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最新消息 - IEHP 展開幼兒健康計畫
lp Me Grow Inland Empire (HMGIE) 聯手打造 IEHP 幼兒健康計畫。該計畫透過預防性篩檢、互動課程、有用的資源等,鼓勵父母瞭解兒童(0-5 歲)的發展里程碑。
發展里程碑有助於評估兒童的成長,並且可以為發展遲緩提供早期警示訊號。IEHP 健康教育主任 Jane Wang 表示:「孩子的成長不僅是身體層面,也可以從孩子的遊戲、學習、說話和行為加以觀察 。」
「最瞭解自己孩子的父母和看護者可能最先發現任何被忽視的里程碑,而這些是構成解決方案的重要部分,」Wang 補充說明。「透過活動和資源提升對於發展里程碑的認識,讓父母有機會更加瞭解他們的孩子,以及他們個人如何影響孩子的成長。」
Jayla(8 個月)的家長 Jessica Cortez 回顧她參與該計畫的時光,她表示:「透過參與該計畫的活動,我學到了不同的方式,得以協助我教育和改善她的學習。如果沒有參加這些課程,我無法規劃出我們現在所做的這些活動。問卷讓我明白應該尋求些什麼,以及我們需要改進哪些方面。」
該計畫與 HMGIE 合作,運用年齡與發育進程問卷 (Ages and Stages Questionnaires, ASQ-3)。問卷的結果為父母提供關於他們的孩子在五個關鍵領域發展狀況的資訊,可以與孩子的兒科醫師討論。五個關鍵領域包括:溝通、粗大動作、精細動作、問題解決和個人-社會。
此外,家長還可以獲得發展篩檢、學前教育和學習材料,在家中促進健康成長和發展。該計畫還包括為父母及其子女開設的虛擬互動 Circle Time 課程,當察覺任何發展問題時,為父母提供支持性資源。
「Help Me Grow Inland Empire 很榮幸能成為 IEHP 健康教育工作者的發展篩檢合作夥伴,」兒科醫師和 HMGIE 醫師倡導者 Marti Baum 醫師表示。「HMGIE 協助 IEHP 轉介的父母和看護者依既定的里程碑評估孩子的發展。當發現問題時,IEHP 的健康教育者會立即開始與家人合作,為孩子提供必要的醫療護理和社會服務。IEHP 和 HMGIE 共同改變幼兒的生活—這樣成功的合作夥伴關係,可以協助我們的年輕孩子在開始就學時做好學習的準備。」
該計畫每週於線上提供,本月將於 IEHP 的 Victorville 社區資源中心恢復面對面互動課程。
「預防性照護和促進健康是我們 IEHP 健康教育的任務核心,」 Wang 表示。「然而,為了真正提供全方面的護理,我們認為也必須持續加強與 IEHP 服務提供者的合作關係–例如利用技術解決方案以便於取得篩檢工具和結果。在未來幾年內,我們希望協助彌合這些努力,讓我們 0-5 歲的年輕孩子能夠在正確的時間獲得正確的照顧,並得以充分發揮他們的潛力。」
IEHP 家長可以寄送電子郵件至 screening@iehp.org 提交篩檢請求,或與孩子一同參加 Circle Time 課程以參與該計畫。如需更多資訊,請造訪 iehp.org,或致電 IEHP 會員服務中心 (Member Service),電話 (800) 440-4347,TTY 使用者請撥打 (800) 718-4347。
最新消息 - IEHP 與社區機構合作為超過 38,000 位 I.E. 居民施打疫苗
Health、SAC Health System、St. Paul African Methodist Episcopal Church、Inland Regional Center 等社區型機構和 San Bernardino 郡提供診所疫苗施打服務,並將持續提供疫苗服務,以降低 COVID-19 的新增確診個案數。
已透過設在健保計畫位於 Rancho Cucamonga 企業總部的 San Bernardino 郡大型疫苗接種站施打了大約 36,900 劑疫苗。此外,過去六個月期間有超過 1,500 劑疫苗是利用社區活動期間 (例如 Que Buena 的 2021 年 Fiestas Patrias 社區活動) 以及透過教會和機構籌辦診所施打。
「我們盡一切力量主動到居民所在的地方和他們接觸,」IEHP 的社區合作計畫主任 Marci Coffey 這麼說。「有些民眾關心的是便利性和取得性。而對於其他人,最重要的則是教育和瞭解。我們很開心能為 I.E. 地區的居民提供這些服務和資源,同時也積極努力為我們的團隊創造更多機會,與社區民眾建立聯繫,提供支持!」
透過州政府 Medi-Cal COVID-19 疫苗接種促進方案提供的資金,IEHP 規劃將擴大合作範圍,確保持續透過診所施打疫苗。健保計畫也制定醫療服務提供者獎勵方案,鼓勵醫師建議病患接種疫苗,提高疫苗施打率。
「事實再清楚不過了。只要每個人都接種疫苗,每個人就會更安全。」IEHP 執行長 Jarrod McNaughton 這麼說。「雖然我們對於協助施打的疫苗數量感到自豪,但仍有許多工作要繼續推動,才能確保社區民眾享受到最佳照護,健康而活躍。我們瞭解接種疫苗是個人選擇,但疫情對社區造成的衝擊實在太大。就像當初疫情是在社區間傳播開來,現在必須要透過社區共同合作與回應來終結疫情。」
如要查詢您附近的 COVID-19 疫苗施打地點,請上網 myturn.ca.gov。
最新消息 - IEHP 領導人榮獲 LLU 年度校友獎
a University, LLU) 各自的學院評為年度校友,以表彰其對母校願景和宗旨的傳承和發揚以及他們對社區所做的貢獻。 Pham 在 LLU 公共衛生學院 (School of Public Health) 獲得了碩士學位,主要研究醫療保健管理。Pham 在 IEHP 始終貫徹 IEHP 的戰略機制,推進健康計畫的使命並努力實現 2030 年宏偉願景:我們將持續努力不懈,讓整個社區都能獲得最完善的照護和保持健康活力。在這項工作中,Pham 不斷為 IEHP 尋找新的方式來更好地服務於社區和最弱势的居民。「很高興,我們能在 2022 年的畢業典禮上為 Thomas Pham 先生頒發 SPH 年度校友獎。作為 IEHP 的一份子,他為 Inland Empire 社區的健康和福祉做出了顯著貢獻,這呼應了我們的願景——讓健康的人們生活在公平衛生機制下的彈性社區,」公共衛生學院 LLU 院長 Helen Hopp Marshak 博士說。Rai 榮獲 LLU 行為健康學院 (School of Behavioral Health) 的社會工作碩士學位。目前她在 IEHP 任職,她的職責是在社區和全州範圍內積極引領發展,以此擴大享受心理健康服務的機會,其中包括學生行為健康鼓舞計畫 (Student Behavioral Health Incentive Program)。 「Loma Linda 大學行為健康學院在畢業典禮上授予 Amrita Rai 2022 年度校友獎,她的這項獎項源於她始終致力於僕人式領導,為 Inland Empire 最弱勢的群體提供公平的行為健康服務,」行為健康學院 LLU 院長 Beverly Buckles 博士說道。 Rai 還在這一年的各種演講活動中分享了她的專業知識和熱情,激發了人們對行為健康服務的發展和供應的認識和持續改進。 「Thomas 和 Amrita 在各自領域所取得的革命性成就足以證明他們對 Inland Empire 社區的熱愛。Thomas 和 Amrita 等團隊成員的積極貢獻和參與讓 IEHP 致力於治愈和激發人類精神這一願景成為可能,我們衷心感謝他們所做的一切,」IEHP 首席執行官 Jarrod McNaughton 說。
領導團隊 - Vinil Devabhaktuni, MBA
計、開發、實施及支援 IEHP 的系統。
Vinil 最近從 Health New England 轉職到 IEHP,他在 Health New England 擔任資訊科技長並負責管理獨特的產品組合,而且將科技的角色從支援功能提升至策略性合作夥伴,在組織增長期間扮演重要角色。Vinil 也為銷售、包銷及會計研發及執行端對端營運藍圖。此外,他重新規劃和簡化生產支援及應用程式發展作業,為組織賦予穩定性、可預測性及最佳化。
在 Vinil 任職於 Health New England 之前,Vinil 擔任過紐約市 AIG 的副總裁暨數位轉型官。在擔任此職務期間,他推動 $5,000 萬美元的全球數位轉型計畫,其中包含來自全球 140 個國家/地區的移轉及整合數位財產。
Vinil 擁有 Longmeadow Bay Path University 的企業管理碩士 (MBA) 學位。
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
P4P - Proposition 56 - GEMT - Proposition 56 & GEMT
2016, now includes proposed supplemental payments for physicians participating in Medi-Cal Fee-For-Service (FFS) and Medi-Cal Managed Care.
Proposition 56 FAQs SFY 19/20 (PDF) Published: February 18, 2020
Click on the following links to jump to that specific section:
Electronic Payments
Ground Emergency Medical Transport (GEMT) Payment
Adverse Childhood Experiences Screening (ACES) Services
HYDE
Developmental Screening Services
Proposition 56 and GEMT Payment Schedule
Family Planning Services
Proposition 56 Payment Dispute Process
Electronic Payments
With the current public health situation that our country is experiencing, it is necessary for IEHP to take additional precautions to ensure the health and well-being of our community. These precautions are being reviewed, and discussed daily, by our Executive leadership team and will be implemented as deemed necessary. Future COVID-19 precautions may include reduced on-site staffing and prioritization of electronic payments over printed checks.
To minimize any disruption or delay in payment, we recommend that you sign up for electronic payments as soon as possible if you have not done so already. Our team is available to assist you with the necessary paperwork required to make this change or to answer any questions you may have. The team can be reached by e-mailing vendormaintenance@iehp.org or by calling (909) 294-3928 and selecting Option 1.
Our priority remains keeping our Members, Providers, Vendors, and Team Members safe while doing what we can to minimize the potential spread of the virus. We will continue to work hard to provide you with the level of service you have come to expect during this uncertain time.
(Back to Prop 56 Menu)
Adverse Childhood Experiences Screening (ACES) Services
Proposition 56 Adverse Childhood Experience Screening (ACES) Services (PDF) Published: May 15, 2020
FAQs on Proposition 56 Payment - Adverse Childhood Experience Screening (ACES) Services (PDF) Published: October 14, 2021
PSA Videos:
Do More
Ask
Resilience
(Back to Prop 56 Menu)
Developmental Screening Services
Proposition 56 Developmental Screening Services (PDF) Published: March 19, 2020
FAQs on Proposition 56 - Developmental Screening Services (PDF) Published: October 14, 2021
(Back to Prop 56 Menu)
Family Planning Services
Proposition 56 - Family Planning Services (PDF) Published: June 1, 2022
FAQs on Proposition 56 - Family Planning Screening Services (PDF) Published: October 13, 2022
(Back to Prop 56 Menu)
Ground Emergency Medical Transport (GEMT) Payment
The Department of Health Care Services (DHCS) has established a Ground Emergency Medical Transport (GEMT) Quality Assurance Fee (QAF) program. In accordance with 42 USC Section 1396u-2(b)(2)(D), Title 42 of the Code of Federal Regulations part 438.114(c), and WIC Sections 14129-14129.7, Medi-Cal Managed Care Health Plans must provide increased reimbursement rates for specified GEMT services to non-contracted GEMT providers. SPA 18-004 implements a one-year QAF program and reimbursement add-on for GEMT provided by emergency medical transportation providers effective for State Fiscal Year (SFY) 2018-19 from July 1, 2018, to June 30, 2019.
GEMT Program Overview (PDF)
FAQs on GEMT (PDF)
GEMT Dispute Request Form (PDF)
Please email completed forms to Prop56Inquiry@iehp.org or fax to (909) 296-3550.
(Back to Prop 56 Menu)
HYDE
Proposition 56 HYDE Services (PDF) Published: May 15, 2020
FAQs on Proposition 56 - HYDE Services (PDF) Published: October 14, 2021
(Back to Prop 56 Menu)
Proposition 56 and GEMT Payment Schedule
Proposition 56 and GEMT Supplemental Payment Schedule CY2023 Updated: January 6, 2023
(Back to Prop 56 Menu)
Proposition 56 Payment Dispute Process
Proposition 56 - Paid Claims Dispute Request Form (PDF)
Proposition 56 - Encounter Dispute Request Form (PDF)
Please email completed forms to Prop56Inquiry@iehp.org or fax to (909) 296-3550.
(Back to Prop 56 Menu)
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Plan Updates - Coronavirus (COVID-19) Advisory
Control and Prevention (CDC) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China and which has now been detected in almost 70 locations internationally, including in the United States. The virus has been named "SARS-CoV-2" and the disease it causes
has been named "coronavirus disease 2019" (abbreviated "COVID-19").
IEHP will continually update you on the latest recommendations, news,
and resources on COVID-19 as it becomes available.
COVID-19 Therapeutics Available for Members
In an effort to provide the most up-to-date treatments against COVID-19, IEHP continues to maintain a list of providers, including but not limited to infusion clinics, ancillary, hospital and non-hospital based infusion centers offering COVID-19 infusion therapy treatment. Under all Member coverage, outpatient COVID therapeutics will be offered immediately after a Member is determined to be clinically eligible under and Emergency Use Authorization (EUA).
List of Infusion Sites
COVID-19 Infusion Treatments by Organization (PDF)
Test-To-Treat
COVID-19 Vaccine Reimbursement for Medi-Cal Providers
DHCS has carved out the COVID-19 vaccine from Medi-Cal managed care health plans and will reimburse providers under the Fee-for-Service (FFS) delivery system for both medical and pharmacy claims. Medi-Cal will reimburse the associated COVID-19 vaccine administration fee at the allowable Medicare rate for all claims (medical, outpatient, and pharmacy), based on the number of required doses for all Medi-Cal beneficiaries.
For further information:
June 13, 2022 - DHCS COVID-19 Vaccine Administration Provider FAQs
How Vaccines Build Immunity
While the COVID-19 vaccines are relatively new - the technology and science behind the vaccines have been in development for decades. In the video below, we demonstrate how years of vaccine research and advanced technology allowed researchers and scientists worldwide to be prepared to develop an mRNA vaccine that could help fight the spread of a global infectious disease.
FIND A TESTING AND VACCINATION SITE NEAR YOU TODAY!
RIVERSIDE
Riverside County Public Health COVID Testing Site
Vaccine Information
Vaccine Locations & Registration
Registrations encouraged but not required for:
The CDC recommends everyone ages 6 months and older get vaccinated against COVID-19 as well as a booster for everyone 5 years and older, if eligible. For more information, visit the Riverside Country Vaccine webpage.
Teenagers 5 to 17 years old must register for a vaccination clinic that offers the Pfizer vaccine and be accompanied by a parent/legal guardian or present a signed written consent from a parent/legal guardian and be accompanied by an adult.
Pfizer Minor Consent Form (PDF) | Spanish
The Moderna and Johnson & Johnson vaccines can only be given to individuals age 18 years and older.
Johnson & Johnson Fact Sheet (PDF) | Spanish - Published April 26, 2021
SAN BERNARDINO
San Bernardino County Public Health COVID Testing Site
Vaccine Locations & Registration
Additional Dose and Boosters Information
COVID-19 Vaccine Consent Form (PDF) | Spanish
The CDC recommends everyone ages 6 months and older get vaccinated against COVID-19 as well as a booster for everyone 5 years and older, if eligible. For more information, visit the San Bernardino County Pediatric COVID-19 Vaccination web page
Walk-ins are now available at County-operated vaccination sites. Walk-in individuals will not need to bring any additional information to the site, however be prepared to register on site, which will include answering health screening questions.
Walk-ins may experience longer wait times and availability may vary based on site demand.
Centers for Disease Control and Prevention (CDC)
Clinical Care Guidance
Vaccines
Vaccination Plans
January 10, 2022 - Continued Coverage of COVID-19 Diagnostic Testing (PDF)
CalVax
CalVax is a state-wide centralized system for health care Providers enrolled or interested in participating in the California COVID-19 Vaccination Program, developed by the California Department of Public Health (CDPH).
The new CalVax platform will provide a system to manage vaccine enrollment, ordering, inventory, administration, reporting and data analytics. Training materials such as job aids, videos, and recorded demos will be available to support all system users as they navigate through the new CalVax platform (mycavax.cdph.ca.gov).
CA Notify
• CA Notify Flyer in English (PDF) and Spanish(PDF)
• CA Notify Shareable Tools for web and social media
• CA Notify Website
Financial Assistance Resources
Riverside County Medical Association - COVID-19 Financial Toolkit for Medical Practice
U.S. Department of Health & Human Services (HHS) CARES Provider Relief Fund
Learn more about the Provider Relief Fund (PRF)
Provider Relief Fund (PRF) Portal
U.S. Small Business Administration. Borrowers may be eligible for Paycheck Protection Program (PPP) loan forgiveness. See if you're eligible here.
Guidance Regarding Monoclonal Antibody Treatment for COVID-19
Even with decreasing cases and hospitalizations, those with high-risk conditions who have tested positive for COVID-19 are encouraged to get monoclonal antibody treatment at Riverside University Health System (RUHS) – Medical Center.
In January, the U.S. Food and Drug Administration (FDA) limited the use of certain monoclonal antibody therapies that were ineffective against the omicron variant. In response, RUHS – Medical Center is administering sotrovimab, an IV infusion shown to be effective against omicron and other variants.
January 14, 2022 - RUHS-Medical Center Offers Monoclonal Antibodies Treatment
Quest Diagnostic
For more information, please visit Quest Diagnostics FAQs
COVID-19 Specimen Collection Instructions (Watch Video Here)
Fact Sheet for Healthcare Providers for COVID-19 Testing (View PDF Here)
LabCorp
For more information, please visit LabCorp's COVID-19 page.
Which COVID-19 Test is Right For You?
COVID-19 FAQs
If you do not have the ability to collect specimens for COVID-19, please refer to your County Public Health resources for guidance on directing Members for testing.
Telehealth
IEHP is strongly encouraging the utilization of telehealth for visits that can be conducted over the phone or via other audiovisual telecommunications. IEHP has published a telehealth FAQ which is available here: Telehealth Services Due to Limiting Exposure to COVID-19 (PDF)- October 17, 2022
Remember:
IEHP Provider Telehealth Information (PDF)
IEHP expects that Providers will offer telehealth services and support to their Members during their published business hours.
Existing authorizations are valid and do not need to be changed even if services are being provided via telehealth
You can request a POS 02 or POS 10 on your authorization however if you do not, you can still utilize the authorization for telehealth services even if a different POS was approved. When billing the claim for the service, you will utilize a POS 02 or POS 10.
ONLY Services that are deemed clinically appropriate to provide via telehealth should be provided via telehealth. If there are treatments, exams, procedures or other services that cannot be provided via telehealth, those are not eligible to be provided via telehealth.
Provider Resources for Combatting COVID-19 Fatigue
ACEs Aware - Support for those on the front lines as California addresses stress and anxiety related to COVID-19
Department of Health Care Services (DHCS) and California Department of Public Health (CDPH) COVID 19 Response
Department of Health Care Services (DHCS)
California Department of Public Health (CDPH)
The California Department of HealthCare Services (DHCS) has published a COVID-19 response page with guidance for Providers and Partners, Home and Community Based Services and Behavioral Health.
Found Here: DHCS COVID‑19 Response | DHCS COVID-19 Medi-Cal FAQs
The California Department of Public Health (CDPH) also has a page with new guidance documents and additional resources and news releases.
Found Here: CDHP COVID-19 Updates
Centers for Medicare & Medicaid Services (CMS)
CMS Health Care Provider Toolkit - Help link to COVID-19 related questions
San Bernardino Medical Society
The San Bernardino County Medical Society promotes the science and art of medicine, the care and well-being of patients, the protection of the public health and to promote the betterment of the medical profession. The latest news, research and developments on the COVID-19 outbreak for physicians can be found here: SBCMS COVID-19.
January 07, 2021 - COVID-19 Vaccines For All Practicing Physicians and Staff – San Bernardino County (PDF)
2-1-1 San Bernardino County Resource & Information Guide
2-1-1 San Bernardino County has curated a COVID-19 Resource & Information Guide and will update this page regularly as the situation changes. For more information, please click here.
Correspondences
May 2, 2022 - Webinar - IWIN COVID and the Community
April 13, 2022 - COVID-19 “Test to Treat” Initiative
April 8, 2022 - 2nd Round of Free At-Home COVID-19 Test Kits Available
February 23, 2022 - COVID-19 Oral Antiviral Drugs – Coverage and Dispensing Pharmacies
January 28, 2022 - Free OTC COVID-19 Antigen Kits Available
January 26, 2022 - Free At-Home COVID-19 Tests Available by Request
January 5, 2022 - Extending SNF COVID-19 Per Diem Rate
December 22, 2021 - COVID-19 Vaccine Billing for Medicare Advantage Enrollees Effective DOS January 1, 2022
December 16, 2021- COVID-19 Vaccine Incentive Program – Program Guide
December 16, 2021 - REMINDER: COVID Vaccine Enrollment Survey - Your Response is Requested
December 10, 2021 - REMINDER: COVID Vaccine Enrollment Survey - Your Response is Requested
December 10, 2021 - COVID-19 Vaccine Billing for Medicare Advantage Enrollees
December 3, 2021- COVID-19 Vaccine Enrollment Survey
December 1, 2021- CDC Encourages COVID Booster Due to Omicron Variant
November 17, 2021- UPDATE! COVID-19 Vaccine FQHC, RHC and IHF Incentive Program
November 9, 2021- Three Upcoming Webinars on Building COVID-19 Vaccine Trust
October 22, 2021- 2021 COVID-19 Vaccination Member Incentive
October 22, 2021- NEW!!! COVID-19 Vaccine FQHC and RHC Incentive Program
October 19, 2021- COVID-19 Treatment – RUHS Monoclonal Antibody Treatment Center
October 12, 2021- Reminder - NEW COVID-19 Vaccine PCP Incentive Program - Kickoff Meeting
October 6, 2021- NEW COVID-19 Vaccine PCP Incentive Program- Kickoff Meetings
October 4, 2021- New COVID-19 Vaccine PCP Incentive Program
September 8, 2021- CDPH Webinar: How to Have Crucial Conversations About COVID-19 Vaccines – Thursday, September 9th
August 18, 2021 - Riverside County Public Townhall on COVID-19 Vaccines
For additional resources regarding COVID-19, please visit:
Centers for Disease Control and Prevention (CDC)
Riverside County Public Health
San Bernardino Public Health
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.
Join Our Network - Community Supports
ffer in place of services or settings covered under the Medicaid State Plan. These services should be medically appropriate and cost-effective alternatives.
Beginning January 1, 2022, Inland Empire Health Plan (IEHP) is offering 11 of the 14 DHCS Preapproved Community Supports services:
Asthma Remediation
Community Transition Services/Nursing Facility Transition to a Home
Home Modifications
Housing Deposits
Housing Tenancy and Sustaining Services
Housing Transition Navigation Services
Medically Supportive Food/Meals/Medically Tailored Meals
Nursing Facility Transition/Diversion to Assisted Living Facilities, such as Residential Care
Recuperative Care (Medical Respite)
Short-Term Post-Hospitalization Housing
Sobering Centers (Riverside County)
Tentative Upcoming Services
Day Habilitation (Date TBD)
Personal Care and Homemaker Services (Date TBD)
Respite Services (Date TBD)
Community Supports FAQs (PDF)
Please return the completed Community Supports Service Provider Assessment (PDF) via email at DGCommunitySupportTeam@iehp.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.
Plan Updates - Public Health Advisory
Disease Activity - Shigella (PDF)
November 11, 2022 - Riverside University Health Systems - Early Respiratory Syncytial Virus (RSV) and Seasonal Influenza Activity (PDF)
October 25, 2022 - Riverside University Health Systems - Outbreak of Ebola Virus Disease Due to Sudan Virus in Central Uganda (PDF)
October 21, 2022 - Riverside University Health Systems - Influenza (PDF)
August 18, 2022 - Updated Monkeypox Guidance (PDF)
August 18, 2022 - Riverside University Health System - Monkeypox Home Isolation Instructions (PDF)
August 18, 2022 - CDC - Dear Colleague: 2022 Monkeypox Outbreak (PDF)
July 19, 2022 - Updated Monkeypox Guidance (PDF)
March 14, 2022 - Riverside County Legionnaires' Disease Advisory (PDF)
By clicking on the links below, you will be leaving the IEHP website.
Pharmacy Services - Academic Detailing
treach program for our providers and pharmacies. We perform phone and one-on-one outreaches with physicians, nurse practitioners, physician assistants, and pharmacy staff. Our goal is to transform the prescriber and pharmacy practice and enhance the provider, pharmacist and member experience.
Clinical Drug Education
Clinical Drug Education provides materials that focus on a specific drug, drug class, and/or disease state. These materials contain pharmacological and clinical practice information to assist providers and pharmacies in their practice. As new drug information is available, it is important to stay up to date on clinical research findings to assist with member care and medication-use decisions.
Practice Development
Practice development education provides materials that focus on enhancing provider and member experience. The materials contain guidance on Formulary Utilization and PA submissions as well as insights regarding electronic prescribing and electronic health records. It is our commitment to provider practice optimization tools and resources to enhance member care.
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.
Biosimilars
A growing trend in healthcare is the use of biosimilar drugs. The following information will assist you and your practice on prescribing biosimilars.
What is a Biosimilar? (PDF)
Biosimilars: Are They the Same Quality? (PDF)
Biological Product Definitions (PDF)
Prescribing Biosimilar Products (PDF)
Prescribing Interchangeable Products (PDF)
Opioid and Chronic Pain Management
In collaboration with Riverside University Health System (RUHS) and Centers for Disease Control and Prevention (CDC), IEHP would like to provide the following information to assist you and your practice on prescribing opioids for chronic pain management.
CURES
CURES FAQ (PDF)
CURES 2.0 User Guide (PDF)
CURES tips and tricks (PDF)
Naloxone
Naxolone Drug facts (PDF)
Naxolone instructions for use (PDF)
First Responder Naxolone administration fact sheet (PDF)
Opioid Prescribing Guidelines
Medication Assisted Treatment (MAT) and Opioid Treatment Program (OTP) FAQ (PDF)
CDC Guideline Infographic (PDF)
CDC Guidelines Factsheet (PDF)
TurnTheTide Pocket Guide for Prescribing Opioids for Chronic Pain (PDF)
CDC Guideline at a Glance
Opioid Tapering
Clinical Pocket Guide to Tapering (PDF)
Tapering Resource-AAFP (PDF)
Opioid Tapering Resource pack (PDF)
Pharmacy
Medication Assisted Treatment (MAT) for Substance Abuse (PDF)
Urine Drug Testing
CDC Clinical Practice Guideline for Prescribing Opioids for Pain
UDT for monitoring opioid therapy-AAFP (PDF)
X-Waiver
X-Waiver resources
Removal of DATA Waiver (X-Waiver) Requirement
https://www.samhsa.gov/medications-substance-use-disorders/removal-data-waiver-requirement
All prescriptions for buprenorphine will now only require a standard DEA registration number. For additional information on the removal of the DATA-Waiver requirement, see the Removal of DATA Waiver (X-Waiver) Requirement.
Practice Optimization
Electronic Prescribing (e-Rx)
Electronic prescribing is a growing standard in the healthcare industry. Most electronic health record systems offer electronic prescription capabilities. The information below will provide insight to the practice of e-prescribing.
Benefits of e-Rx brochure (PDF)
Formulary Utilization
The IEHP Formulary offers a variety of drugs based on safety and efficacy for any condition. The information below will help you find out how to access and interpret the formulary
Medicare FAQ (PDF)
The process of submitting a prior authorization may be cumbersome for your practice. The information below will help you understand this process and assist with receiving a proper decision in a timely manner.
For any questions regarding Pharmacy Academic Detailing Training please contact:
PharmacyAcademicDetailing@iehp.org
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.
Information on this page is current as of January 1. 2022
Provider Resources - Non-Contracted Providers
s for Contracted and Non-Contracted Providers
Emergency and Post-Stabilization Care for IEHP Members
IEHP DualChoice (HMO D-SNP) Model of Care Training for Non-Contracted Providers
Provider Dispute Resolution Process for Contracted and Non-Contracted Providers
Definition of a Provider Dispute
A provider dispute is a written notice from the provider to Inland Empire Health Plan (IEHP) that:
Challenges, appeals, or appeals, or requests reconsideration of a claim (including a bundled group of similar claims) that has been denied, adjusted, or contested
Challenges a request for reimbursement for an overpayment of a claim
Seeks resolution of a billing determination or other contractual dispute
What is not Considered to be a Provider Dispute
Claims denied for missing or additional documentation requirements such as consent forms, invoices, Explanation of Benefits from primary carrier, or itemized bills are not considered Provider Disputes
Corrected Claims
Pre-Service Authorization Denials
Provider Dispute Time Frame
IEHP accepts disputes from providers if they are submitted within 365 days of receipt of IEHPs decision (for example, IEHPs Remittance Advice (RA) indicating a claim was denied or adjusted).
Submission of Provider Disputes
When submitting a provider dispute, a provider should use a Provider Dispute Resolution Request form. If the dispute is for multiple, substantially similar claims, complete the spreadsheet on page 2 of the Provider Dispute Resolution Request Form
All Provider Disputes and supporting information must be submitted to:
IEHP Claims Appeal Resolution Unit
PO BOX 4319
Rancho Cucamonga, CA 91729-4349
Acknowledgement of Provider Dispute
IEHP acknowledges receipt of each provider dispute, regardless of whether the dispute is complete, within 15 business days of receipt.
Resolution Timeframe
IEHP resolves each provider dispute within 45 business days following receipt of the dispute, and provides the provider with a written determination stating the reasons for determination.
PDR Determination Resulting in Additional Payment
If IEHP determines to pay additional monies based on information originally provided and/or available at the time the claim was first presented to IEHP for adjudication, or a result of a processing error IEHP will automatically include the appropriate interest amount if payment is not issued within required regulatory timeframes.
Non-Contracted Provider Disputes Resolution Process for IEHP DualChoice (HMO D-SNP)
A non-contracted provider, on his or her own behalf, is permitted to file a standard appeal for a denied claim only if the non-contracted provider completes a waiver of liability statement, which provides that the non-contracted provider will not bill IEHP DualChoice (HMO D-SNP) Plan Members.
Who to Call with Questions on IEHPs PDR Process
Contracted providers may visit our online secure provider portal at www.iehp.org for more information. Providers may also call the IEHP Provider Call Center at (909) 890-2054 or (866) 223-4347 Monday-Friday, 8:00 am to 5pm PST.
(Back to Non-Contracted Providers Menu)
Emergency and Post-Stabilization Care for IEHP Members
Triage and Advice Systems
IEHP provides Members triage, screening, and advice services by telephone 24 hours a day, 7 days a week through its Nurse Advice Line (NAL). By calling the NAL, Members receive assistance with access to urgent or emergency services from an on-call physician, or licensed triage personnel. IEHP Members can reach this 24/7 Nurse Advice Line at (888)-244-IEHP (4347) or 711 (TTY).
Post-Stabilization Care
IEHP requires contracted and non-contracted hospitals to obtain prior authorization for post-stabilization care for Members (patients). IEHP requests the patient’s diagnosis as indicated by the treating physician or surgeon and any other information reasonably necessary for the Plan to decide on whether to authorize post-stabilization care or to assume management of the patient’s care by prompt transfer to another facility. The hospital should request prior authorization from IEHP’s Utilization Management (UM) Department by:
Phone at (866) 649-6327; or
Fax at (909) 477-8553 to send clinical notes for medical necessity review.
IEHP makes every effort to respond to requests for necessary post-stabilization care within thirty (30) minutes of receipt. The services are considered approved if IEHP does not respond within this timeframe. All subsequent hospital day are subject to review for medical necessity.
IEHP will inform the provider of the Plan’s decision and will coordinate the transfer of the Member if IEHP denies the request for authorization of post-stabilization care and elects to transfer the Member to another health care provider.
Non-Emergency Services
If a Member presents at the emergency department for non-emergency services, please refer the Member to their IEHP Member Handbook, section 3 (How to Get Care), which outlines the process for obtaining a referral.
Claims Reimbursement
Complete facility claims for authorized health care services must be sent to:
Inland Empire Health Plan
Attn: Claims Department – IEHP Direct
PO BOX 4349
Rancho Cucamonga, CA 91729-4349
Complete professional claims for authorized health care services must be sent to:
For IEHP-Direct Members, please send to address above.
For IEHP Members assigned to an IPA, please click for here for more information on how to send to the appropriate IPA.
Billing IEHP Members
Providers under the Medi-Cal program must not submit claims to, demand or otherwise collect reimbursement from a Medi-Cal beneficiary, or from other persons on behalf of the beneficiary, for any service included in the Medi-Cal program’s scope of benefits in addition to a claim submitted to the Medi-Cal program for that service.
IEHP DualChoice (HMO D-SNP) Model of Care Training for Non-Contracted Providers
The Centers for Medicare & Medicaid Services (CMS), the Department of Health Care Services (DHCS), and National Committee for Quality Assurance (NCQA) requirement that out-of-network providers routinely seen by IEHP DualChoice (HMO D-SNP) Members, receive training on IEHPs Model of Care for our D-SNP Members:
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
2023 IEHP DualChoice (HMO D-SNP) Model of Care Non-Contracted Provider AOR (PDF)
Report an Issue
To report any issues with this system or process or for any questions, please send an email to DGHospitalRelationsServiceTeam@iehp.org
(Back to Non-Contracted Providers 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.
Clinical Information - Medication Therapy Management
MTM is a term to describe a broad range of services offered by Pharmacists on our health care team.
The IEHP Clinical Pharmacy Team reviews the Members’ medicines, making sure they’re taking the right ones for their health conditions. If you are a Provider for IEHP Members who qualify for the MTM Program, you can let them know to look out for a letter from us. They will be enrolled automatically—unless they opt-out. MTM is offered to Members at no additional cost.
IEHP's MTM services include these core elements:
Medication therapy reviews
Medication education
Disease management
A team of Pharmacists and Doctors developed these MTM services to help provide better prescription drug coverage for our Members. For example, MTM also helps identify possible medication errors.
Medicare MTM Program
This is a free program under Medicare Part D for IEHP DualChoice Members who have multiple medical conditions, take many prescription drugs, and have high drug costs to assist with better medication management and overall health.
IEHP DualChoice Members’ enrollment includes a yearly comprehensive medication review (CMR) and regular targeted medication review (TMR) services throughout the year. MTM services include:
Comprehensive Medication Review (CMR)
An IEHP Clinical Pharmacist will provide an annual comprehensive review of the IEHP DualChoice Member’s medications over the phone. The Pharmacist will review IEHP DualChoice Member’s medications and make clinical recommendations to IEHP DualChoice Members and Providers.
Targeted Medication Review (TMR)
The IEHP Clinical Pharmacy Team will also offer TMRs through the year by reviewing issues with the participating IEHP DualChoice Member’s medicines. The team will perform TMRs for all enrolled beneficiaries every three months. The beneficiary may get TMR recommendations by mail and their Primary Care Provider may receive recommendations by fax—if the IEHP Clinical Pharmacy Team deems it necessary.
For more information, IEHP DualChoice Members eligible for CMR or TMR services can call 1-877-273-IEHP (4347), 8am-5pm (PST), 7 days a week, including holidays. TTY users should call 1-800-718-4347. Click here for a blank personal medication list.
Medicare MTM Program services may have limited eligibility criteria. They are available for the following conditions:
1. The IEHP DualChoice Member has a minimum of three (3) disease states:
Bone Disease-Arthritis-Osteoporosis
Bone Disease-Arthritis-Rheumatoid Arthritis
Chronic Heart Failure (CHF)
Diabetes
Dyslipidemia
End-Stage Renal Disease (ESRD)
Hypertension
Mental Health Chronic/ Disabling Mental Health Conditions
Respiratory Disease – Asthma
Respiratory Disease – Chronic Obstructive Pulmonary Disease (COPD)
2. The IEHP DualChoice Member is prescribed a minimum of five (5) different medications to treat those disease states:
ACE-Inhibitors
Angiotensin II Receptor Blockers (ARBs)
Antidepressants
Antihyperlipidemic
Antihypertensives
Antipsychotics
Beta Blockers
Bronchodilators
Calcium Channel Blockers
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
Diuretics
Insulins
Oral Hypoglycemics
Selective Serotonin Reuptake Inhibitors (SSRIs)
Tumor Necrosis Factors (TNFs)
Inhaled Corticosteroids
Calcimimetic
Cardiac Glycoside
Colony Stimulating Factors
Glucagon-Like Peptide-1
Glucocorticosteroids
Neprilysin Inhibitor
NSAIDs
Phosphate Binders
Vitamin D Analogs
3. Drug costs of $1,233.75 (one-fourth of $4,935) for the previous three months are likely to be incurred.
To learn more about MTM, call IEHP DualChoice (HMO-DSNP) at 1-877-IEHP (4347), 8am-8pm (PST), 7 days a week, including holidays.
TTY users should call 1-800-718-4347.
For answers to frequently asked questions, please download the FAQ document below:
MTM FAQs (PDF)
For details, contact the IEHP Pharmaceutical Services Department at (909) 890-2049, Monday-Friday, 8am-5pm.
IEHP DualChoice (HMO-D-SNP) [Medicare-Medicaid Plan] is a Health Plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees.
Information on this page is current as of March 2023.
H5355_CMC_20_1900233_Accepted
COVID-19 - COVID-19 疫苗
,也不會導致感染 COVID-19。接種疫苗者可能出現一些輕微副作用,但並不會造成傷害,並且只持續幾天。疫苗可幫助我們結束疫情並拯救生命。已接種疫苗者應繼續配戴口罩及勤洗手,且在公共場所保持至少 6 英呎的社交距離。如需瞭解更多資訊,IEHP 會員可繼續造訪 IEHP 網站及/或造訪加州衛生部 (California Department of Health) 網站 (www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/COVID-19Vaccine.aspx)。 造訪 MYTURN.CA.GOV,以查找附近的疫苗接種診所。 疫苗如何增強免疫力 雖然 COVID-19 疫苗相對較新,但支援疫苗開發的技術與科學原理已發展數十年之久。在下方影片中,我們展示了多年的疫苗研究與進階技術如何支援全世界研究人員和科學家妥善開發 mRNA 疫苗,以協助遏止全球傳染病的擴散。 CDC 更新:PFIZER 疫苗已完全獲得 FDA 的批准。 2021 年 8 月 23 日,美國食品藥物管理局 (U.S. Food and Drug Administration, FDA) 首次批准可投入使用的 COVID-19 疫苗,即 Pfizer-BioNTech COVID-19 疫苗(眾所周知的 Pfizer 疫苗)。該核准疫苗現以 Comirnaty (koe-mir’-na-tee) 品牌上市,可幫助年滿 16 歲者預防 COVID-19 疾病。Pfizer 疫苗適用於 5 至 15 歲的兒童,並可根據緊急使用權,針對某些免疫力低下的人士進行第三劑接種。 請注意,Pfizer 疫苗和 Comirnaty 為同一種疫苗。FDA 報告顯示其配方相同且可通用。 何處可接種疫苗? 對於想要接種該疫苗的會員,請參考以下幾種選項: IEHP 建議線上造訪 My Turn (myturn.ca.gov)。My Turn 是加州公共衛生局 (Department of Public Health) 的一站式便利網站,需要接種 COVID-19 疫苗的人士可: 安排第一劑、第二劑和加強劑的疫苗接種時間。 安排家庭或團體疫苗接種時間 尋找所在區域的免預約接種診所 安排上門疫苗接種時間(如果需要) 安排交通服務(如果需要) 如果無法接入網際網路,請致電加州 COVID-19 熱線 1-833-422-4255,以尋求相同的服務。 CVS 和 Walgreens 等大型連鎖藥房也提供疫苗接種。大部分均提供免預約疫苗接種服務。IEHP 建議先致電相關藥房予以確認。 另外,亦可透過所在郡縣的公共衛生部門進行線上疫苗預約登記。 對於河濱郡,請造訪 www.ruhealth.org/covid-19-vaccine。 對於聖貝納迪諾郡,請造訪 www.sbcovid19.com/vaccine/。 我是否需要支付任何疫苗費用? 不需要。願意接種疫苗的所有人都無需支付任何費用。 疫苗是否安全? 安全,全國與加州最頂尖醫療專家一致認為,COVID-19 疫苗安全且有效。此疫苗已在大型臨床試驗中進行測試,以確保其符合各項安全標準。來自不同年齡層、種族與族裔群體以及具有不同醫療狀況的許多人都參與了試驗。 接種疫苗後是否會出現任何副作用? 接種 COVID-19 疫苗之後,大部分人不會遭遇嚴重的問題。接種疫苗之後產生的所有輕微症狀通常會在一週內自行消失。但如果開始出現嚴重頭痛、腹部疼痛、腿部疼痛/腫脹,或者呼吸急促、胸痛、感覺心跳加速、心房顫動或劇烈心跳聲等任何症狀,請立即致電醫師。醫師或醫療服務提供者會向您說明所有潛在副作用,以及您應該如何處理。 自 Moderna 與 Pfizer-BioNTech COVID-19 疫苗獲得緊急使用授權以來,接種此等疫苗的部分人士患上心肌炎與心包膜炎等疾病。大多數人是在接種疫苗第二劑後的數天內開始出現相關症狀。現已有數例確認報告顯示,疫苗接種者罹患心肌炎與心包膜炎,尤其是在 30 歲及以下的男性中。此種情況引起了各方疑慮,目前尚在進一步調查當中。不過,接種 COVID-19 疫苗之後罹患心肌炎與心包膜炎的案例其實非常罕見,要知道在 2020 年 12 月 14 日至 2021 年 6 月 21 日期間,全美總共施打了超過 3.18 億劑 COVID-19 疫苗。 接種疫苗是否會出現任何長期副作用? COVID-19 疫苗已在大型臨床試驗中進行測試,以評估其安全性。我們需要花費更多時間,並需要更多人接種疫苗,才能真正瞭解是否會出現非常罕見或長期的副作用。食品藥物管理局 (Food and Drug Administration, FDA) 及美國疾病控制與預防中心 (Centers for Disease Control, CDC) 將繼續監控 COVID-19 疫苗的安全性。醫療服務提供者需要向「疫苗不良事件報告系統」(Vaccine Adverse Event Reporting System, VAERS) 報告疫苗接種相關的任何問題或不良事件。 如果我出現副作用,該怎麼辦? 請立即聯絡您的醫師。CDC 推出了一款名為 V-Safe 的智能手機新工具,可用於檢查 COVID-19 疫苗接種者的健康狀況。當您接種疫苗時,您也會收到一張 V-Safe 傳單,告知您如何加入計畫。如果您加入計畫,您將定期收到包含問卷調查連結的簡訊,供您報告在接種 COVID-19 疫苗後所遭遇的任何問題或副作用。 疫苗是否會導致我感染 COVID-19? 不會,疫苗無法讓您感染 COVID-19,因為疫苗並不包含任何傳染性病毒。 我需要接種幾劑疫苗? Pfizer 與 Moderna 疫苗需要接種兩劑,每劑間隔 3 至 4 週。雖然第一劑已建立了保護力,但您仍然需要在數週後接種第二劑,以獲得疫苗所能提供的最大保護力。醫師會向您告知何時接種第二劑,具體間隔時間依據疫苗種類的不同而有所差異。J&J 疫苗僅需要接種一劑。 接種 2 劑疫苗之後,是否還需要配戴口罩以及避免與他人近距離接觸? 是的。在專家們進一步瞭解 COVID-19 疫苗所能提供的保護力之前,請繼續使用目前已知有助於阻止 COVID-19 傳播的所有工具。也即是說,您必須繼續配戴口罩、勤洗手、避免群聚,且在公共場所應至少保持 6 英呎的社交距離。 我是否需要接種加強劑疫苗?研究表明,接種 COVID-19 疫苗後,由於變種病毒的變化,疫苗對病毒的防護力和防止感染變種病毒的能力可能會隨著時間的推移而有所降低。不過,接種加強劑疫苗有望提高對 COVID-19 及其變種病毒的免疫反應,從而強化對病毒的防護力。 誰可以接種加強劑疫苗? 年滿 12 歲且完全接種疫苗的所有人均可接種加強劑疫苗,但接種加強劑疫苗的時間因疫苗和年齡層而有所差異。 我何時可以接種加強劑疫苗? 如果已接種 Pfizer-BioNTech 疫苗,則年滿 12 歲的所有人都應至少在完成初始 COVID-19 疫苗接種系列五個月後再接種加強劑疫苗。 如果已接種 Moderna 疫苗,則年滿 18 歲的成人應至少在完成初始 COVID-19 疫苗接種系列六個月後再接種加強劑疫苗。 如果已接種 Johnson & Johnson 的 Janssen 疫苗,則年滿 18 歲的成人應至少在接種 J&J/Janssen COVID-19 疫苗兩個月後再接種加強劑疫苗。 接種加強劑疫苗是否有任何副作用?接種加強劑疫苗後,您可能會出現副作用。這些是人體開始建立 COVID-19 防護力的正常徵象。 兒童與嬰兒是否可能感染 COVID-19? 可能會。兒童也會感染 COVID-19。感染 COVID-19 的大部分兒童都僅有輕微症狀,或者可能完全無症狀,也即是無症狀感染者。感染 COVID-19 的兒童人數少於成人。不過,對於存在特定醫療狀況的嬰兒(未滿 1 歲者)與兒童而言,感染 COVID-19 的風險可能較高。 兒童是否能接種 COVID-19 疫苗? COVID-19 疫苗適用於年滿 5 歲的兒童。如需瞭解更多資訊,請造訪 CDC 網站和/或所在郡的公共衛生局網站: 按一下此處進入聖貝納迪諾郡網站 按一下此處進入河濱郡網站 接種疫苗之後,多久可獲得保護力? 雖然接種第一劑疫苗後便會立即建立保護力,不過 COVID-19 疫苗需要接種兩劑,每劑間隔 3 至 4 週。也即是說,在接種第二劑後一至兩週時,才能獲得疫苗所能提供的最大保護力。 我可否同時接種 COVID-19 疫苗及流感疫苗? 可以。CDC 已批准兒童、青少年及成人可在同一天(以及相隔 14 天內)接種常規疫苗和 COVID-19 疫苗。請諮詢醫師,討論哪種方案最適合您。 如果我先前曾確診 COVID-19,是否仍然可以接種疫苗? 可以。我們建議所有人都接種 COVID-19 疫苗,即使曾感染 COVID-19 也不例外。原因在於 COVID-19 可能會二次感染。如果在過去三個月內曾被診斷為確診者,請與醫師討論何時應接種疫苗。 IEHP 是否提供前往 COVID-19 疫苗接種診所的交通服務? 是的,IEHP 可提供前往您居住郡之 COVID-19 疫苗接種診所的交通服務。 如何申請交通服務? 請致電 1-800-440-4347 與 IEHP 交通客服中心聯絡。 司機是否會等我? 抱歉,司機不等人。該交通服務為往返接送。您需要聯絡交通服務提供者,在準備好返回時要求提供返程接送。 我可否攜家人同行? IEHP 可為 IEHP 會員及一名同行者提供交通服務。 申請交通接送需要多久? IEHP 將在 5 個工作日內協助安排前往 COVID-19 疫苗接種診所的交通服務。不過,我們無法保證可處理同日申請。 我何處可瞭解 COVID-19 與 COVID-19 疫苗的相關資訊? 如需更多資訊,IEHP 會員可造訪 IEHP 網站或加州衛生部網站。會員還可透過加州新冠病毒響應網站或 CDC 網站進一步瞭解 COVID-19
聖貝納迪諾郡 Medi-Cal
5 歲以下聖貝納迪諾郡居民沒有保險。
這就是 Inland Empire Health Plan (IEHP) 為聖貝納迪諾和河濱郡的數百萬會員提供保險的原因。
發現將其成員置於其宇宙中心的健康計畫。我們將持續努力不懈,讓整個社區都能獲得最完善的照護和保持健康活力。
繼續閱讀以詳細瞭解 IEHP 和提供給 Medi-Cal 領取者的福利。
IEHP 為聖貝納迪諾郡的 Medi-Cal 領取者提供保險
Medi-Cal 是一項免費或低價的健康保險計畫。為符合資格的低收入加州居民提供健康、牙科與視力保險。IEHP 是聖貝納迪諾郡 Medi-Cal 領取者的健康計畫。我們致力於為我們的會員和當地社區提供最佳護理和活力充沛的健康狀況。
一流的 Medi-Cal 服務
Medi-Cal 是一項免費或低價的健康保險計畫。為符合資格的低收入加州居民提供健康、牙科與視力保險。IEHP 是聖貝納迪諾郡 Medi-Cal 領取者的健康計畫。我們致力於為我們的會員和當地社區提供最佳護理和活力充沛的健康。
透過 IEHP 和 Medi-Cal 保險,會員不僅可以獲得一般醫療保健,還可以獲得高級和專業護理,例如:
跨性別服務
實驗室檢驗服務
放射科服務
兒科照護
心理健康服務
成癮康復護理
這些只是 IEHP 的保健業者網絡如何為聖貝納迪諾郡的會員及其家庭提供廣泛醫療服務的幾個例子。
如需在聖貝納迪諾郡申請 Medi-Cal,請致電 IEHP 註冊顧問,電話為 (866) 294-4347,服務時間為星期一至星期五上午 8 點至下午 5 點。TTY 使用者請撥打 (800) 720-4347。
您也可以致電 1-800-430-4263 與 Health Care Options 聯絡,或造訪 www.healthcareoptions.dhcs.ca.gov。TTY 使用者請撥打 1-800-430-7077。
視力服務
IEHP 提供視力保險,並有一個廣泛的視力專家網路。
IEHP 會員每 24 個月接受一次免費視力檢查,如有醫療需要(例如糖尿病患者),則可以進行額外或更頻繁的眼科檢查。如果您獲得有效處方,您還能每 24 個月就獲得一副眼鏡(包含鏡框和鏡片)。如果因為眼部疾病或醫療狀況而無法佩戴眼鏡,則隱形眼鏡檢查和隱形眼鏡可能也在承保範圍內。
Medi-Cal 聖貝納迪諾郡牙科服務
透過 Medi-Cal,您和您的家人可以獲得專業的牙科服務。此福利已納入您的 Medi-Cal 給付範圍,且您無須承擔費用或僅須承擔少量費用。提供的一些牙科護理類型包括:
診斷和預防性牙科衛生(例如檢查、X 射線治療和牙齒清潔)
為止痛而提供的緊急服務
拔牙
根管治療 (前/後)
刮牙術與牙周整平
牙冠(預製/實驗室製作)
符合條件的兒童齒顎矯正
全口義齒或部分義齒
局部塗氟
若您有任何疑問或需要找尋 Medi-Cal 牙科服務保健業者方面的協助,請致電 1-800-322-6384 與 Medi-Cal 牙科客服專線聯絡,或造訪 www.smilecalifornia.org。
醫療旅行交通
Medi-Cal 福利包括計畫給付健康服務及 Medi-Cal 給付服務(例如心理健康、藥物濫用與牙科服務)的聖貝納迪諾郡與河濱郡的往返交通。
IEHP 涵蓋:
造訪您的初級照護醫師、專科醫師與緊急照護診所。
造訪牙科、心理健康、藥物濫用與其他服務。
點擊此處瞭解有關 IEHP 提供的交通服務的更多資訊。
聖貝納迪諾郡如何申請 Medi-Cal
IEHP 治愈疾病和鼓舞心靈的使命之所以能夠實現,是因為其設立了一個願景 — 為了讓社區獲得最佳照護和充滿活力而竭盡所能。 這就是我們繼續為聖貝納迪諾郡所有社區服務的原因。
申請 Medi-Cal 的方式有多種,其中包括:
致電 IEHP
於週一至週五上午 8 點至下午 5 點撥打 1-866-294-4347。TTY 使用者請撥打 1-800-720-4347。您將與 IEHP 友善的雙語投保顧問進行交流。
郵寄
您可以將填妥並簽名的申請表郵寄至:
Covered California
P.O.Box 989725
West Sacramento, CA 95798-9725
或郵寄至河濱郡 Medi-Cal 辦公室。
現場申請
按一下此處以查找河濱郡 Medi-Cal 辦公室的地點。
線上申請
點擊此處線上申請。
立即獲得健康承保服務
成為 IEHP 計畫會員,享受一流的加州醫療保險服務。超過 25 年以來,IEHP 一直自豪地為 Inland Empire 居民及其家人提供服務。立即加入 IEHP,讓您的健康成為我們的首要任務。
使命始終是幫助會員取得 高品質的醫療、行為健康和保健服務。
IEHP 簡介
IEHP 是管理式照護健保計畫。我們成立於 1996 年,當時有 62,000 位 Medi-Cal 會員。 時至今日,我們已擴大為前 10 大 Medi-Cal 健保計畫。IEHP 的網絡有超過 8,000 個醫 療服務提供者以及超過 2,000 位員工,為 Riverside 和 San Bernardino 郡逾 140 萬居民 服務。我們與您當地的醫師、醫院和其他健 康照護服務提供者合作,向會員提供更理想 的健康照護協調及高品質照護。
身為 IEHP 會員, 我可以取得哪些福利?
加入 IEHP,您也可以使用:
由超過 8,000 個醫師、專科醫師和其 他健康照護服務提供者組成的網絡
照護協調
24 小時護士諮詢專線
視力服務
緊急照護中心
養成健康生活習慣的課程和方案
還有更多其他福利!
如需更多關於 IEHP 福利和服務的資訊, 請前往我們的網站,網址 www.iehp.org, 或聯絡 IEHP 會員服務部。
我成為 IEHP 會員後還 可以保有 MEDI-CAL 嗎?
可以的,您仍可保有 Medi-Cal 以及您原本 即有的全部福利和服務,例如無月費及醫 生看診、藥物和住院零費用。唯一的不同是 您的健康照護服務現在將透過 IEHP 協調。
其他 Medi-Cal 服務包括預防照護,例如疫 苗和精神健康、發展和物質濫用失調篩檢。 您可透過 Medi-Cal 牙科方案取得按服務收 費的 Medi-Cal 牙科服務。
我加入 IEHP 後還可以繼續去看 同樣的醫師嗎?
只要醫師在 IEHP 的醫療服務提供者網絡 中,您就可以繼續向同一位醫師接受照護。 您可以致電 IEHP 會員服務部查詢,電話 1-800-440-IEHP (4347),週一至週五,太 平洋標準時間 (PST) 上午 8 時至下午 5 時。 聽語障專線使用者請撥 1-800-718-4347。 如果您也有 Medicare,只要醫師服務是由 Medicare 提供,您便能繼續去看這些醫師。
認識我們
我們的使命
我們要療癒和鼓舞人心。
我們的期許
我們的努力永不停止,因為我們要讓服務的 社區都享有最佳照護,讓民眾活躍而健康。
我們的價值
我們做正確的事,例如:
將會員視為我們的核心利益。
揮灑創意、發揮勇氣以增進民眾健康與 福址。
始終以負責的態度專注於我們的工作。
對於我們與會員、醫療服務提供者、合作 夥伴及彼此間的承諾,絕不妥協。
我們很樂意回答您的問題,幫助您開始踏出 邁向健康的旅程!
健康照護獎學金基金
擔,並且培養更龐大的專業健康照護人員陣容,以利照顧內陸帝國日益增長的 Medi-Cal 投保會員。 為什麼需要 HSF? 根據加州健康照護基金會 (California Health Care Foundation) 所載,內陸帝國每 10 萬人中擁有初級照護醫師 (PCP) 與專科醫師的比例為加州最低的地區之一。此外,內陸帝國缺乏適任的專業與行為健康執業人員,無法因應現階段越來越龐大的人口。 取得四年制醫學文憑的平均花費至少要 276,800 美元,因此,有能力投身醫療領域的人逐年減少。HSF 的資助能幫助學生擺脫就讀醫學院的財務重擔,讓許多有理想和抱負的專業健康照護人員能夠自由選擇,也讓獲得資助的學生得以立即投身健康照護領域。 我是學生,想當醫生,我該怎麼做? 建議有意申請 IEHP HSF 的學生與下列學術機構聯絡,進一步瞭解申請方式。各機構的資格條件未必相同,但所有 HSF 獎學金一律規定學生保證畢業後會在內陸帝國執業至少 5 年的時間。 合作的學校和學程包括: 羅馬林達大學醫學院 加州大學河濱分校 加州科學暨醫藥大學
健康照護獎學金基金
擔,並且培養更龐大的專業健康照護人員陣容,以利照顧內陸帝國日益增長的 Medi-Cal 投保會員。 為什麼需要 HSF? 根據加州健康照護基金會 (California Health Care Foundation) 所載,內陸帝國每 10 萬人中擁有初級照護醫師 (PCP) 與專科醫師的比例為加州最低的地區之一。此外,內陸帝國缺乏適任的專業與行為健康執業人員,無法因應現階段越來越龐大的人口。 取得四年制醫學文憑的平均花費至少要 276,800 美元,因此,有能力投身醫療領域的人逐年減少。HSF 的資助能幫助學生擺脫就讀醫學院的財務重擔,讓許多有理想和抱負的專業健康照護人員能夠自由選擇,也讓獲得資助的學生得以立即投身健康照護領域。 我是學生,想當醫生,我該怎麼做? 建議有意申請 IEHP HSF 的學生與下列學術機構聯絡,進一步瞭解申請方式。各機構的資格條件未必相同,但所有 HSF 獎學金一律規定學生保證畢業後會在內陸帝國執業至少 5 年的時間。 合作的學校和學程包括: 羅馬林達大學醫學院 加州大學河濱分校 加州科學暨醫藥大學
創新和品質績效 - 品質績效
id 計畫。經過健康照護成效數據與資訊組合 (Healthcare Effectiveness Data and Information Set, HEDIS) 與消費者對醫療照護提供者與系統的評估 (Consumer Assessment of Healthcare Providers and Systems, CAHPS) 判斷後,NCQA 向 IEHP 授予了 Medi-Cal 認證資格。只有在臨床與服務計畫上滿足或超越 NCQA 標準的健康計畫,才能獲得認證資格。
以下提供 IEHP 如何提供高品質服務與照護的詳細資訊。
品質報告
在 2020 年的品質報告中,我們將利用重要的衡量指標檢視過去一年的績效,以此說明品質。我們將說明資料如何化為有利於會員、提供者、團隊成員的實際成果。雖然我們在許多領域表現傑出,也有地方浮現改善機會。
本品質報告的目標是對您及我們自己保持公開透明。這趟旅程仍在持續中,我們希望從中學習,為了最依賴我們的人做得更好,變得更好。
2020 年度品質報告 (PDF)
品質管理
IEHP 支持推動主動、不間斷、全面的品質管理計畫,主要目標為持續監控及改進照護品質、照護的近用、病患安全、向 IEHP 會員提供的服務品質。品質管理 (QM) 計畫提供正式程序,系統化地監控本健康計畫的品質、效率、成效,並加以客觀評估、追蹤、掌握趨勢。
品質管理評估
2019 年度品質管理評估 (PDF)
品質管理計畫說明
2022 年品質管理計畫說明 (PDF)
HEDIS
每一年, IEHP 都會評估 IEHP 會員接受的健康照護整體品質。IEHP 會透過致力於提升健康照護品質的私立非營利組織 NCQA 來實現這一目標。NCQA 為許多不同的健康照護組織提供認證與證明,並管理 HEDIS® 的發展,後者提供:
一套以統計學上有效的會員樣本數為基礎的標準化績效衡量指標
供大眾比較健康計畫績效的資訊
HEDIS 評分:
2020 年 Medi-Cal HEDIS 評分 (PDF)
2020 年 Medicare HEDIS 評分 (PDF)
醫師滿意度
IEHP 重視與提供者之間穩固的合作關係。為了支持提供者,我們提供的許多服務涵蓋線上支援、客服中心、專任服務代表。這正是醫師給予 IEHP 高度評價的原因。事實上,SPH Analytics 進行的 2019 年提供者滿意度調查顯示,98.5% 的醫師都會向其他醫師推薦 IEHP。
瞭解 2020 年提供者滿意度調查 (PDF) 的完整結果。
人口需求評估
IEHP 每年都會寄送人口評估調查給 IEHP 會員,以深入瞭解會員的需求。下方可檢視結果。
2020 年人口需求評估結果
您需使用 Adobe Acrobat Reader 6.0 或更高版本,才能檢視 PDF 檔案。 下載 Adobe Acrobat Reader。
性別健康 - 性別健康
重的情況下,獲得您所需的所有照護。IEHP 會給付所有具醫療必要性的 Medi-Cal 給付性別健康服務。IEHP 的醫師與專科醫師都擁有性別健康服務的豐富經驗。請致電 IEHP 會員服務中心深入瞭解。 如何開始 請定期到您的 IEHP PCP 看診。 若您尚未到您的醫師看診,或已經很久未看診,請今天就約診。您的醫師是您的整體健康照護的關鍵,不但瞭解您的健康史,還能協助確保您獲得必要的照護。 必要時,您的醫師可將您轉介給專科醫師。這包括符合您的醫療需求的任何性別健康選項,因此請與您的醫師討論您的治療目標。 您可隨時變更您的 IEHP 醫師。 福利 請與您的醫師討論下列性別健康福利: 行為健康服務 荷爾蒙替代劑治療 手術與療程 IEHP 擁有熟悉性別健康服務的專屬照護管理師團體,可協助處理下列事宜: 轉介專科醫師 獲取醫療耗材 獲取藥品 為您提供社區資源 IEHP 還提供各項非診療資源,如: 照護協調 社區與法律資源 人口統計資料更新 家庭支持團體 資源 有關性別健康照護的相關教育與訓練,請參考下列資源: 成人性別健康手冊 (PDF) 兒童性別健康手冊 (適用父母與未滿 18 歲兒童) (PDF) 診療指南 (PDF) LGBTQ 資源 (PDF) 您需使用 Adobe Acrobat Reader 6.0 或更高版本,才能檢視 PDF 檔案。免費下載版本。點選 Adobe Acrobat Reader。
Medi-Cal 行為健康治療
執業醫師、外科醫生或執業心理醫師的建議,證明行為健康治療 (BHT) 服務具醫療必要性。 病情穩定 智力障礙者,不需要醫院或中期照護機構提供 24 小時醫療/照護監控或療程。 行為健康治療 (Behavioral Health Treatment, BHT) 是指設計、執行與評估環境改變,運用行為刺激與影響,產生具社會意義的人類行為改變,包括對環境與行為間關係進行直接觀察、衡量與功能分析。 BHT 服務可透過行為觀察與強化教導各項技能,或透過提醒的方式教導目標行為的各個步驟。BHT 服務係依據可靠證據進行,而非實驗。其治療可能包括或可能不包括應用行為分析 (Applied Behavioral Analysis, ABA)。 在提供者完成全面發育監控與篩檢,並建議 BHT 服務在治療持續發育不良行為方面具臨床必要性,及/或能夠以 BHT 服務改正或改善時,則認定 BHT 具醫療必要性。異常行為包括但不限於自殘、攻擊行為,以及語言能力、日常生活能力與社交能力方面的障礙。 PCP 會持續將需要任何 BHT 服務及/或診斷需求的會員,直接轉介加入 IEHP 行為健康服務,無論其 IPA 是誰。 若您有任何疑問,或希望就篩檢、診斷與治療獲取您的 PCP 的建議,可於週一至週五上午 8 點至下午 5 點聯繫 IEHP 會員服務中心,電話 1-800-440-IEHP (4347)/TTY 使用者請撥 (800) 718-4347。 會員自負費用 會員不須就此等服務支付任何費用。 造訪 IEHP 的心理健康頁面,獲取一般心理健康資訊。