - Spanish (PDF) 2023 Immunization Timing Chart - Chinese (PDF) 2023 Immunization Timing Chart - Vietnamese (PDF) Immunization Updates (PDF) 2023 Recommended Child and Adolescent Immunization Schedule (0-18 years) (PDF) 2023 Recommended Adult Immunization Schedule (19+ years) (PDF) Adult Vaccines are a covered benefit and do not require prior authorization (must adhere to CDC/ACIP Immunization Recommendation and/or FDA approved indication). Grow Well Childhood Immunization Toolkit for Providers (PDF) This toolkit contains commonly used immunization codes, best practices for reporting immunizations including information on registering with CAIR, tips on talking with parents and information on understanding vaccination hesitancy. CAIR2 Resource Guide (PDF) This guide contains helpful links and contact information for locations to register for CAIR2 or current users. Reimbursement process: Complete a CMS1500 form by including the appropriate CPT codes, quantity dispensed and billed amount. Mail:  IEHP Claims Department P.O. Box 4349  Rancho Cucamonga, CA 91729-4349. For the latest updates and news regarding the vaccines, please visit CDC's ACIP website at https://www.cdc.gov/vaccines/hcp/acip-recs/index.html. By clicking on this link, you will be leaving the IEHP website. (Back to P4P Menu) Quality Bonus Services Dispute Form Please e-mail completed forms to QualityPrograms@iehp.org Quality Bonus Service Dispute Request Form (PDF) (Back to P4P Menu) OB/GYN P4P Program Inland Empire Health Plan (IEHP) has released the OB/GYN P4P Program Guide which details the program requirements, performance measures, updated code sets, and payment timelines. OB/GYN P4P Program Guide (PDF) Published: January 01, 2023 OB P4P Frequently Asked Questions FAQs (PDF) Published: February 13, 2023 Postpartum Depression Screening (PDF) (Back to P4P Menu) Hospital P4P Program Inland Empire Health Plan (IEHP) is pleased to announce the Hospital Pay For Performance Program (Hospital P4P) for IEHP Medi-Cal contracted Hospitals servicing Riverside and San Bernardino Counties. The goal of the Hospital P4P Program is to provide substantial financial rewards to Hospitals that meet quality performance targets and demonstrate high-quality care to IEHP Members. 2023 Hospital P4P Program Guide (PDF) Published: May 9, 2023 2023 Hospital P4P Program Guide (PDF) Published: March 23, 2023 P4P 2023 MX Data Contributions (PDF) Published: February 02, 2023 IEHP P4P 2023 Data Guidelines (PDF) Published: February 02, 2023 2022 Hospital P4P Program Guide (PDF) Published: March 20, 2023 P4P 2022 MX Data Contribution (PDF) Published: April 18, 2022 P4P 2022 MX Data Guidelines (PDF) Published: April 18, 2022 (Back to P4P Menu) Potentially Avoidable Emergency Department (ED) Visits: Potentially Preventable Diagnosis Codes The Potentially Preventable Diagnosis Code List includes diagnosis codes for visits to an ED in which the condition could be treated by a Physician or other health care Provider in a non-emergency setting or conditions that are potentially preventable or are ambulatory care sensitive. Potentially Preventable Diagnosis List (PDF) Published: February 04, 2022 (Back to P4P Menu) Substance Use Disorders and Mental Health Diagnosis Lists The Substance Use Disorders and Mental Health Diagnosis Lists includes diagnosis codes to identify substance use disorders, drug overdose, mental health or intentional self-harm diagnoses. Mental Health Diagnosis List (PDF) Published: February 02, 2022 Substance Use Disorders Diagnosis List (PDF) Published: February 02, 2022 (Back to P4P Menu)   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here

管理壓力 避免危險性飲酒 識別憂鬱症狀 健康體重 其他資源 自我管理工具手冊 - 本手冊內容涵蓋有關上述主題的資訊。如果您想要索取書面版本的自我管理工具手冊，請於週一至週五上午 7 點至晚上 7 點以及週六至週日上午 8 點至下午 5 點致電 IEHP 會員服務中心，電話 1-800-440-IEHP (4347)。TTY 使用者請致電 1-800-718-4347。 計算您的身體質量指數 (Body Mass Index, BMI) – 20 歲及以上的成年人 計算您的身體質量指數 (BMI) – 2 歲到 19 歲的未成年人

後影響他們的健康。IEHP 希望能夠協助確保青少年儘可能做出最健康的選擇。 IEHP 希望確保青少年可以遠離高風險的習慣，例如： 抽菸 喝酒及服用其他藥物 進行不受保護的性行為 蹺課 IEHP 希望提倡健康的習慣，例如： 均衡飲食 接受青少年心理健康照護 運動 獲得充足睡眠 定期接受醫師看診 正在找尋任何資訊？ 請造訪下列連結，取得與青少年健康主題有關的有用資訊與工具。 點選下列任何連結，您將會離開 IEHP 網站。 疾病控制與預防中心 (CDC) - 青少年與學校健康  美國衛生與公眾服務部：青少年健康局 

親切地協助您參加免費課程、取得健康照護資訊以及瞭解健康保險。我們的大門隨時為 IEHP 會員和社區民眾敞開。  我們提供實體以及線上課程 健身課程 我們的課程包括瑜珈、倫巴（所有層級）、太極拳、排舞、適合老年人與殘障人士的瑜珈課程、冥想、拳擊有氧、拉丁舞、肌力與體能訓練和兒童有氧運動。 健康課程 瞭解營養學知識、哮喘症狀管理、糖尿病控制、壓力管理、呼吸和放鬆。 在哪裡可以找到課程資訊？ 現場： 河濱市 | 聖貝納迪諾市 | 維克多維爾市 線上： 虛擬課程 在 Facebook 關注我們以掌握最新消息 河濱市社區資源中心 查看我們的每月河濱市 CRC 行事曆 按一下以下載 PDF Click to Download PDF 河濱市 CRC 地址： 3590 Tyler Street, Suite 101, Riverside, CA 92503 河濱市 CRC 電話： 1-866-228-4347 TTY 使用者請致電 711 檢視我們的其他 CRC 據點： 聖貝納迪諾 CRC 維克多維爾 CRC  虛擬/線上  按一下以在 Google 地圖中檢視 聖貝納迪諾市社區資源中心 查看我們的每月聖貝納迪諾 CRC 行事曆 按一下以下載 PDF Click to Download PDF 聖貝納迪諾 CRC 地址： 805 West 2nd Street, Suite C, San Bernardino, CA 92410 聖貝納迪諾 CRC 電話： 1-866-228-4347 TTY 使用者請致電 711 檢視我們的其他 CRC 據點： 河濱市 CRC 維克多維爾 CRC  虛擬/線上  按一下以在 Google 地圖中檢視 維克多維爾社區資源中心 查看我們的每月維克多維爾 CRC 行事曆 按一下以下載 PDF Click to Download PDF 維克多維爾 CRC 地址： 12353 Mariposa Road, Suites C-2 & C-3, Victorville, CA 92395 維克多維爾 CRC 電話： 1-866-228-4347 TTY 使用者請致電 711 檢視我們的其他 CRC 據點： 河濱市 CRC a href="#sbEvents">維克多維爾 CRC  虛擬/線上  按一下以在 Google 地圖中檢視 維克多維爾社區資源中心在此也想要應該我們的以下夥伴： Goodwill Southern California：勞動力提供者協助個人透過生活所需的技能和工作支援服務提升自己的能力。 聖貝納迪諾市住宅管理局：透過房券或是平價住房單位為低收入家庭提供平價住房和租金援助。 Young Visionaires Youth Leadership Academy：透過教育、就業、健康、輔導以及社區服務等領域的生活建設活動和說明，豐富年輕人生活的指導課程。 聖貝納迪諾市社區行動合作關係：為聖貝納迪諾市居民提供家庭能源協助計畫 (Home Energy Assistance Program, HEAP) 以及住房援助。 TODEC：提供合法移民服務、宣傳、社區組織和公民參與。 虛擬課程 查看我們的每月線上課程行事曆 按一下以下載 PDF Click to Download PDF 透過 Facebook 加入課程： 我們的社區資源中心會透過 Facebook 提供各種虛擬課程。立即加入課程。 透過 WebEx 加入課程：   Webex 課程（密碼：12345）： Apple 使用者 Android 使用者 電腦使用者

here. TITLE DATE RECIPIENTS June 2023     2023 Underutilization Reports Available - Comp Diabetes Care HbA1c Testing Measure Replaced 06/07 All IPAs ACTION REQUIRED - 2023 HIV/AIDS Specialist Survey 06/07 All IEHP Direct PCPs & Specialists Updates to AB 1184 - Confidential Communication of Medical Information Involving Sensitive Services 06/05 All Medi-cal Providers & IPAs IPA Monthly Interim PM Changes 06/05 All IPAs REMINDER: DHCS APL 23-010 -Behavioral Health Treatment Coverage for Members Under the Age of 21 06/05 All BHT Providers sFTP Critical Vulnerability Detected! 06/02 All IPAs, Hospitals & SNFs New DHCS Drug Use Review (DUR) Board Educational Articles 06/02 All PCPs & OB/GYNs REMINDER - AB 1184 Confidential Communication Request (CCR), Effective June 2, 2023 06/01 Medi-Cal IPAs Updated IEHP sFTP Retention Policy 06/01 EDI Trading Partners May 2023     REMINDER – Review the Early Start Roster the Portal 05/30 All Medi-Cal IPAs and PCPs ACTION REQUESTED: Empowering Members, Resolving Non-Compliance: Provider - Patient Collaboration 05/26 All PCPs, OBGYNs, & Pediatricians NCQA Health Equity Race and Ethnicity Data Collection 05/26 All PCPs, Specialists, BH, BHT & Vision Providers SAVE THE DATE - DHCS EVV Office Hours - June 6th, 12th & 30th 05/26 All EVV Impacted Providers & Individual Nurse Providers UPDATE - PASRR Requirements for SNFs 05/25 Skilled Nursing Facilities Reminder: Utilize Member Alternate Contact Information for AER Outreach! 05/25 All PCPs, Specialists & BH Providers Weekly Sessions: Achieve IEHPs P4P MX Connectivity Measure - Deadline Approaching 05/24 All Medi-Cal PCPs Month-End IEHP Outbound 834 File Update 05/24 IEHP 834 Trading Partners REMINDER - DHCS Quarterly Timely Access Survey 05/23 All Medi-Cal PCPs, Specialists, BH & Ancillary UPDATE - Independent Medical Review (IMR) Forms 05/23 All Medi-Cal IPAs Memorial Day Holiday 05/22 All IEHP Providers and IPAs UPDATE - PASRR Requirements for GACHs 05/19 All General Acute Care Hospitals Provider Portal – Sub User Account Types and Access Levels 05/19 All IEHP Providers UPDATE - PASRR Requirements for SNFs 05/19 All Skilled Nursing Facilities APL 23-005 EPSDT 05/19 All Medi-Cal PCPs APL 23-005 EPSDT 05/19 All Medi-Cal IPAs Termination - SNF COVID-19 Per Diem Rate 05/17 All Skilled Nursing Facilities 2023 GQ P4P PCP - MX Deadline Reminder 05/17 All GQ P4P PCP Providers Medicare P4P IEHP Direct Blood Pressure Control Billing Guidance 05/16 All Direct DualChoice PCPs REMINDER - 2023 Global Quality P4P Program - CAIR2 Participation Requirement 05/15 All Medi-Cal PCPs Notice – APL 23-004 (Supersedes APL 22-018) – Skilled Nursing Facilities – Long Term Care Benefit Standardization and Transition of Members to Managed Care 05/12 All Skilled Nursing Facilities Behavioral Health Training Webinar – June 14, 2023 05/12 All BH Providers Behavioral Health Treatment Training Webinar - June 7, 2023 05/12 All BHT Providers Manifest MedEx Provider Listening Session 05/10 All PCPs, Specialists & IPAs Pharmacy Recalls, Withdrawals & Safety Alerts for April 2023 05/10 All IEHP PCPs, All IEHP Pharmacy Providers UPDATE-Treatment Authorization Process 05/10 All Skilled Nursing Facilities IPA Monthly Interim PM Changes 05/08 All IPAs NEW - Behavioral Health Transition of Care Tool Requirement 05/05 All PCPs & BH Providers New COVID-19 Vaccine Status Alerts Added to the Provider Portal 05/05 All PCPs SAVE THE DATE - DHCS EVV Office Hours - May 10th, 24th, 26th 05/05 EVV Impacted Providers & Individual Nurse Providers NEW: Annual Medi-Cal Eligibility Renewal (AER) Roster Now Available to Download Under CSV! 05/04 All Medi-Cal PCPs & IPAs REMINDER: Initial Health Appointment (IHA) Roster 05/04 Medi-Cal PCPs & IPAs Notice - Release of APL 22-032 “Continuity of Care” 05/04 All IPAs Retired/Revised - UM Authorization Guidelines 05/03 All IPA Administrators & Medical Directors Global Quality P4P PCP – NEW 2023 Interim Reports 05/03 Medi-Cal PCPs & IPAs ACTION REQUIRED - AB 1184 Delegate Response Due by May 9, 2023 05/02 Medi-Cal IPAs & Delegates Phase III – Lift 3 - Medi-Cal Rx Transition Policy Change 05/02 Medi-Cal PCPs & Specialists Care Management Monthly Medicare Log Templates & Attachments 05/01 Medicare IPAs Care Management Monthly Medi-Cal Log Templates & Attachments 05/01 Medi-Cal IPAs Maternal Wellness Event 05/01 OB/GYNs, BH, Hospitals, Medi-Cal PCPs & IPAs IEHP Outbound Monthly 834 File Delay 05/01 834 Trading Partners April 2023     REMINDER - IEHP Interpreter Service Benefit for Members! 04/28 All Providers & IPAs Month-End IEHP Outbound 834 File Update 04/26 834 Trading Partners Weekly Sessions - Achieve IEHPs P4P MX Connectivity Measure 04/25 All Medi-Cal PCPs New! 2023 IEHP Direct Stars Incentive Program – Reports and Rosters 04/25 All Direct DualChoice PCPs UPDATES - Global Quality P4P - IPA 2023 Program Guide 04/25 All Medi-Cal IPAs UPDATES - Global Quality P4P - PCP 2023 Program Guide 04/25 All Medi-Cal PCPs EVV CODE Changes Effective April 20 04/18 EVV Impacted Providers, Home Infusion Providers & Individual Nurse Providers SAVE THE DATE - DHCS EVV Office Hours - April 24th & 27th 04/18 EVV Impacted Providers and Individual Nurse Providers Now Live! Annual Medi-Cal Eligibility Renewal (AER) Alerts and Roster! 04/17 All Medi-Cal PCPs & IPAs UPDATE - 2023 IEHP Direct Stars Incentive Program Guide 04/17 All Direct DualChoice PCPs Care Plans and Health Risk Assessments (HRAs) Reminder 04/14 All PCPs, Specialists, SNFs and CBAs REMINDER: 2023 Global Quality P4P Program - CAIR2 Participation Requirement 04/12 Medi-Cal PCPs Weekly Sessions - Achieve IEHPs P4P MX Connectivity Measure 04/12 Medi-Cal PCPs Choice90Rx Optimization Program 04/11 All DualChoice PCPs UPDATE to eAuth (eReferral) Form - Referral Determination Date Goes Live! 04/11 Direct PCPs Pharmacy Recalls - Withdrawals - Safety Alerts - January to March 2023 04/10 All IEHP PCPs & Pharmacy Providers Phase III – Lift 1 - Medi-Cal Rx Transition Policy Change 04/10 All Medi-Cal PCPs & Specialists The ABCs of ACOs (Accountable Care Organizations) 04/07 Physicians & Practice Administrators POSTPONED - Addition of Referral Determination Date to e-Auth Form 04/07 Direct PCPs UPDATE to eAuth (eReferral) Form - Referral Determination Date 04/06 Direct PCPs Phone Number CORRECTION: IEHP Eligibility Renewal Support Team First Round of Yellow Medi-Cal Renewal Packets Mailed to Members! 04/06 Medi-Cal PCPs & IPAs IEHP Outbound Daily 834 Delta File Delay 04/06 834 Trading Partners 2023 IEHP Direct Stars Incentive Program Kick Off Meeting 04/04 All Direct DualChoice PCPs 2023 IEHP DualChoice (HMO D-SNP) Plan Benefits 04/03 Medicare PCPs, Specialists, Vision Providers & IPAs March 2023     New DHCS Drug Use Review (DUR) Board Educational Articles 03/31 All Medi-Cal PCPs & Specialists IEHP DualChoice (HMO D-SNP): Known Billing Issue 03/31 All IEHP Pharmacy Providers Pharmacy Recalls - Withdrawals - Safety Alerts - March 1-15, 2023 03/31 All IEHP PCPs & Pharmacy Providers Pharmacy Recalls - Withdrawals - Safety Alerts - Dec 2022 to Feb 2023 03/31 All IEHP PCPs & Pharmacy Providers Access Standards - Appointment Availability - BH 03/29 All BH Providers Achieve IEHPs P4P MX Connectivity Measure - Weekly Sessions 03/29 All Medi-Cal PCPs CMS Signature Requirement Guidelines for Member Medical Records 03/28 All PCPs, Specialists, BH Providers & IPAs The PHE is ending - How Will this Affect your IEHP Members? 03/27 All Medi-Cal PCPs & IPAs Month-End IEHP Outbound 834 File Update 03/27 All IEHP 834 Trading Partners REMINDER – Action Required by March 31st - Blood Lead Survey 03/23 All Pediatricians, Family Practice & Community Clinics REMINDER - IEHP Contracts with Call the Car for Transportation 03/23 All Hospital Administrators, SNFs & Dialysis Center REVISED – UM Authorization Guidelines 03/22 All IPA Administrators, Medical Directors & BH Providers Reminder Coordination of Care Reports and Rosters 03/21 All IPAs 2023 IEHP Direct Stars Incentive Program Guide Release 03/17 All Direct DualChoice PCPs PHA - Increased Enteric Disease Activity - Shigella 03/17 All PCPs Manifest MedEx Seminar - Achieve IEHP's MX Connectivity Quality Process Measure 03/17 All Medi-Cal PCPs Phase III – Lift 1 - Medi-Cal Rx Transition Policy Change 03/16 All Medi-Cal PCPs & Specialists RESPONSE REQUIRED – Provider Newsletter and Communication Survey 03/15 All PCPs, Specialists, Vision, BH & BHT Providers REMINDER - 2023 Global Quality P4P Program - CAIR2 Participation Requirement 03/15 All Medi-Cal PCPs Comprehensive Practice Optimization Workshop 03/15 All Riverside County PCPs Medical Assistants: Enhancing Patient Safety & Reducing Liability Risks 03/15 All Riverside County PCPs IEHP Coordination of Benefits Agreement (COBA) Implementation – Update 03/13 All PCPs, Specialists, Ancillary, & Hospitals ACTION REQUIRED - Blood Lead Survey 03/13 All Pediatricians, Family Practice & Community Clinics Opioid Attestation for Coverage Determinations and Removal of X-Waiver 03/10 All DualChoice Providers Social Determinants of Health - Community Supports Services Referral Process 03/10 All PCPs, Behavioral Health Providers & IPAs Complex Case Management (CCM) Program – Severe Chronic Conditions 03/08 All Medi-Cal IPAs, PCPs, Specialists, & Behavioral Health Providers UPDATE - IEHP Coordination of Benefits Agreement (COBA) Implementation 03/07 All FQHCs, IHCs, & RHCs REMINDER - Clean Claim Tool Guide Available 03/07 All Skilled Nursing Facilities GQ P4P PCP – 2023 Program Guide Update - Social Determinates of Health Measure 03/03 All Medi-Cal PCPs GQ P4P IPA – 2023 Program Guide Update - Social Determinates of Health Measure 03/03 All Medi-Cal IPAs Encouraging Sexual History Taking for Patient Care and Partner Services 03/03 All PCPs Encounter Data Submission Enhancements – Live Now! 03/02 All Direct PCPs IEHP Global Quality P4P Manifest MedEx (MX) FAQs 03/02 All Medi-Cal PCPs & IPAs Riverside County Medical Association - Physician Burnout Webinar 03/02 All Riverside and San Bernardino County PCPs Riverside County Medical Association's 19th Annual Cruisin' Thru CME 03/02 All Riverside County PCPs February 2023     CMS Alert - Fraudulent Activities and Monitoring Recommendations 02/28 All Medicare IPAs Update to D-SNP Letter Template 02/24 All Medicare IPAs Alternate Contact Information for Members Now Available! 02/23 All PCPs Alzheimer's and Dementia Seminar (ECHO) - Beginning March 29th 02/23 All PCPs Month-End IEHP Outbound 834 File Update 02/23 834 Trading Partners RESPONSE REQUESTED – Provider Newsletter and Communication Survey 02/21 All PCPs, Specialists, Vision, BH and BHT Providers UPDATE - Referral Timeline Standards for IEHP DualChoice (HMO D-SNP) Members 02/21 All Medicare IPAs Skinny Gene Project - Diabetes Prevention Program (DPP) 02/21 All PCPs Protocols for Emergency and Post-Stabilization Care for IEHP Members 02/17 All Hospitals REMINDER - 2023 Global Quality P4P Program - CAIR2 Participation Requirement- PCPs 02/16 All Medi-Cal PCPs Last Phase - Medi-Cal Rx Reinstatement of PAs for 46 Drug Classes, Including Medical Supplies - Eff. February 24th 02/14 All Medi-Cal PCPs & Specialists Presidents' Day Holiday 02/13 All IEHP Providers & IPAs RESPONSE REQUIRED – Provider Newsletter and Communication Survey 02/13 All PCPs, Specialists, Vision, BH and BHT Providers New Provider Portal Alert - Inpatient Discharges 02/09 All PCPs Quality Bonus Services RA’s Now Available! 02/09 All Medi-Cal PCPs Ask DHCS – Open Office Hours for EVV Home Health Care Services – February 17, 2023 02/03 All EVV Impacted Providers & Individual Nurse Practitioners UPDATE – Initial Health Appointment and Retirement of IHEBA/SHA 02/02 All Medi-Cal PCPs & IPAs Transition to 30-day Coverage Determination Backdating 02/02 All LTC & SNF Providers Redlands Community Hospital – Behavioral Health Unit Closed 02/01 All PCPs & BH Providers UPDATE - Independent Medical Review Form 02/01 All Medicare IPAs January 2023     KidsVaxGrant 3.0 Deadline to Apply is February 17, 2023 01/31 All Pediatricians and Family Practice PCPs Effective February 1, 2023 - Call The Car Will Replace American Logistics Company (ACL) for ALL Member Transportation 01/31 All PCPs, Specialists, BH & IPAs Provider Manual Acknowledgement of Receipt (AOR) Winners 01/27 All Providers Crisis Recovery Resource Guide and Toolkit Available 01/27 All Community Support Services REMINDER - BHT Providers Must Submit Exit Reports and Exit Letters! 01/27 All BHT (QASP) Providers D-SNP Model of Care Incentive Program - 2023 Program Guide Release 01/26 All Medicare IPAs Help Protect Members - Flu Vaccine Reminder 01/25 All PCPs 2023 Global Quality P4P PCP Kick Off Meeting 01/25 All Medi-Cal PCPs 2023 Global Quality P4P IPA Kick Off Meeting 01/25 All IPAs An ECHO Learning Opportunity - Alzheimer's And Dementia Care - Weekly Sessions Begin Feb 16th 01/24 All PCPs REMINDER - 2023 Global Quality P4P Program - CAIR2 Participation Requirement- PCPs 01/23 All Medi-Cal PCPs REMINDER - 2023 Global Quality P4P Program - CAIR2 Participation Requirement- IPAs 01/23 All Medi-Cal IPAs Response Requested by Thursday, January 26! - CBAS Emergency Remote Services (ERS) 01/23 All CBAS Providers Global Quality P4P PCP Program - 2023 Program Guide Release 01/19 All Medi-Cal PCPs UPDATE! Medi-Cal Letter Templates 01/17 All Medi-Cal IPAs Emergency Resource Guide and Services – Flooding Services Available! 01/17 All Community Support Services Providers Medicare P4P IEHP Direct – Blood Pressure Control Billing Guidance 01/13 All DualChoice PCPs NEW! Regulatory Submission Response Files – MAO-004 XWalk 01/13 All Medicare IPAs ALERT! 837 SBR04 Encounter Data Requirement Changes 01/13 All Medicare IPAs IEHP DualChoice (D-SNP) Model of Care Training Requirement 01/12 All DualChoice Hospitals IEHP DualChoice (D-SNP) Model of Care Training Requirement 01/10 All Medicare IPAs IEHP DualChoice (D-SNP) Model of Care Training Requirement 01/10 All DualChoice Providers IEHP Outbound 834 File Update 01/10 All 834 Trading Partners IEHP HOLIDAY - Martin Luther King Jr. Day 01/09 All IEHP Providers CORRECTION to Changes to Quarterly Workplan Requirements 01/05 All Medicare IPAs LAST CHANCE to Win a $50 Gift Card - Submit 2023 Provider Policy and Provider Manual Acknowledgement of Receipt (AOR) 01/04 All IEHP Providers 2023 Population Health Management Academy 01/04 All Riverside County PCPs CORRECTION - 2022 GQ P4P PCP - Quality Bonus Services Code Update 01/03 All Medi-Cal PCPs December 2022     Outbound Eligibility File Delay on January 1, 2023 12/29 All IPAs and Ancillary Providers REMINDER - CoverMyMeds - Prior Authorization Submission Method for Dual Choice Members– Effective January 1, 2023 12/29 All Dual Choice PCPs & Specialists REMINDER - Pharmacy Benefits Manager (PBM) Change for DualChoice (HMO D-SNP) - Member Outreach in Process 12/29 All Dual Choice PCPS and Medicare IPAs Access Standards – Appointment Availability - BH Providers 12/28 All Behavioral Health Providers Mandatory Managed Care Enrollment (MMCE) Phase II - January 1, 2023 12/27 All Medi-Cal PCPs & Specialists Access Standards – Appointment Availability - PCPs & OB/GYNs 12/27 All PCPs & OB/GYNs Access Standards – Appointment Availability - Specialists 12/27 All Specialists NEW! State Fair Hearing and Independent Medical Review Forms added to D-SNP Letter Templates (Effective January 2, 2023) 12/27 All Medicare IPAs REMINDER - Help Your Members Update Their Contact Information! 12/22 All PCPs 2022 GQ P4P PCP - Quality Bonus Services Code Update 12/22 All Medi-Cal PCPs & IPAs UPDATED! D-SNP Letter Templates (Effective January 2, 2023) 12/21 All Medicare IPAs Phase II Wave I– Prior Authorization Submission – January 20, 2023 12/21 Medi-Cal PCPs & Specialists Crossing the Line - Examining Professional, Personal, & Ethical Boundaries 12/21 Riverside County PCPs & Specialists IEHP Outbound Daily 834 Delta File Delay 12/20 All 834 Trading Partners Revised UM Authorization Guidelines 12/19 All IPA Administrators & Medical Directors REMINDER - IEHP DualChoice (HMO D-SNP) begins Jan 2023 12/19 All Medicare PCPs, Specialists & BH Providers OB P4P Program - Early Postpartum Visit Update 12/19 All Medi-Cal OB/GYNs My Life. My Choice. - An Online Advanced Care Planning Program 12/16 All Dual Choice PCPs REMINDER - CoverMyMeds - Prior Authorization Submission Method for Dual Choice Members– Effective January 1, 2023 12/16 All Dual Choice PCPs & Specialists IEHP 2022-2023 Holiday Hours 12/15 All Providers & IPAs 2022 Global Quality P4P Program – Data Submission Deadlines for PCPs! 12/15 All Medi-Cal PCPs 2022 Global Quality P4P Program – Data Submission Deadlines for IPAs! 12/15 All Medi-Cal IPAs CORRECTION– New Fax Number for Physician Certification Statements for Non-Emergency Medical Transportation 12/09 All Hospitals and SNFs Medicare Formulary Changes for 2023 IEHP DualChoice (HMO D-SNP) 12/08 All Medicare PCPs, Specialists & IPAs Pharmacy Recalls, Withdrawals & Safety Alerts - November 2022 12/07 All PCPs REMINDER - Physician Certification Statement (PCS) Requirement 12/06 All PCPs, Specialists, BH & IPAs EVV Home Health Care Services Open Office Hours – December 16th 12/06 EVV Impacted Providers & Individual Nurse Practitioners Mpox (formerly Monkeypox) Vaccine Available through Local Health Departments 12/05 All Medi-Cal PCPs & IPAs IMPORTANT! DHCS Error – Members Will NOT be Disenrolled From IEHP 12/05 All Medicare PCPs & IPAs Global Quality P4P PCP – 2022 Program Guide Update (Quality Bonus Services) 12/05 All Medi-Cal PCPs The Alzheimer's Association Event - Resources for Improving Dementia Care in the Clinical Practice 12/02 All PCPs CoverMyMeds - Prior Authorization Submission Method for Dual Choice Members– Effective January 1, 2023 12/02 All Dual Choice PCPs REMINDER - IEHP Dual Choice (HMO D-SNP) begins Jan 2023 12/02 All Medicare PCPs, Specialists & BH Providers Response Requested by December 6, 2022! - CBAS Emergency Remote Services - Reporting 12/02 All CBAS Providers IEHP Formulary Changes - November P&T Update 12/02 All PCPs November 2022 Pharmacy and Therapeutics Subcommittee Update 12/02 All PCPs NEW! D-SNP Letter Templates - Claims (Effective January 2, 2023) 12/02 All Medicare IPAs Effective Today! - IEHP Contracts with Call The Car For Transportation 12/01 All Hospitals & SNFs COVID-19 Isolation in SNF 12/01 All SNFs Living the Mission Awards Nomination Form 12/01 All IEHP Providers November 2022     Inland Empire Community Health Assessment 11/30 All PCPs, IPAs, Specialists, & Behavioral Health Providers Pharmacy Benefits Manager (PBM) Change for DualChoice (HMO D-SNP) - Member Outreach in Process 11/29 All DualChoice PCPs & Medicare IPAs ID Cards with Errors Reissued to Dual Choice Members 11/23 Select Dual Choice PCPs Inland Caregiver Resource Center Informational Webinar - ECHO 11/23 All PCPs IEHP’s Quarterly Behavioral Health Provider Training 11/18 All Behavioral Health (BH) Providers Thanksgiving Holiday 11/18 All IEHP Providers IEHP Outbound Daily 834 Delta File Delay 11/18 All 834 Trading Partners CoverMyMeds - Prior Authorization Submission Method for Dual Choice Members– Effective January 1, 2023 11/17 All IEHP DualChoice PCPs IEHP DualChoice (HMO D-SNP) 2023 Vision Benefits 11/17 All Vision Providers Riverside County Medical Association's Physician Holiday Social 11/17 All Riverside County PCPs & Specialists RUHS - PHA - Early Respiratory Syncytial Virus (RSV) and Seasonal Influenza Activity 11/17 All Riverside County PCPs Global Quality P4P PCP Meeting - 2023 Program Preview 11/16 All Medi-Cal PCPs BHT (QASP) Provider Training 11/15 All BHT (QASP) Providers Reminder - BH Emergency Instruction Standards 11/15 All BH Providers Reminder - PCP and Specialist Emergency Instruction Standards 11/15 All PCPs & Specialists UPDATE! D-SNP Letter Templates (Effective January 2, 2023) 11/15 All Medicare IPAs UPDATE - Revised UM Authorization Guidelines to November 3, 2022 - UM-BH 08 11/14 All Medi-Cal IPAs & BHT Providers Pharmacy Recalls, Withdrawals & Safety Alerts - October 2022 11/14 All PCPs REMINDER: IEHP DualChoice (HMO D-SNP) begins Jan 2023 11/10 All Medicare PCPs, Specialists & BH Providers REMINDER: Help Your Members Update Their Contact Information! 11/10 All IEHP PCPs Maternal Wellness Event Flyer 11/09 All Medi-Cal PCPs, OB/GYNs, Peds, BH Providers & IPAs Essure System - No Longer a Covered Benefit 11/09 All OB/GYNs ACTION REQUIRED -Submit 2023 Provider Policy and Provider Manual Acknowledgement of Receipt (AOR) - Win a $50 Gift Card 11/08 All IEHP Providers Veterans Day 11/04 All IEHP Providers & IPAs Revised UM Authorization Guidelines 11/03 All BH Providers & IPAs Pharmacy Recalls, Withdrawals & Safety Alerts - September 2022 11/02 All PCPs October 2022     Medicare - Nondiscrimination Notice and Taglines Templates 10/31 All Medicare IPAs REMINDER: IEHP Interpreter Services – A Covered Benefit! 10/31 All PCPs & IPAs Continuous Glucose Monitors 10/28 All Medicare PCPs, Endocrinologists & IPAs Health Education Classes Available in Riverside Area 10/27 All Riverside Area PCPs, Specialists & OBs PHA - Outbreak of Ebola Virus Disease Due to Sudan Virus in Central Uganda 10/25 All Riverside County PCPs 834 Eligibility File Format Changes 10/25 All IHEP 834 Trading Partners Global Quality P4P IPA Meeting – 2023 Program Preview 10/21 All Medi-Cal IPAs REMINDER DHCS Hospice Rates – Prospective Calculation Based on Medicaid Rates 10/21 All Hospice Providers NEW! D-SNP Letter Templates (Effective January 2, 2023) 10/21 All Medicare IPAs Help Protect Your Members Against the Flu 10/20 All PCPs & IPAs Public Health Emergency (PHE) Ending Soon – Help Your Members Reenroll! 10/19 All IEHP PCPs REMINDER - Balance Billing of IEHP Members Not Permitted! 10/14 All IEHP Providers ACTION REQUIRED - Correct Prioritization of Authorization Requests 10/14 All PCPs, Specialists & IPAs Global Quality P4P PCP Meeting – 2023 Program Preview 10/13 All Medi-Cal PCPs Flu Vaccine Notice -Access to Pharmacy Vaccine Network 10/13 All PCPs  Cal MediConnect Sunsets and IEHP Dual Choice (D-SNP) Begins 10/12 All PCPs Academic Detailing Services Now Offered 10/11 All IEHP Providers & Pharmacies REMINDER - ACTION REQUIRED - Electronic Visit Verification (EVV) Implementation Requirements – Self Registration Required by October 19, 2022 10/10 All Home Health Care Services (HHCS) Providers & Personal Care Services (PCS) UPDATE - Independent Medical Review (IMR) Forms 10/10 All Medicare IPAs UPDATE to September 8, 2022 Communication Authorization Timeframes 10/6 All Medi-Cal IPAs Special Fraud Alert - Exercise Caution with Purported Telemedicine Companies 10/6 All IEHP Providers & IPAs FAQs For Delegate Monitoring of Utilization Measures 10/5 All IPAs September 2022     Global Quality P4P Programs – NEW 2022 Quality Bonus Services! 09/30 All Medi-Cal PCPs Diversity Awareness Month - October 2022 - Please Join Us! 09/30 All IEHP Providers & IPAs REMINDER - IEHP Coordination of Benefits Agreement (COBA) Implementation – Action Required! 09/30 All PCPs, Specialists, ANC & Hospitals ICD-10-CM Risk Adjustment Code Changes for CMS HCC Code Capture 09/26 All Direct Dual Choice PCPs UPDATE! – Continuous Glucose Monitoring (CGM) Systems (IPA) 09/23 All Medi-Cal IPAs UPDATE! – Continuous Glucose Monitoring (CGM) Systems 09/22 All Medi-Cal PCPs & Endocrinologists ACTION REQUIRED - Electronic Visit Verification (EVV) Implementation Requirements – Self Registration Required by October 19, 2022 09/22 All Home Health Care Services (HHCS) Providers & Personal Care Services (PCS) UPDATED Medi-Cal Letter Templates 09/22 All Medi-Cal IPAs URGENT ATTENTION: Phishing Email Alert 09/21 All IEHP Providers Pharmacy Times - Medication Reconciliation 09/21 All Dual Choice PCPs Grievance Process Updates - Grievance Summary Form - Due Date 09/15 All IPAs Continuity of Care (COC) Rosters Now Available on SFTP 09/15 All IPAs REMINDER - Enhanced Care Management Available for Members 09/15 All Medi-Cal ANC and Vision Providers  Coordination of Benefits Agreement (COBA) Implementation - Action Required 09/12 All PCPs, Specialists, ANC & Hospitals REMINDER - Dilated Retinal Exam (DRE) for Diabetic Members 09/09 All PCPs & Vision Providers Revised UM Authorization Guidelines 09/09 All IPA Administrators & Medical Directors Annual BH&CM Medi-Cal IPA Training Survey 09/08 All Medi-Cal IPA Care Management Staff IEHP Provider Portal Updates – Reports now Viewable by TIN 09/08 All Medi-Cal PCPs NEW - Collecting Social Determinants of Health Data (SDOH) 09/08 All Medi-Cal PCPs, Specialists & BH Providers Authorization Timeframes Notice of Action (NOA) Translation & Attachment 09/08 All Medi-Cal IPAs Please Notify IEHP if Your Availability has Changed due to Area Fires 09/08 All Hemet and Big Bear Area Providers  Recalls, Withdrawals & Safety 09/08 All IEHP Providers & Pharmacies IEHP Formulary Changes (P&T) 09/07 All IEHP PCPs Access Standards - Appointment Availability - Specialists 09/02 All Specialists Access Standards - Appointment Availability - PCP, Ob 09/02 All PCPs & Obs Access Standards - Appointment Availability - BH 09/02 All Behavioral Health Providers Vaccination Clinic and Resource Fair - September 10 09/02 All Direct PCPs IEHP Medi-Cal Medical Benefit Formulary 09/02 All Medi-Cal PCPs, Specialists & Psychiatrists August 2022 P&T Update 09/02 All IEHP Providers & Pharmacies August 2022     2022 - 2023 Flu Vaccination for IEHP Members  08/31 All IEHP Providers & Pharmacies REMINDER: Medi-Cal Rx Gradual Reinstatement of PAs – Phase 1 08/31 All Medi-Cal PCPs & Specialists Labor Day Holiday 08/30 All IEHP Providers & IPAs REMINDER: Enhanced Care Management Available for Members 08/30 All Medi-Cal PCPs & IPAs Final REMINDER: Submit the 2022 Provider Satisfaction Survey 08/29 All PCPs, Specialists & BH Providers REMINDER: Community Supports Services Available for Members 08/29 All PCPs, Specialists & BH Providers Medication Reconciliation Program 08/29 All IEHP Providers & Pharmacies NOTICE: DHCS Approved Letter – Prior Authorization Not Required 08/26 All Medi-Cal IPAs NOTICE: DHCS Approved Letter – Prior Authorization Not Required 08/26 All Medi-Cal PCPs, Specialists & Ambulatory Surgery Centers REMINDER: Aug 2022 Provider Educational Series: “How to Navigate Rosters & Reports” 08/24 All Direct Medi-Cal PCPs NEW: Health Education Classes Offered in Desert Hot Springs and Mecca 08/24 All Coachella Valley PCPs ADVISORY: Updated Monkeypox Guidance 08/23 All Riverside County PCPs San Bernardino County Public Health - Monkeypox Guidance 08/23 All San Bernardino County PCPs & Specialists REMINDER: Medication Reconciliation 08/22 All IEHP Providers REMINDER: 2022 Provider Satisfaction Survey 08/22 All PCPs, Specialists, & BH Providers REMINDER: DHCS Quarterly Timely Access Survey 08/22 All Medi-Cal PCPs, Specialists, BH & Ancillary Providers Medication Reconciliation Program 08/22 All IEHP Providers & Pharmacies Reinstatement of PA Requirements for 11 Drug Classes 08/17 All Medi-Cal PCPs REMINDER: Appropriate Billing for Dispensing of Vision Materials 08/17 All Vision Providers REMINDER: Provider Directory Verification Form due August 26th 08/17 Select PCPs & Specialists Medication Reconciliation Program 08/15 All IEHP Providers & Pharmacies REMINDER: Timely Provision of Denial Packets 08/12 All Medicare IPAs Member Grievance Updates: Medical Record Requests 08/12 All Direct PCPs, Specialists, & Ancillary 2022 Global Quality P4P Program Guide Updates - SDOH Rate Measure 08/12 All Medi-Cal PCPs & IPAs Medi-Cal Letter Templates 08/11 All Medi-Cal IPAs Recalls, Withdrawals & Safety 08/10 All IEHP Providers & Pharmacies UPDATE: IEHP’s Network is Open to New QASP Providers 08/08 All BHT Providers 2022 Provider Educational Series – How to Navigate Rosters & Reports 08/08 All Direct Medi-Cal PCPs Proposition 56 – Don’t Miss Out on Available Supplemental Payments 08/05 All Medi-Cal PCPs 2022 Provider Quality Resource Guide 08/05 All PCPs Changes to Quarterly Workplan Requirements 08/03 All IPAs REMINDER: Provider Preventable Conditions - Reporting Requirements 08/03 All IEHP Providers, Ambulatory Surgical Centers & IPAs Webinar: COVID-19 In the Black and Brown Community and the Post Long-Term Effects 08/01 All PCPs & IPAs Medication Reconciliation Program 08/01 All IEHP Providers & Pharmacies July 2022     NEW DATE: Medi-Cal Rx Gradual Reinstatement of Prior Auths (PAs) – Phase 1 – September 16, 2022 07/29 All Med-Cal PCPs & Specialists Practitioner Reporting Requirements - UB-04 Claim Form 07/29 All SNFs, Hospitals, & Ancillary Free Webinar: It Takes a Village to Manage COVID-19 07/27 All PCPs & IPAs REMINDER: Medi-Cal Rx Gradual Reinstatement of PAs – Phase 1 – August 1, 2022 07/25 All Medi-Cal PCPs & Specialists ALERT: Hospice Policy and Procedures 07/25 Select Contract and Non-Contracted Hospice Providers Inappropriate Treatment Delays and Denials for HIV PrEP and PEP 07/22 All Medi-Cal PCPs & Specialists UPDATED: Telehealth Services FAQs 07/21 All PCPs, Specialists, BH, BHT Providers & IPAs 2022 Global Quality P4P Program – Provider Directory Verification 07/20 All Medi-Cal PCPs NEW: Riverside County Public Health: Updated Monkeypox Guidance 07/20 All Riverside County PCPs & Specialists DHCS Plan Data Feed Project – Files Available on SFTP 07/19 All IPAs 2022 Global Quality P4P PCP Program Guide- UPDATES 07/18 All Medi-Cal PCPs 2022 Global Quality P4P IPA Program Guide- UPDATES 07/18 All Medi-Cal IPAs 2022 Appointment Availability Survey – Fax Survey 07/15 All PCPs & IPAs 2022 Appointment Availability Survey – Fax Survey 07/15 All BH Providers 2022 Appointment Availability Survey – Fax Survey 07/14 All Specialists, Ancillary & IPAs UPDATE: Diabetic Vision Outreach Campaign – EXTENDED to July 22, 2022 07/14 All Vision Providers Medi-Cal Rx Gradual Reinstatement of PAs – Phase 1 07/11 All Medi-Cal PCPs & Specialists 2022 Global Quality P4P (GQ P4P) Interim Reports Data Refresh 07/11 All Medi-Cal PCPs & IPAs Update: Risk Adjustment Telehealth and Telephone Services 07/11 All Dual Choice PCPs, Specialists & BH Providers Cal MediConnect Sunsets and IEHP Dual Choice (D-SNP) Begins 07/08 All Medicare PCPs, Specialists & BH Providers 2022 Provider Satisfaction Survey 07/07 All PCPs, Specialists & BH Providers 2022 Provider Educational Series - Provider Directory Verification Process (Virtual) 07/07 All Medi-Cal PCPs Recalls, Withdrawals & Safety 07/07 All IEHP Providers & Pharmacies IEHP Medi-Cal Medical Benefit Formulary 07/01 All Medi-Cal PCPs, Specialists & Psychiatrists IEHP Providers Can Post Jobs and Find Candidates for Free on SoCalDocJobs.com 07/01 All PCPs You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.