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Member Testimonials - Our Members
group of students from the Inland Empire. More than 30 recipient students grew up in the Inland Empire and more than 50% are first generation medical students and grew up in low-income households. Through the scholarship fund, aspiring healthcare professionals will be guided through the system and connected to the health plan’s provider network. This allows students to pursue successful careers in healthcare immediately after graduation to help support the region’s growing population. Loma Linda University School of Medicine Inland Empire Medical Community Service Awardees Class of 2022 Ye Jin Jeon Ye Jin's Why: “I applied for the Inland Empire Medical Community Service Award because the goal and priority to expand access to care and healthcare provider options for the Southern California region aligns with my calling. As a child growing up in the San Bernardino County, I saw the economic disproportion within my own neighborhood, and this compelled me…God has led me pursue my medical career” Class of 2024 Edwin Choque Edwin's Why: “Simply put, my heart lies in the Inland Empire. This community of individuals have fostered me and loved me since I was a child and all I can hope is to pay that love and care forward. . . . My dream is to be on the front lines as a representative for these individuals who frequently become marginalized…” University of California, Riverside Dean's Mission Recipients Four Year Award Elizabeth Celaya-Ojeda Elizabeth's Why: “I want to work particularly with the underserved in this area because I truly believe that being a physician is a privilege and with that there is a responsibility to be an advocate for those who are facing health disparities. I am particularly interested in providing care to underserved Native American and Hispanic communities. Not many healthcare providers are aware of the disparities these two communities face and I want to be an advocate for them, especially in the Inland Empire.” Alfonso Parocua Alfonso's Why: “Growing up, my family lacked meaningful access to healthcare and relied on a local free clinic as our only means of interacting with a physician. Through my personal experience with the free clinic, I developed a passion for service to the underserved communities who lack meaningful access to basic healthcare amenities due to low socioeconomic status. I sought opportunities that would allow me to pay my gratitude forward by becoming part of the solution to healthcare disparities in Inland Southern California. Through my volunteer efforts in free clinics and other community involvement programs, I witnessed the passion and dedication that health care providers and volunteers in the area have towards the underserved community. This realization deepened my connection to Inland Southern California because I was reminded so much of the health care professionals that helped my family when they couldn't help themselves.” Two Year Award Cesar Fortuna Cesar's Why: “A San Bernardino native, I have had the opportunity to volunteer in my community as a Spanish language translator for free clinics. Most patients I have spoken with fell into the category of uninsured, underinsured, or undocumented. It became clear the extent of need in this region when I would translate to the providers that this was the first-time dozens of our patients had ever seen a medical professional; however, this wasn’t uncommon. To these patients and their stories, I thank them because they inspire me to pursue Emergency Medicine where I can become a valuable player in providing care, providing resources, or providing comfort.” Lavinia Mitroi Lavinia's Why: “My goal of pursuing a career at the intersection of medicine and public health is driven by a desire to put patients and communities at the center of our health care system in the U.S. This desire was sparked most poignantly by my own experiences as an IEHP patient growing up in the Inland Empire. As I prepare for a future career as a pediatrician in this region, I hope to serve as an advocate for children and families, providing direct health services but also creating systems change.” Armando Navarro Armando's Why: “The earliest memory of my grandfather is him telling me, “Mijo, tienes que aprender Español para ayudar tu comunidad, you have to learn how to speak Spanish to help your community”. These words were often repeated to me by my grandfather who lamented the fact that he only spoke Spanish. I witnessed the health disparities affecting my community; doctors who did not speak Spanish, parents who could not afford a trip to the doctors’ office, and a healthcare system that was not inclusive of my community’s culture. I have a duty to give back to a school, a community, that has given me so much.” Christ Ordookhanian Christ's Why: “I see the medical profession through the lens of an individual who had lived through challenging times and witnessed how one individual provider can make such and impact when their heart is in the right place. My dedication to our underserved community stems from that of a lifelong mission I have set for myself which is to ensure I give back to a community that I am deeply associated with, they are my founding roots in the United States, and I vow to be at the forefront of the next generation of physicians that care and give the underserved hope.” University of California, Riverside Dean's Mission Recipients Daphne Du Daphne's Why: “I spent most of my life in underprivileged areas and saw firsthand how difficult healthcare access could be through inadequate financial resources, transportation, or translation services. Thanks to this investment in my studies, there is less stress in my life. I can focus on my studies and eventually give back to the community by becoming a physician who will advocate for patients without meaningful access to health care.” Judith Gonzales Judith's Why: “As a first-generation college student, there have always been many barriers in my path to higher education. I am the eldest daughter of an immigrant family, and it is truly an honor to be able to reach this point in my education and in my career, and to give back to my parents who have sacrificed so much for me and my sisters. Growing up in an underserved community showed me the long-lasting impacts of health inequities and strengthened my resolve to pursue a career in medicine. Working in the Inland Empire, I hope to not only address, but actively work towards combating the health inequity present in our communities.” Jordan Hough Jordan's Why: “Despite disadvantages encountered when living in a low-income community, I am grateful for the privilege I had in meeting physicians dedicated to their practice and willing to share that love through mentorship. These individuals have served as exemplary medical professionals and have encouraged me to follow in their footsteps. As a future physician, I aspire to empathetically care for patients by allowing my past experiences to enhance my understanding of their needs. I also plan to incorporate teaching into patient care by presenting opportunities for students to shadow and be mentored for a career in medicine.” Diana Martinez Diana's Why: “I am the daughter of Mexican Immigrants and grew up in Compton, California where I unfortunately was quickly desensitized to violence and was able to tell the difference between a firework and a gun shot. My mother had to travel a significant distance to ensure we had adequate healthcare. Despite these conditions, my parents always stressed education and did their best to give me what I needed. These life circumstances ignited my passion to serve those in disadvantaged communities, which I interacted with throughout my educational career. The Inland Empire Health Program Scholarship means I can achieve my dream –by practicing medicine in a community that deserves adequate, equitable, and accessible healthcare. I will serve as a bilingual physician in the Inland Empire that can serve families like my own and many more.”
Special Programs - Alcohol & Drug (SABIRT)
ant to the Department of Health Care Services (DHCS) APL 21-014 (PDF), “Alcohol and Drug SABIRT,” IEHP has updated its requirements for alcohol and substance use screening in the primary care setting. Helpful resources: Correspondence - June 2022 - Alcohol and Drug SABIRT Training Guide (PDF) Screening Tools Alcohol Use Disorders Identification Test (AUDIT-C) Brief Addiction Monitor (BAM) (PDF) Cut Down-Annoyed-Guilty-Eye-Opener Adapted to Include Drugs (CAGE-AID) (PDF) Tobacco Alcohol, Prescription Medications and other Substances (TAPS) (PDF) National Institute on Drug Abuse (NIDA) Quick Screen for Adults (PDF) Drug Abuse Screening Test (DAST-10) (PDF) Parents, Partner, Past, and Present (4Ps) for pregnant women and adolescents (PDF) Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) for non-pregnant adolescents (PDF) Michigan Alcoholism Screening Test Geriatric (MAST-G) alcohol screening for geriatric population (PDF) Assessment Tools Alcohol Use Disorders Identification Test (AUDIT) (PDF) Brief Addiction Monitor (BAM) (PDF) NIDA-Modified Alcohol, Smoking and Substance Involvement Screening Test (NM-ASSIST) (PDF) Drug Abuse Screening Test (DAST-20) (PDF) Pamphlets Riverside Brochure (English) (PDF) Riverside Brochure (Spanish) (PDF) San Bernardino Brochure (English) (PDF) San Bernardino Brochure (Spanish) (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.
Join Our Network - IPA
p 1668 S. Garfield 2nd Fl. Alhambra, CA 91801 (877) 282-8272 (626) 943-6329 Dignity Health Medical Network - Inland Empire 3400 Data Drive, Rancho Cordova, CA 95670 (916) 851-2026 (916) 851-7642 LaSalle Medical Associates 1855 W. Redlands Blvd. 2nd Floor, Redlands, CA 92373 (888) 554-4562 (626) 943-6369 Optum Care Network - Inland Faculty MG 1860 Colorado Blvd. Ste 200, Los Angeles, CA 90041 (800) 371-7547 (323) 257-7329 Physicians Health Network P.O. Box 11429, San Bernardino, CA 92423 (909) 300-5030 (909) 332-5555 Horizon Valley Medical Group 18564 US Highway 18 Ste 105, Apple Valley, CA 92307 (760) 813-6950 (760) 813-6947 DualChoice CalMediConnect CPN - Horizon Valley Medical Group 18564 US Highway 18 Ste. 105, Apple Valley, CA 92307 (760) 242-7777 (760) 242-0487 Dignity Health Medical Network - Inland Empire 3400 Data Drive, Rancho Cordova, CA 95670 (916) 851-2026 (916) 851-7642 EPIC Health Plan 1615 Orange Tree Lane, Redlands, CA 92374 (909) 799-1818 (909) 786-0816 Alliance Desert Physicians, Inc. Beaver Medical Group Chaffey Medical Group FENIX Medical Group Pinnacle Medical Group Redlands - Yucaipa Medical Group TriValley Medical Group Heritage Provider Network 8510 Balboa Blvd. Ste 275, Northridge, CA 91325 (818) 654-3461 Desert Oasis Healthcare 275 N El Cielo Rd., Palm Springs, CA 92262 (760) 320-8814 Heritage Victor Valley Medical Group 12370 Hesperia Rd., Victorville, CA 92395 (760) 245-4747 Regal Medical Group 621 E Carnegie Dr. Ste 140, San Bernardino, CA 92408 (818) 654-3400 PrimeCare, part of Optum Care 3990 Concourse St., Ontario, CA 91764 (909) 605-8000 Optum Care Network - Citrus Valley 9130 Anaheim Place Ste 130, Rancho Cucamonga, CA 91730 (909) 466-8000 (909) 484-6825 Optum Care Network - Corona 2275 Sampson Ave. Ste 111, Corona, CA 92879 (951) 371-8440 (951) 371-3910 Optum Care Network - Hemet Valley 41391 Kalmia St. Ste 310, Murrieta, CA 92562 (951) 461-0762 (951) 698-5194 Optum Care Network - Inland Valley 9130 Anaheim Pl. Ste 130, Rancho Cucamonga, CA 91730 (909) 466-8000 (909) 484-6825 Optum Care Network - Moreno Valley 1467 Ford St. Ste 103, Redlands, CA 92373 (909) 798-7766 (909) 792-8627 Optum Care Network - Redlands 1520 Barton Rd., Redlands, CA 92373 (909) 798-7766 (909) 792-8627 Optum Care Network - Riverside 2275 Sampson Ave. Ste 111, Corona, CA 92879 (951) 371-8440 (951) 371-3910 Optum Care Network - San Bernardino 1467 Ford St. Ste 103, Redlands, CA 92373 (909) 798-7766 (909) 792-8627 Optum Care Network - Sun City 41391 Kalmia St. Ste 310, Murrieta, CA 92562 (951) 461-0762 (951) 698-5194 Optum Care Network - Southwestern Valleys 41391 Kalmia St. Ste 310, Murrieta, CA 92562 (951) 461-0762 (951) 698-5194 Optum Care Network - Valley Physicians 24630 Washington Ave. Ste 203, Murrieta, CA 92562 (951) 704-1900 (877) 397-7682 Riverside Medical Clinic 3660 Arlington Ave., Riverside, CA 92506
Join Our Network - Hospitals
CA 92324 (909) 580-1000 (909) 580-6308 Barstow Community Hospital 820 E Mountain View Barstow, CA 92311 (760) 256-1761 (760) 957-3397 Bear Valley Community Healthcare District 41870 Garstin Drive Big Bear Lake, CA 92315 (909) 866-6501 (909) 878-8282 Chino Valley Medical Center 5451 Walnut Ave. Chino, CA 91710 (909) 464-8600 (909) 464-8882 Colorado River Medical Center 1401 Baily Ave. Needles, Ca. 92363 (909) 326-7100 (909) 326-7292 Community Hospital of San Bernardino 1805 Medical Center Dr #201 San Bernardino, CA 92411 (909) 887-6333 (909) 806-1044 Corona Regional Medical Center 800 S Main St. Corona, CA 92882 (951) 737-4343 (951) 736-6310 Desert Regional Medical Center 1150 N Indian Canyon Dr. Palm Springs, CA 92262 (760) 323-6511 (760) 323-6330 Desert Valley Hospital 16850 Bear Valley Rd. Victorville, CA 92395 (760) 241-8000 (760) 951-2034 Eisenhower Medical Center 39800 Bob Hope Dr. Rancho Mirage, CA 92270 (760) 340-3911 (760) 773-1532 Hemet Global Medical Center 1117 E Devonshire Ave. Hemet, CA 92543 (951) 652-2811 (951) 765-4745 Hi-Desert Medical Center 6601 White Feather Rd. Joshua Tree, CA 92252 (760) 366-3711 (760) 365-9309 Inland Valley Regional Medical Center 36485 Inland Valley Dr., Wildomar, CA 92595 (951) 677-1111 (951) 698-7721 John F. Kennedy Memorial Hospital 47111 Monroe St. Indio, CA 92201 (760) 347-6191 (760) 775-8014 Loma Linda University Children's Hospital 11234 Anderson St. Loma Linda, CA 92354 (909) 558-8000 (909) 558-3278 Loma Linda University Medical Center 11234 Anderson St. Loma Linda, CA 92354 (909) 651-1702 (909) 478-3202 Loma Linda University Medical Center - Murrieta 28062 Baxter Rd. Murrieta, CA 92563 (951) 290-4000 (951) 290-4092 Menifee Global Medical Center 28400 McCall Blvd. Sun City, CA 92585 (951) 679-8888 (951) 766-6470 Montclair Hospital Medical Center 5000 San Bernardino St. Montclair, CA 91763 (909) 625-5411 (909) 626-4777 Mountains Community Hospital 29101 Hospital Rd. Lake Arrowhead, CA 92352 (909) 336-3651 (909) 336-4730 Palo Verde Hospital 250 N 1st St. Blythe, Ca 92225 (760) 922-4115 (760) 921-5263 Parkview Community Hospital Medical Center 3865 Jackson St. Riverside, CA 92503 (951) 688-2211 (951) 352-5363 Pomona Valley Hospital Medical Center 1798 N. Garey Ave. Pomona, CA 91767 (909) 865-9500 (909) 865-2104 Rancho Springs Medical Center 25500 Medical Center Dr. Murrieta, CA 92562 (951) 696-6000 (619) 627-5949 Redlands Community Hospital 350 Terracina Blvd. Redlands, CA 92373 (909) 335-5500 (909) 335-6497 Riverside Community Hospital 4445 Magnolia Ave. Riverside, CA 92501 (951) 788-3000 (951) 788-3201 Riverside University Health Care System 26520 Cactus Ave. Moreno Valley, CA 92555 (951) 486-4000 (951) 486-4475 San Antonio Regional Hospital 999 San Bernardino Rd. Upland, CA 91786 (909) 985-2811 (909) 920-6357 San Gorgonio Memorial Hospital 600 N Highland Springs Ave., Banning, CA 92220 (951) 845-1121 (951) 845-2836 St. Bernardine Medical Center 2101 N Waterman Ave., San Bernardino, CA 92404 (909) 883-8711 (909) 881-4337 St. Mary Medical Center 18300 US Highway 18 Apple Valley, CA 92307-2206 (760) 242-2311 (760) 946-8714 Temecula Valley Hospital 31700 Temecula Pkwy Temecula, CA 92592 (951) 331-2200 (951) 331-2211 Victor Valley Global Medical Center 15248 Eleventh St. Victorville, CA 92395 (760) 245-8691 (760) 245-6996
Join Our Network - Ancillary
ly contracted provider. PLEASE NOTE, IEHP is currently not accepting new: DME Hospice Specialty Pharmacy Clinical Laboratories Please check monthly for updates on Network Availability. Prior to extending a contract, we must receive the following documents: 1. Ancillary Provider Network Participation Request Form (PDF) 2. W-9 Form A current Taxpayer Identification Number and Certification Form 3. Liability Insurance Certificate Professional general liability in the minimum amount of One Million Dollars ($1,000,000) per occurrence. Three Million Dollars ($3,000,000) aggregate per year for professional liability. 4. Ownership Information (PDF) Name, Title and Percentage of Ownership 5. Provider Accreditation Certificate 6. CMS/DHCS Passing Site Survey (Approval Letter) Required for each facility 7. California State License (if applicable) Required for each facility 8. Urgent Care Minimum Qualifications (if applicable) All Ages (PDF) Pediatrics (PDF) 9. Medi-Cal Number Ancillary Providers need to successfully enroll in the State's Medi-Cal Program 10. Provider Acknowledgment of Receipt (AOR) (PDF) IEHP is required by State and Federal regulators to maintain an AOR form on file for our Providers signifying your receipt and review of the Policy & Procedure manuals, including annual updates 11. Electronic Remittance Advice (ERA) Form (PDF) Ancillary Providers must complete the ERA form Contracts Maintenance Request Form can be found here (PDF). Any delay in receiving the above stated documents will affect the effective date of the contract that will be mailed to you. The contract collateral and other supporting contract documents should be e-mailed to firstname.lastname@example.org. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Join Our Network - Behavioral Health
l Health Forms Behavioral Health As a local Health Plan, Inland Empire Health Plan (IEHP) is committed to improving behavioral health services for our Members by developing direct relationships with select clinicians. IEHP now has over 1,000,000 Members. Behavioral Health Clinicians are viewed as "Specialists" that are partners in improving the health status of our Members. IEHP Behavioral Health is an integrated essential partner with primary medical care. IEHP’s Direct Behavioral Health Program will offer our Behavioral Health Specialists: Streamlined Authorization & Claims Submission - via our fast and secure website. Competitive Reimbursement Rates - based on current Medicare rates. Speedy Payments - our track record is payment in less than 3 weeks (in most cases). Personal, Friendly Service - to ensure a successful and long-lasting working relationship. IEHP is committed to develop direct partnerships with Psychiatrists, Psychologists, LCSW's, LMFT's, Psychiatric Nurse Practitioners, Physician Assistants, and most recently, Licensed Professional Clinical Counselors (LPCC) who have met the couples and family qualifications. LPCCs without this qualification will not be considered eligible to join IEHP's Behavioral Health Network. For any questions or concerns, please email Contract@iehp.org. Requirements for this certification can be found here: https://www.bbs.ca.gov/pdf/publications/lpcc_couple-fam_courses.pdf In compliance with APL 17-019 (a DHCS regulation), IEHP now requires Behavioral Health Providers to begin the process of enrolling with Medi-Cal prior to contracting with IEHP. To ensure timely processing of your application, IEHP will accept your application to contract upon receipt of verification of Medi-Cal enrollment submission. Prospective Providers: QASP PLEASE NOTE, IEHP is now accepting new QASP Providers in all services areas. Behavioral Health Behavioral Health Provider Letter and Application (PDF) Why You Should Contract with IEHP Directly for Behavioral Health (PDF) How IEHP Keeps You Informed and Drive Business to Your Practice (PDF) Medi-Cal Number (Physicians should be enrolled in the State's Medi-Cal Program) Existing Providers: Contracts Maintenance Request Form (PDF) W-9 Form (PDF) (Remittance advice address change) Medi-Cal Number (Physicians should be enrolled in the State's Medi-Cal Program) Frequently Asked Questions (FAQs) What is IEHP? How do I contract with IEHP? What are IEHP's compensation rates? What are IEHP’s minimum requirements to be considered for your BH Network? What if I have additional information about my practice, specialties or experience that is not covered on the survey; where can I send this information? When will I hear back from IEHP after I send my contract in? What services does IEHP offer online? What are the benefits and limitations for Medicare DualChoice Members? I am a Behavioral Health Treatment Provider for one or more of the following services, how do I contract with IEHP? (Services for Individuals (0-21) with Autism, Developmental Disabilities, or Specialized Behavioral needs; utilizing Applied Behavior Analysis and Behavior Modification treatment modalities) What is IEHP? IEHP stands for Inland Empire Health Plan. IEHP is a not-for-profit health plan that serves over 1,000,000 Members in public-sponsored health coverage programs including Medi-Cal and Medicare Special Needs Plan. How do I contract with IEHP? The first step is to fill out the Behavioral Health Provider Letter and Application (PDF) and email Contract@iehp.org. We will contact you directly once we have evaluated our Member’s needs and are ready to proceed with contracting. What are IEHP compensation Rates? Reimbursement rates for Behavioral Health Services are based on Medicare rates. What are IEHP’s minimum requirements to be considered for your BH Network? A valid California License (LCSW, LMFT, LPCC, Psychologist, Psychiatrist, Nurse Practitioner) $1 million to $3 million Malpractice Insurance Must be enrolled with Medi-Cal Satisfy all IEHP’s standard credentialing requirements What if I have additional information about my practice, specialties or experience that is not covered on the survey; where can I send this information? You can send your information to: Inland Empire Health Plan Attention: Provider Relations P.O. Box 1800 Rancho Cucamonga CA 91729-1800 When will I hear back from IEHP after I send my contract in? Over the next two to three months we will be gathering information and determining our needs and as soon as we have determined what Providers we will need we will send out draft contracts with rate sheets for review. What services does IEHP offer online? Member Eligibility Verification Claims Submission Services Claims Status Authorization Status Medication Search Pharmaceutical Services Information Resources Provider Manuals; Benefit Manuals; EDI manuals What are the benefits and limitations for Medicare DualChoice Members? Click here. I am a Behavioral Health Treatment Provider for one or more of the following services, how do I contract with IEHP? (Services for Individuals (0-21) with Autism, Developmental Disabilities, or Specialized Behavioral needs; utilizing Applied Behavior Analysis and Behavior Modification treatment modalities) The first step is to fill out the Behavioral Health Provider Letter and Application (PDF) and email Contract@iehp.org. We will contact you directly once we have evaluated our Member’s needs and are ready to proceed with contracting. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Provider Resources - POLST Registry
fornia Physician Orders for Life Sustaining Treatment (POLST) Registry (CPR) to connect a digital POLST network throughout the Inland Empire Healthcare System which includes independent physicians, hospitals, skilled nursing facilities, and the Health Information Exchange (HIE). The goal of this initiative is to provide a more effective means of documenting, communicating, and ensuring Member desired Treatment at the end of life is being honored. By clicking on these links, you will be leaving the IEHP website. To login, visit Working Toward a Statewide POLST Registry in California | POLST (capolst.org) To sign up, simply go to POLST for Healthcare Providers | POLST (capolst.org) CPR Correspondence (PDF) CPR FAQ (PDF) For any questions, please contact Care Directives at (888) 621-4383 or email email@example.com. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Provider Resources - Additional Resources & Tools
ols Menu Click on the following links to jump to that specific section: After Hours Care After Hours Phone Numbers IEHP Access Standards IEHP Direct Adult Hospitalists LabCorp Locations Urgent Care Clinics After Hours Care IEHP Providers can direct Members to access care after hours. After hour care includes the 24-Hour Nurse Advice Line, DocOnline and Urgent Care Clinics. Fever? Pain? Cold? Call our 24-Hour Nurse Advice Line --> Your Members can call the IEHP 24-Hour Nurse Advice Line for medical advice anytime, day or night: 1-888-244-IEHP (4347) DocOnline, an extension to the Nurse Advice Line, allows Members to speak with a board-certified Physician for advice after hours using telephonic and/or video devices. DocOnline Physicians will triage, assess, and provide diagnoses for minor acute conditions. Physicians may also give treatment advice, refill select prescriptions and refer Members for in-person care. DocOnline FAQs (PDF) Prescription Medication Refill List (PDF) (Back to Additional Resources Menu) After Hours Phone Numbers for Coverage Determination and Expedited Appeals IEHP DualChoice (HMO D-SNP) Members The following numbers are to be used for after hour requests: Coverage Determinations: Phone: (888) 860-1297 Expedited Appeals: Phone: (866) 223-4347 Fax: (909) 890-5748 (Back to Additional Resources Menu) IEHP Access Standards On an annual basis, IEHP conducts the Appointment Availability Access Study. All Members must receive access to all covered services without regard to sex, race, color, religion, ancestry, national origin, creed, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, sexual orientation, or identification with any other persons or groups defined in Penal Code Section 422.56, except as needed to provide equal access to Limited English Proficiency (LEP) Members or Members with disabilities, or as medically indicated. Appointment Standards for All Provider Types (PDF)| Last Revised: 12/12/2022 Appointment Standards for Behavioral Health (PDF)| Last Revised: 01/11/2023 (Back to Additional Resources Menu) IEHP Direct Adult Hospitalists Direct Adult Hospitalist (PDF) | Last Revised: 02/27/2023 (Back to Additional Resources Menu) LabCorp Locations A listing of LabCorp Patient Service Centers around the Inland Empire can be found below: LabCorp Patient Service Centers (PDF) LabCorp Patient Service Centers at Walgreens (PDF) (Back to Additional Resources Menu) Urgent Care Clinics --> Any of your IEHP Members needing medical attention may visit an Urgent Care Clinic after regular business office hours and on weekends. A listing of all Urgent Care Clinics is found on the IEHP Doctor Search. (Back to Additional Resources Menu) You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Provider Resources - IEHP DualChoice - Model of Care
als who are dual eligible for both Medicare and Medi-Cal in Riverside and San Bernardino counties, including the most vulnerable population. This also includes members transitioning from IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan). IEHP has identified the most vulnerable as the following: Age 21-70 Identified as High and Rising Risk Diagnosed with Cardiovascular Disease AND/OR Diabetes RUB Score of 4 & 5. *RUB is Resource Utilization Band which is a predictor of using acute or costly services. IEHP will identify the most vulnerable members assigned to IPAs IEHP and its IPAs must design care management specific interventions to demonstrate how they support these member's health and wellness goals. Examples of Specially Tailored Services for the Most Vulnerable Population Remote Patient Monitoring Medically Tailored Meals and Other Community Supports Nutrition Education Pharmacy Services (medication reconciliation and other programs) Long-Term Services and Supports (LTSS) Telehealth Behavioral Health Services Transportation More frequent care management contact 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, Chrome or MS Internet Explorer You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Provider Resources - Pharmacy
gram, Prior Authorization Criteria, Clinical Practice Guidelines, Forms, IEHP Formulary, and Safety Resources with drug recall information. If you have any questions regarding services provided by the Pharmaceutical Services Department, please feel free to contact the IEHP Pharmacy Department at (909) 890-2049. Pharmaceutical Services
Provider Resources - Claims
d range of topics for all types of Providers with questions regarding billing requirements and claims processing guidelines. Resources are not limited to webinars, computer based training, and webinars. Providers also have direct access to their Regional Representative and the Small Provider Billing Unit (SPBU) through this link (By clicking on this link, you will be leaving the IEHP website) https://learn.medi-cal.ca.gov/. Medi-Cal Rates and Codes By clicking on these links, you will be leaving the IEHP website. Medi-Cal Rates The file lists the maximum reimbursement rates payable by the Medi-Cal program for covered procedures described in the HCPCS and CPT-4 coding system. Resource: website CPT Codes This website is aimed at providing information to Providers on Medicare's National CCI edits, but will not address specific CCI edits. Resource: website Alpha-Numeric HCPCS Files These files contain the Level II alpha-numeric HCPCS procedure and modifier codes, their long and short descriptions, and applicable Medicare administrative, coverage, and pricing data. Resource: website ZIP code To Carrier Locality File This file is primarily intended for use by ambulance suppliers to map ZIP Codes to CMS carriers and localities. This file will also map ZIP Codes to their State and can determine whether the ZIP Code has a rural designation as determined by CMS. Resource: website Medicare Physician Fee Schedule Information on services covered by the Medicare Physician Fee Schedule (MPFS). Resource: website IEHP Fee Schedule IEHP Fee Schedule - December 08, 2020 (PDF) Provider Dispute Resolution Process For more information about the Provider dispute resolution process for contracted and non-contracted Providers, click here Other Health Coverage (OHC) Coordination of Benefits with Other Health Coverage (OHC) (PDF) Frequently Asked Questions (FAQs) - OHC (PDF)
P4P - Proposition 56 - GEMT - Prop 56 - Value Based Payment
OS June 30, 2022, payments will run out through June 2023. The Proposition 56 VBP Program provided direct payments incentivizing Providers to meet specific measures aimed at delivering key quality healthcare services that improve the quality of care to Medi-Cal beneficiaries. Targeted areas were behavioral health integration, chronic disease management, prenatal/post-partum care and early childhood prevention. For more information about the VBP Program, please visit the DHCS website at https://www.dhcs.ca.gov/provgovpart/Pages/VBP_Measures_19.aspx. By clicking on this link, you will be leaving the IEHP website. Value Based Payments Program Guide Value Based Payments (VBP) Program Guide (PDF) - Published: January 01, 2022 Value Based Payments Dispute Forms Value Based Payments Program - Paid Claims Dispute Request (PDF) Published: January 19, 2022 Value Based Payments Program - Encounter Dispute Request (PDF) Published: January 19, 2022 Please e-mail completed forms to ValueBasedPaymentsProgram@iehp.org At-Risk Condition Codes The At-Risk Condition Codes list includes diagnosis codes to identify Serious Mental Illness, Substance Use Disorder or Homelessness Conditions for the VBP Program. These conditions qualify Providers for an additional payment amount for VBP services. Please refer to page 4 of the VBP Program Guide for additional details. At-Risk Condition Codes (PDF) Published: March 25, 2020 You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
COVID-19 - 檢測地點
檢測以治療」站點完成。 如果您的醫療狀況使您更有可能因 COVID-19 加重病情，您可能有資格接受治療。 成人和年滿 12 歲的兒童可以接受治療，但必須在出現症狀後 5 天內盡快開始治療。 按一下此處以進一步瞭解 COVID-19「檢測以治療」計畫的相關資訊。 免費的居家 COVID-19 檢測 美國境內的每個家庭都有資格訂購一個免費的 COVID-19 檢測試劑盒，其中包括四個居家檢測試劑。這些檢測完全免費。按一下此處以訂購由美國郵政管理局 (United States Postal Service, USPS) 提供的免費居家檢測。 自 2022 年 2 月 1 日起，Medi-Cal 會員可接受 Medi-Cal 網絡內藥局提供的居家 COVID-19 檢測服務。加州衛生保健服務局 (California Department of Health Care Services, DHCS) 每月可為每名會員報銷最多 8 份檢測試劑盒。如需瞭解哪些檢測試劑盒在承保範圍內，或者如果您需要處方相關協助，請諮詢您的醫生或您的藥劑師。 如果 Medi-Cal 會員在 2021 年 3 月 11 日至 2022 年 1 月 31 日期間購買居家檢測試劑盒，則可以透過此處列出的程序由 DHCS 報銷費用（須提供收據）。 San Bernardino 郡支援的檢測點將為在 San Bernardino 郡生活、工作或上學的人士提供免費的居家 COVID-19 檢測試劑盒（需要提供居住或就業證明）。按一下此處以尋找郡級協助檢測點的清單。 檢測 IEHP 會承保提供者安排進行的檢測，包括 PCR、快速檢測、居家檢測等。如果您的醫生為您安排檢測，IEHP 將承擔檢測費用。您的提供者需要為這些檢測直接向 IEHP 請款。 如會員選擇支付並非由提供者要求進行的 COVID 檢測，IEHP 不會予以報銷。 如需更多有關 Riverside 郡 COVID-19 檢測點的資訊，請造訪 Riverside 郡公共衛生處 網站。 如需更多有關 San Bernardino 郡 COVID-19 檢測點的資訊，請造訪 San Bernardino 郡 COVID-19 檢測點。
最新消息 - IEHP 25 週年慶「做正確的事」
並僱用近 2,500 名團隊成員，繼續在策略道路上前行以紀念此重要里程碑。 「在過去 25 年裡，我們非常高興能讓本地區數百萬人獲得全人醫療保健服務，」IEHP 執行長 Jarrod McNaughton 說道。「隨著 CalAIM 等大型計畫的實施和 COVID-19 疫情的持續，我們必須繼續滿足會員、提供者和團隊成員的需求，以便有效地合作，為本地區居民提供最佳照護和健康活力。」 IEHP 自 1996 年開始營運，擁有超過 60,000 名 Medi-Cal 會員，並於 1998 年啟動健康家庭計畫 (Healthy Families Program)，積極為不符合 Medi-Cal 資格之工薪家庭中的未投保兒童提供保險。截至 2000 年，IEHP 已成為加州第一批獲得 NCQA「值得推薦」認證的純 Medi-Cal 健康計畫，並在美國最大的 Medicaid 計畫中排名第九。 隨著多項支持兒童（健康兒童計畫 (Healthy Kids)）、老年人（Medicaid）、殘障人士（Medicare 雙選計畫 (Medicare DualChoice)）和特定健康狀況（如糖尿病和氣喘）人群計畫的建立，IEHP 能夠支持因《平價照護法案》(Affordable Care Act) 而增加的符合醫療服務資格的內陸帝國居民，2015 年健康計畫的會員數增加至 100 萬人。 最近，此健康計畫被評為加州老齡化總體計畫 (Master Plan for Aging) 的典範，並為本州的多年轉型計畫提供多個創意，以解決影響本州 Medi-Cal 人口 (CalAIM) 的許多複雜挑戰。作為典範的計畫包括圍繞健康和住房創新主題的健康計畫，例如 IEHP 的 住房計畫 (Housing Initiative) 和健康之家計畫 (Health Home Program)。 除了支持 CalAIM 等轉型計畫外，IEHP 也致力尋求永續性解決方案，以提高本地區居民的正向健康成果。「雖然我們慶祝在本地區的優異表現，但我們作為一個社區型健康計畫的工作還有一大段路要走，」McNaughton 說道。 「在內陸帝國建立和加強提供者網路以抵消持續的提供者短缺問題，並與我們的合作夥伴共同建立電子病歷系統 (Electronic Medical Record System) 以更好地照顧會員，只是我們努力進行的兩項優先事項，」McNaughton 補充說道。「我們的口號是始終為會員『做正確的事』，我們的使命是治癒和激勵人道精神，這將引導我們的思想、決策，而且最重要的是，引導我們透過這些項目和 IEHP 在未來數月和數年採取行動。」
最新消息 - 社區植物園以食品、魚類和友誼伴您成長
lan (IEHP) 與社區合作夥伴密切合作，為這些植物園提供支持，其中包括與音樂公司 Music Changing Lives (MCL) 首席執行官 Josiah Bruny 愉快的合作，大家攜手為聖貝納迪諾打造出一個全新的社區植物園。 這片土地位於聖貝納迪諾 Electric Avenue 與 North 40th Street 的拐角處，曾是該市最大的垃圾場之一，現已被改造成 MCL 的城市植物園。除了解決食品無保障的問題外，植物園還旨在提供一個安全的空間，讓鄰居們可以聚在一起學習、鍛煉、就餐、探究、放鬆和玩樂。 每月的第四個星期日都會舉辦「靈魂星期天」(Soulful Sunday) 活動，邀請當地居民參觀植物園，參加園藝工作坊和各種志願者活動，同時享受各種美食與音樂等。如需查看有關 Soulful Sunday 的資訊，請造訪 MCL 的 Facebook 網頁。 「這項計畫的亮點在於它是完全由社區領導，」Bruny 說。「只要我們所有人齊心協力，便能為該地區及最需要幫助的人帶來更多的關愛。我們期盼能持續合作，讓 Inland Empire 成為對所有人來說都更美好的家園。」 除了提供贊助外，IEHP 還透過公司的團隊成員「樂於助人」 (Helping Hearts) 計畫和健康教育 (Health Education) 團隊召集志願者為植物園提供支持。志願者們與計畫負責人一起除草、植樹、鋪地膜、建造園圃以及灌溉農作物。 「有了完美的伙伴關係、同情心、治愈與振奮人類精神的動力，這些植物園會不斷蓬勃發展，並讓我們的鄰居體驗到各種健康，」IEHP 社區健康高級主任 Cesar Armendariz 說。「我們非常感激 Music Changing Lives 對 Inland Empire 以及這裡的居民們的熱愛，也十分期待能繼續攜手種植和建立更多的植物園，從而打造一個更健康的社區。」 該健康計畫還向「Jardín Comunitario de la Salud」（西班牙語意思為「健康社區植物園」）提供贊助，幫助支持聖貝納迪諾 Loma Linda University Health SACHS 診所的大型魚菜共生植物園。 這個植物園是 Inland Empire 的第一個此類植物園，它養殖了大量魚類，這些魚類生活在一處，可以滋養園圃。另外，這個植物園還在努力種植出豐收好且可供社區享用的食品。 植物園遍佈在庫卡蒙格牧場、安大略、朱魯帕、佩里斯與聖貝納迪諾。如需瞭解當地社區植物園的更多資訊，請造訪：riversidefoods.org。
最新消息 - 聯合權力機構的例行會議公告
AN AND IEHP HEALTH ACCESS. Date of Meeting: March 14, 2022 Time of Meeting: 9:00 AM Location of Meeting: Inland Empire Health Plan Headquarters 10801 Sixth Street, Suite 120 Rancho Cucamonga, California 91730 This Notice shall confirm the REGULAR MEETING of the Joint Powers Agencies - INLAND EMPIRE HEALTH PLAN AND IEHP HEALTH ACCESS. If disability-related accommodations are needed to participate in this meeting, please contact Annette Taylor, Secretary to the IEHP Governing Board at (909) 296-3584 during regular business hours of IEHP (M-F 8:00 a.m. – 5:00 p.m.) Agenda Copies of the Packet may be obtained here.
最新消息 - IEHP 贊助者 Inland Empire 殘障人士合作獎學金和獎項
0,000 美元，發放給 10 名申請 IEDC 獎學金的學生。 獎學金於 6 月 16 日在 San Bernardino Valley College 為學生發放，IEDC 成員 Denise Booker 也憑藉將六月節 (Juneteenth) 理念貫穿河濱郡社區而受到表彰。 「為他們提供機會、援助以及繼續倡導和支持那些捍衛人人平等的人士，對於讓我們的地區獲得最佳的護理和健康活力至關重要，」IEHP 社區健康主任 (IEHP Director of Community Health) 兼 IEDC 董事會主席 (IEDC Board President Gabriel Uribe) 博士說。「自 2019 年以來，IEDC 已向本科、研究生、職業或技術學位的 Inland Empire 有残障的學生髮放了 33 份獎學金。我們希望能夠透過合作夥伴關係和社區支持一直延續這個傳統。」 IEDC 成立於 2006 年，在 IEHP、Community Access Center 和 PossAbilities of Loma Linda University Health.等合作夥伴的支持下日益強大。如今，該組織匯集了來自 Inland Empire 多個組織的 900 多家服務提供商，它們專為老年人和殘障人士提供服務。 「我們必須竭盡所能去創造公平的競爭環境，並為服務不到位和邊緣化社區。這正是 Booker 夫人振奮人心之處。她敢於站出來，敢於發聲，她為社區帶來了積極的改變，」Uribe 補充道。 Booker 自 2017 年以來便是 IEDC 的一名成員，並且一直在積極倡導黑人社區。Booker 透過自己的組織和黑人合作組織 (Black Collaborative)，領導宣傳工作，向當地政客和領導人宣傳六月節，以及這一天在我們國家歷史上的重要性。 「與 IEDC 的合作讓我有機會為社區的部分成員提供幫助，否則僅靠自己的一份力量預計難以實現，」Booker 說。「我與 IEDC 的關係正如非洲的一句諺語一樣，‘一人獨行走得快，與人同行走得遠。」
最新消息 - 與 Maria 邂逅：92 歲的老人在 IEHP 社區資源中心重拾健康與生活的樂趣
會痛哭不止，」92 歲的 Maria 用西班牙語談到她在聖貝納迪諾 (San Bernardino) 那簡陋空蕩但生活了許久的家。 彷彿上天聽到了她的祈禱，Inland Empire Health Plan (IEHP) 於 2015 年開設了聖貝納迪諾社區資源中心 (San Bernardino Community Resource Center)——Maria 離這靜謐之處只差幾步之遙。 「萬分感謝他們將該中心設立在此處，」Maria 表示。「我對自己說‘，這裡簡直就是天選之地。我必須得參加，我可以自己走過去，我不需要任何人帶我前往。它幾乎就在我家門前。」 IEHP 的願景 因此，在過去的七年裡，Maria 每天都穿上她的運動裝——配上一雙漂亮的斯凱奇 (Skechers) 運動鞋——從她家步行幾步便可抵達社區資源中心，在那裡她成了最受歡迎的人。 會員的利益永遠是第一位。IEHP 社區衛生高級主管 Cesar Armendariz 說：「Maria 詮釋了 IEHP 的核心價值——以會員為中心。」 中心的所有服務皆可享受——Inland Empire 所有會員免費——Maria 參加了各種健身課程，包括尊巴、有氧拳擊、拉丁舞和瑜伽。另外，她還參加了健康教育課程，瞭解哮喘、糖尿病和營養方面的知識。 IEHP 聖貝納迪諾社區資源中心的工作人員將 Maria 視為其「願景」的鼓舞和動力。「從她身上我們看到了我們提供的服務的價值」 Armendariz 說。「瞭解到我們為 Maria 建立了聯繫並為她創造了充滿愛的空間，讓她可以享受黃金歲月，而不是在無盡的孤獨中獨自承受這些痛苦，這樣也可以幫助我們實現自己的目標。這便是心靈治愈、鼓舞人心的定義！」 同時，Maria 對他人總是笑容滿面，同 IEHP 團隊成員和社區居民談笑風生。 IEHP 聖貝納迪諾社區資源中心團隊成員 Marjorie Chavez 說：「後來，無論誰加入了我們中心，她都能與其相處得十分融洽。」「看到每個人都如此喜歡 Maria，以及她對每個經過中心的人表示歡迎的方式，這樣的光景讓人感到十分詫異和驚喜。」 心之所向 觀看 Maria 最新的 Zumba® 動作，火熱的歌曲配上踏轉移的舞步——不錯過任何一個節拍——您永遠不會知道她已經 92 歲了。 親眼見證 Maria 與中心其他成員的快樂互動，您永遠無法瞭解她內心曾經的傷痛。 對於 Maria 來說，在 IEHP 踏入她的生活之前她的空虛已經消失了——眼淚也消失了。 她現在認識到 IEHP 的聖貝納迪諾社區資源中心才是心之所向。 「在這裡，我的整個生活都發生了變化。我感到煥然一新，」Maria 說，在此也向其他聖貝納迪諾居民發出誠摯的邀請。「快加入這個中心，這裡可以為每個人都提供幫助——包括我們的身心。」 按一按此處進一步瞭解 IEHP 3 家社區資源中心。
最新消息 - IEHP 利用青年活動促進平衡
為健康臨床主任 Amrita Rai 表示：「課外活動可降低兒童和年輕人發生危險行為的可能性，並且強化聯繫感和歸屬感。任何有助於支持健康情感發展的活動機會，都可以增加自尊心以及與同伴互動的能力，並且對成年期有所助益。」 IEHP 的社區資源中心可以幫助培養和改善年輕一代 Inland Empire 居民的心理健康。這些中心在河濱郡、聖貝納迪諾 和 Victorville 的三個地點提供包括 Zumba、創意藝術、烹飪和園藝等課程和活動。活動於週一至週六舉行，詳見 iehp.org 。 美國公共衞生署長 2021 年諮詢報告 進一步強調了 COVID-19 對持續發生的青少年心理健康危機的影響，指出為了正面應對這些挑戰，迫切需要社區和聯邦組織的合作行動，並承認心理健康是整體健康的重要組成部分。 這個概念對 IEHP 而言並不陌生，IEHP 目前正與一些社區組織和當地教育機構合作，擴展學校內外的行為健康服務（學生行為健康激勵計畫）。 該健康計畫還透過與 Young Visionaries Youth Leadership Academy 合作，探索在其中心為青少年和年輕人增加更多免費課程和活動的機會。 IEHP Victorville 社區資源中心經理 Delia Orosco 表示：「我們期待在未來數周和數個月內，將更多樂趣添加到我們中心的安排表中。我們的中心為所有參與的人提供安全空間，無論他們年齡為何，都能夠在這裡真正釋放自己，我們非常重視這一點。」 如需了解更多關於 IEHP 資源中心和課程表的資訊，請造訪 iehp.org。