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Updates and Letters

Amendments to the information in these manuals are made through updates or signed letters distributed by fax, the United States Postal Service or other carrier and email.

18-001 – Encounter Data Submission Validation (PDF)  

18-002 – Encounter Data Submission Validatio (PDF) (CalViva Health)

18-003 – Physician Certification Statement for Non-Emergency Medical Transportation for Medi-Cal Members (PDF) (FFS and Shared Risk)

18-004 – Physician Certification Statement for Non-Emergency Medical Transportation for Medi-Cal Members (FFS and Shared Risk) (PDF) (CalViva Health) 

18-006 – NEMT/NMT Benefit Change Dual Risk (PDF)

18-007 – NEMT/NMT Benefit Change Dual Risk (PDF) (CalViva Health) 

18-009 – NEMT/NMT Benefit Change Shared Risk (PDF)

18-010 – NEMT/NMT Benefit Change Shared Risk (PDF) (CalViva Health) 

18-012 – Treating and Managing Behavioral Health Conditions Primary Care Provider Toolkit is Available Online (PDF)

18-022 – Ancillary Provider Data Verification Update-wave 3 (PDF)

18-029 – Ancillary Provider Data Verification Update-wave 3 (PDF) (CalViva Health)

18-062 – After-Hours Access Guidelines and Access to Urgent/Emergent Services (PDF)

18-064 – After-Hours Access Guidelines and Access to Urgent/Emergent Services (PDF) (CalViva Health)

18-065 – Activation of Direct Network Providers for Medi-Cal Members in San Diego (PDF)

18-066 – Improving Health Literacy (PDF)

18-068 – Perinatal Notification Incentive Program Continues in 2018 (PDF)

18-069 – Perinatal Notification Incentive Program Continues in 2018 (PDF)

18-070 – Perinatal Notification Incentive Program Continues in 2018 (PDF)

18-071 – Perinatal Notification Incentive Program Continues in 2018 (PDF)

18-072 – Medi-Cal Provider Data Verification Update (PDF)

18-079 – Time Frames to Reply to Request for Records for Independent Medical Reviews (PDF)

18-081 – Time Frames to Reply to Request for Records for Independent Medical Reviews (PDF)(CalViva Health)

18-091 – Childhood Lead Poisoning Screening is a Covered Preventive Service (PDF)

18-092 – Childhood Lead Poisoning Screening is a Covered Preventive Service (PDF) (CalViva Health) 

18-095 – Provider Screening and Enrollment Update (PDF)

18-097 – Provider Screening and Enrollment Update (PDF) (CalViva Health) 

18-099 – After-Hours Acess: PCP Requirements for Urgent Services (PDF)

18-101 – After-Hours Acess: PCP Requirements for Urgent Services (PDF) (CalViva Health)

18-102 – Dedicated Telephone Line for Inquiries Regarding EHS Medical Group and Multicultural Medical Group Termination (PDF)

18-103 – Dedicated Telephone Line for Inquiries Regarding EHS Medical Group Termination (PDF)

18-105 – Be Prepared - Upcoming DHCS Provider Calls on Appointment Availability (PDF)

18-106 – Be Prepared - Upcoming DHCS Provider Calls on Appointment Availability (PDF) (CalViva Health)

18-110 – 2018 PPG Webinar Calendar (PDF)

18-112 – 2018 PPG Webinar Calendar (PDF) (CalViva Health) 

18-113 – Overdose Education and Naloxone Webinar Series (PDF)

18-115 – Overdose Education and Naloxone Webinar Series (PDF) (CalViva Health) 

18-117 – HEDIS® Improvement Program Incentive (PDF) 

18-118 – HEDIS® Improvement Program Incentive (PDF) (CalViva Health) 

18-122 – Medication Trend Updates and Formulary Changes – 1st Quarter 2018 (PDF)

18-123 – Medication Trend Updates and Formulary Changes – 1st Quarter 2018 (PDF) (CalViva Health) 

18-125 – Breast Pumps and Infant Nutrition are Covered Benefits (PDF)

18-126 – Breast Pumps and Infant Nutrition are Covered Benefits (PDF) (CalViva Health) 

18-131 – Medical Policies - 4th Quarter 2017 (PDF)

18-133 – Medical Policies - 4th Quarter 2017 (PDF) (CalViva Health) 

18-142 – Advanced Imaging and Cardiac Imaging Prior Authorization for Molina(PDF)

18-161 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Updated (PDF)

18-162 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Updated (PDF) (CalViva Health) 

18-164 – Upcoming Provider Webinar: Best Practices to Support Vaginal Delivery and Reduce the NTSV Cesarean Section Rate (PDF)

18-165 – Upcoming Provider Webinar: Best Practices to Support Vaginal Delivery and Reduce the NTSV Cesarean Section Rate (PDF) (CalViva)

18-166 – Ancillary Provider Data Verification Update-wave 4 (PDF)

18-173 – Ancillary Provider Data Verification Update-wave 4 (PDF) (CalViva Health)

18-181 – Non-Participating Hospitals Notification for ER Admission for Post-Stabilization Services Letter (PDF)

18-182 – Non-Participating Hospitals Notification for ER Admission for Post-Stabilization Services Letter (PDF) (CalViva Health)

18-183 – Health Net Implements New Payment Integrity Policies (PDF)

18-184 – Implementation of New Payment Integrity Policies (PDF)

18-187 – Reimbursement for American Indian Health Service Programs (PDF)

18-188 – Reimbursement for American Indian Health Service Programs (PDF) (CalViva Health)

18-189 – Fee-For-Service Utilization Data Report (PDF)

18-190 – Fee-For-Service Utilization Data Report (PDF) (CalViva Health) 

18-193 – Prior Authorization Requirement for EPSDT Private Duty Nursing Services (PDF)

18-194 – Prior Authorization Requirement for EPSDT Private Duty Nursing Services (PDF) (CalViva Health)

18-199 – Access to Unusual Specialty Services (PDF)

18-200 – Access to Unusual Specialty Services (PDF) (CalViva Health) 

18-201 –  Timely Provider Data Demographic Data Validation Reminder (PDF)

18-203 –  Timely Provider Data Demographic Data Validation Reminder (PDF) (CalViva Health)

18-207 – Changes to Application Submission Time Frame for Medi-Cal Provider Enrollment (PDF) (CalViva Health) 

18-208 – Changes to Application Submission Time Frame for Medi-Cal Provider Enrollment (PDF)

18-209 – DHCS Audit Notification (PDF) (CalViva Health)

18-211 – Translated Letters Now Available on ICE Website (PDF)

18-213 – Alternative Treatments for Low Back Pain (PDF)

18-214 – Alternative Treatments for Low Back Pain (PDF) (CalViva Health) 

18-216 – DHCS Annual Network Certification Process (PDF)

18-217 – DHCS Annual Network Certification Process (PDF) (CalViva Health) 

18-219 – DHCS Medical Review Audit Notification (PDF)

18-221 – Medications Newly Approved by the U.S. Food and Drug Administration (PDF)

18-223 – Medications Newly Approved by the U.S. Food and Drug Administration (PDF)(CalViva)

18-224 – Medications Newly Approved by the U.S. Food and Drug Administration (PDF) (LA-DHS)

18-232 – Reimbursement for American Indial Health Service Programs (PDF)

18-233– Reimbursement for American Indial Health Service Programs (PDF) (CalViva Health) 

18-234 – Provider Webinar – Decreasing NTSV Cesarean Section Rates (PDF)

18-235 – Provider Webinar – Decreasing NTSV Cesarean Section Rates (PDF) (CalViva)

18-242 – Proposition 56 Supplemental Payments for Certain Physician Services (PDF) (CalViva Health) 

18-243 – Proposition 56 Supplemental Payments for Certain Physician Services (PDF)

18-247 – Ancillary Provider Data Verification Update-Regional (PDF)

18-254 – Ancillary Provider Data Verification Update-Regional (PDF) (CalViva Health) 

18-268 – Quality Management Program (PDF)

18-269 – Quality Management Program (PDF) (CalViva Health)

18-270 – Quality Management Program (PDF)

18-272 – Influenza and Streptococcus Group A Testing Clinical Policy Change (PDF)

18-273 – Influenza and Streptococcus Group A Testing Clinical Policy Change (PDF) (CalViva Health) 

18-274 – MedXM In-Home Well Child Assessment Pilot Program (PDF)

18-281 – Revised Medi-Cal Care Management Referral form (PDF)

18-282 – Revised Medi-Cal Care Management Referral form (PDF) (CalViva Health)

18-285 – Staying Healthy Assessment Reminder (PDF) (CalViva Health) 

18-286 – Staying Healthy Assessment Reminder (PDF)

18-287 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds (PDF)

18-288 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds (PDF)

18-290 – Medication Trend Updates and Formulary Changes – 2nd Quarter 2018 (PDF)

18-291 – Medication Trend Updates and Formulary Changes – 2nd Quarter 2018 (PDF) (CalViva Health) 

18-298 – Notification of Hospital Admissions (PDF)

18-300 – Notification of Hospital Admissions (PDF) (CalViva Health) 

18-301 – DHCS Medi-Cal Documenting and Reporting Immunization Requirements (PDF)

18-303 – DHCS Medi-Cal Documenting and Reporting Immunization Requirements (PDF)(CalViva Health) 

18-305 – Q2 - Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update (PDF)

18-307 – Q2 - Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update (PDF) (CalViva Health) 

18-313 – Correction - 18-212, Health Net Translated Letter Templates Available on ICE Website (PDF)

18-314 – Medi-Cal Provider Data Verification Update-CalViva Health (PDF) (CalViva Health) 

18-327 – Delayed Implementation of Payment Integrity Policies (PDF)

18-328 – Delayed Implementation of Payment Integrity Policies (PDF) (CalViva Health) 

18-335 – MedXM In-Home Health Assessment Program (PDF)

18-350 – 2018 Provider Appointment Availability & After-Hours Survey Prep (PDF) (CalViva Health) 

18-353 – 2018 Provider Appointment Availability & After-Hours Survey Prep (PDF)

18-356 – Partial fill schedule II drug prescriptions (PDF)

18-357 – Partial fill schedule II drug prescriptions (PDF) (CalViva Health) 

18-358 – MedXM: In-Home Postpartum Care Expansion

18-359 – MedXM Postpartum Care Program Reminder for CalViva Health Members (PDF) (CalViva Health) 

18-360 – Behavioral Health Treatment Coverage for EPSDT Member (PDF)

18-361 – Behavioral Health Treatment Coverage for EPSDT Member (PDF) (CalViva Health)

18-362 – Hospital Provider Data Verification Update (PDF)

18-367 – Hospital Provider Data Verification Update (PDF) (CalViva Health)

18-372 – Submitting Medical Prior Authorization Requests (PDF)

18-373 – Submitting Medical Prior Authorization Requests (PDF) (CalViva Health) 

18-382 – Provider Appeals Informationa nd Documentation Requirements (PDF)

18-383 – Provider Appeals Informationa nd Documentation Requirements (PDF) (CalViva Health) 

18-384 – Expanded List of Providers Who Can Authorize Non-Emergency Medical Transportation (NEMT) for Medi-Cal Members (FFS and Shared Risk (PDF)

18-385 – Expanded List of Providers Who Can Authorize Non-Emergency Medical Transportation (NEMT) for Medi-Cal Members (FFS and Shared Risk) (PDF) (CalViva Health) 

18-388 – Medical Policies - 1st Quarter 2018 (PDF)

18-390 – Medical Policies - 1st Quarter 2018 (PDF) (CalViva Health) 

18-404 – Medi-Cal Provider Data Verification Update (PDF) (CalViva Health) 

18-433 – Canceled Implementation of Payment Integrity Policies (PDF)

18-434 – Canceled Implementation of Payment Integrity Policies (PDF) (CalViva Health) 

18-437 – New Outpatient Cardiac Rehabilitation Services Requirements for Medi-Cal (PDF)

18-438 – New Outpatient Cardiac Rehabilitation Services Requirements for Medi-Cal (PDF)(CalViva Health)

18-441 – Provider Demographic Data Validation -Q2 (PDF)

18-443 – Provider Demographic Data Validation -Q2 (PDF) (CalViva Health) 

18-444 – Medical Paper Claims Submission Rejections and Resolutions (PDF)

18-445 – Medical Paper Claims Submission Rejections and Resolutions (PDF) (CalViva Health) 

18-447 – Secure Messaging Changes (PDF)

18-449 – Secure Messaging Changes (PDF) (CalViva Health)

18-455 – PM 160 INF Forms Continue to be Accepted for CHDP Services (PDF)

18-456 – PM 160 INF Forms Continue to be Accepted for CHDP Services (PDF) (CalViva Health) 

18-462 – Language Assistance Program and Cultural Competency (PDF) (CalViva Health) 

18-464 – Language Assistance Program and Cultural Competency (PDF)

18-479 – Health Net Implements New Clinical Payment Policies (PDF)

18-480 – Implementation of New Clinical Payment Policies (PDF) (CalViva Health) 

18-487 – Action Required: Submit Your Application for Medi-Cal Provider Enrollment to DHCS (PDF) (CalViva Health) 

18-488 – Action Required: Submit Your Application for Medi-Cal Provider Enrollment to DHCS (PDF)

18-490 – State of Emergency: Health Net Members Impacted by West Fire in San Diego County (PDF)

18-493 – Deletions to Prior Authorization Requirements for Medi-Cal (PDF)

18-494 – Deletions to Prior Authorization Requirements for Medi-Cal (PDF) (CalViva Health)

18-499 – Mobile Mammography Pilot Program (PDF) 

18-500 – Mobile Mammography Pilot Program (PDF) (CalViva Health) 

18-504 – Ancillary Wave 1 2019 Provider Update FaxBack (PDF)

18-511 – Ancillary Wave 1 2019 Provider Update FaxBack (PDF) (CalViva Health) 

18-530 – 2019 Medi-Cal Provider Data Verification Update (PDF) (CalViva Health)

18-541 – Paper Claims Submission Adress and Provider Appeals Address (PDF)

18-542 – Paper Claims Submission Adress and Provider Appeals Address (PDF) (CalViva Health) 

18-552 – Promoting HN's Community Resource Center in LA (PDF)

18-554 – State of Emergency: Support for Health Net Members Impacted by Steele Fire in Napa County (PDF)

18-558 – Updated Contract Language Required for NCQA Health Plan Accreditation (PDF)

18-561 – Expanded Availability and Types of Substance Abuse Treatment in Fresno County (PDF) (CalViva Health) 

18-564 – Submitting Claims with Member Identification Number Starting with R and AK Rejection Code (PDF)

18-568 – PPG Required Specialty Types (PDF)

18-570 – PPG Required Specialty Types (PDF) (CalViva Health)

18-573 – Reminder: HEDIS® Improvement Program Incentive (PDF)

18-574 – Reminder: HEDIS® Improvement Program Incentive (PDF) (CalViva Health) 

18-575 – Submitting Claims with Member Identification Number Starting with R and AK Rejection Code (PDF) (CalViva Health) 

18-577 – Use the Correct Entity name for Paper Claims Submission (PDF)

18-579 – Use the Correct Entity name for Paper Claims Submission (PDF) (CalViva Health) 

18-580 – State of Emergency: Support for Health Net Members Impacted by Holy Fire in Orange and Riverside Counties (PDF)

18-583 – Medication Trend Updates and Formulary Changes – 3rd Quarter 2018 (PDF)

18-584 – Medication Trend Updates and Formulary Changes – 3rd Quarter 2018 (PDF) (CalViva Health) 

18-587 – Medi-Cal 2017 Provider Appointment Availability and After-Hours Access Survey Results (PDF) (CalViva Health) 

18-588 – Medi-Cal 2017 Provider Appointment Availability and After-Hours Access Survey Results (PDF)

18-591 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Updated - HMO/Medicare/Medi-Cal (PDF)

18-592 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Updated (PDF) (CalViva Health)

18-608 – Eligibility Report Field Addition for Medi-Cal Member (PDF)

18-609 – Eligibility Report Field Addition for Medi-Cal Member (PDF) (CalViva Health)

18-611 – Upcoming 2018 Provider Satisfaction Survey (PDF)

18-613 – Upcoming 2018 Provider Satisfaction Survey (PDF) (CalViva Health)

18-623 – Provider Offshore Subcontracting Requirements Annual Reminder (PDF)

18-625 – Provider Offshore Subcontracting Requirements Annual Reminder (PDF) (CalViva Health) 

18-630 – Medi-Cal Provider Data Verification Update (PDF) (CalViva Health)

18-635 – Opioid Use (or Miisuse) in Pregnancy & Treatment Webinar (PDF)

18-636 – Opioid Use (or Miisuse) in Pregnancy & Treatment Webinar (PDF)  (CalViva Health) 

18-641 – W-9 Required for Proposition 56 Supplemental Payments (PDF)

18-642 – W-9 Required for Proposition 56 Supplemental Payments (PDF) (CalViva Health) 

18-643 – Medi-Cal Provider Screening & Enrollment (PDF)

18-644 – Medi-Cal Provider Screening & Enrollment (PDF) (CalViva Health)

18-646 – Initial Health Assessment Reminder (PDF)

18-647 – Initial Health Assessment Reminder (PDF) (CalViva Health)

18-658 – Reduce High-Risk Preterm Deliveries with CalViva Health Pregnancy Program (PDF) (CalViva Health) 

18-659 – Medical Policies - 1st Quarter 2018 (PDF)

18-661 – Medical Policies - 1st Quarter 2018 (PDF) (CalViva Health) 

18-663 – Provider Office Telephone Access Survey (PDF)

18-664 – Provider Office Telephone Access Survey (PDF)

18-673 – Provider Update - Importance of Developmental Screenings (PDF)

18-674 – Provider Update - Importance of Developmental Screenings (PDF) (CalViva Health) 

18-685 – Timely Response to Request for Medical Records Reminder (PDF)

18-687 – Timely Response to Request for Medical Records Reminder (PDF) (CalViva Health)

18-689 – Corrected Individual Family Plan Prior Authorization Request Form (PDF)

18-691 – Best Practices Flu Vaccine Flyer (PDF)

18-693 – Best Practices Flu Vaccine Flyer (PDF) (CalViva Health) 

18-715 – Better Treatment Outcome Potential Through Care Management Programs (PDF)

18-716 – Better Treatment Outcome Potential Through Care Management Programs (PDF)(CalViva Health)

18-721 – Concurrent Reviews (PDF)

18-723 – Concurrent Reviews (PDF) (CalViva Health) 

18-725 – Learning Collaborative to Improve HPV Immunization Rates (PDF)

18-726 – Learning Collaborative to Improve HPV Immunization Rates (PDF) (CalViva Health) 

18-728 – Provider Demographic Data Validation -Q3 (PDF)

18-730 – Provider Demographic Data Validation -Q3 (PDF) (CalViva Health)

18-731 – Chiropractic and Podiatry Coverage (PDF)

18-732 – Chiropractic and Podiatry Coverage (PDF) (CalViva Health) 

18-748 – HEDIS Annual Medical Record Collection (PDF)

18-753 – Serogroup B Meningococcal Outbreak at San Diego State University (PDF)

18-756 – How to Navigate The New Provider Portal Webinars (PDF)

18-757 – Denial of Incontinence Supplies from Noncontracting Suppliers (PDF)

18-758 – Denial of Incontinence Supplies from Noncontracting Suppliers (PDF) (CalViva Health)

18-761 – 2019 Medi-Cal Provider Data Verification Update V2-CalViva Health (PDF) (CalViva Health)

18-768 – 2017–2018 Payment Programs for Public and Private Hospitals (PDF)

18-769 – 2017–2018 Payment Programs for Public and Private Hospitals (PDF) (CalViva Health) 

18-771 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds (PDF)

18-772 – Requesting Electronic Prescription Drug Prior Authorization Using CoverMyMeds (PDF) (CalViva Health) 

18-775 – Single Member ID Now Displaying on the Provider Portal (PDF)

18-778 – Health Net Implements New Payment Integrity Policies (PDF)

18-779 – Implementation of New Payment Integrity Policies (PDF) (CalViva Health) 

18-782 – Meningococcal Serogroup B Vaccine Inventory Information Needed (PDF)

18-783 – Website and Account Manager Access at provider.healthnetcalifornia.com (PDF)

18-786 – Medication Trend Updates and Formulary Changes - 4th Quarter 2018 (PDF)

18-787 – Medication Trend Updates and Formulary Changes - 4th Quarter 2018 (PDF) (CalViva Health) 

18-795 – Recognizing Signs of Suicide Risk (PDF) (CalViva Health) 

18-797 – Prior Authorization Requirement Changes (PDF)

18-799 – Prior Authorization Requirement Changes for CalViva Health Members (PDF) (CalViva Health)

18-800 – Prior Authorization Requirement Changes (PDF) (LA-DHS)

18-802 – Whooping Cough Epidemic Anticipated for 2018 (PDF)

18-805 – Whooping Cough Epidemic Anticipated for 2018 (PDF) (CalViva Health) 

18-807 – Collaborative Care Models Support Cesarean Reduction (PDF) (CalViva Health) 

18-808 – Collaborative Care Supports Cesarean Reduction - Provider Webinar (PDF)

18-809 – MedXM In Home Health Assessment (PDF) (CalViva Health) 

18-814 – Required Primary Diagnosis Code for Outpatient Cardiac Rehabilitation Services (PDF)

18-815 – Required Primary Diagnosis Code for Outpatient Cardiac Rehabilitation Services (PDF)(CalViva Health)

18-816 – Cost Comparison Tool Transitions to HealthSparq on January 1, 2019 (PDF)

18-824 – 2018-2019 Influence Vaccine Recommendations (PDF)

18-825 – 2018-2019 Influence Vaccine Recommendations (PDF) (CalViva Health) 

18-829 – Reminder: Substance Abuse Treatment Services Expanding in Fresno County (PDF) (CalViva Health) 

18-830 – Submit a W-9 Form to Receive Pop 56 Supplemental Payments (PDF)

18-831 – Submit a W-9 Form to Receive Pop 56 Supplemental Payments (PDF)

18-832 – At Home Well Child Visit - MedXM (PDF)

18-836 – Health Net to Use Verify Health Care Portal to Conduct Provider Data Verification (PDF)

18-840 – Upcoming Deadline for the Perinatal Notification Incentive Program Forms (PDF) (CalViva Health)

18-841 – Upcoming Deadline for the Perinatal Notification Incentive Program Forms (PDF)

18-842 – Upcoming Deadline for the Perinatal Notification Incentive Program Forms (PDF)

18-843 – Upcoming Deadline for the Perinatal Notification Incentive Program Forms (PDF)

18-844 – Reversing Opioid Depression with Naloxone Hydrochloride (PDF)

18-845 – Reversing Opioid Depression with Naloxone Hydrochloride (PDF) (CalViva Health) 

18-850 – State of Emergency: Hill and Woolsey Fires in Los Angeles and Ventura Counties (PDF)

18-851 – Q4 HCPCS DOFR Crosswalk (PDF)

18-853 – Q4 HCPCS DOFR Crosswalk (PDF) (CalViva Health) 

18-854 – 2017–2018 Payment Programs for Public and Private Hospitals (PDF)

18-856 – Provider Demographic Data Validation - Q4 (PDF)

18-858 – Provider Demographic Data Validation - Q4 (PDF) (CalViva Health)

18-864 – Depression Screening and Follow-up Plan for Adolescents and Adults (PDF)

18-865 – Update to Provider Update 17-267 - Clinical Depression and Follow-up Plan (CDF) Screening for Medi-Ca l (PDF) (CalViva Health) 

18-866 – Update to Provider Update 17-268 - Clinical Depression and Follow-up Plan (CDF) Screening for Medi-Cal (PDF)

18-874 – Medical Policies - 3rd Quarter 2018 (PDF)

18-875 – Medical Policies - 3rd Quarter 2018 (PDF) (CalViva Health) 

18-879 – LexisNexis to Conduct Provide Data Verification for PPGs (PDF)

18-880 – HEDIS®   Quality Measures for Patient Opioid Use (PDF)

18-881 – HEDIS®   Quality Measures for Patient Opioid Use (PDF) (CalViva Health) 

18-884 – URGENT: Telehealth Services for California Fire Victims (PDF)

18-890 – Directory Accuracy, Why is this so Hard? Webinar (PDF)

18-899 – Updates to Language Assistance Program and Notification of Cultural Competency Training (PDF) (CalViva Health)

18-904 – Resources to Improve Low Back Pain (PDF)

18-905 – Resources to Improve Low Back Pain (PDF) (CalViva Health) 

18-908 – Training and Attestation Requirements (PDF)

18-909 – Training and Attestation Requirements (PDF) (CalViva Health) 

18-927 – Claims Rejection Letters to Be Sent Beginning December 26, 2018 (PDF)

19-002 – Are You Ready for the CAHPS Survey? (PDF)

19-003 – Are You Ready for the CAHPS Survey? (PDF) (CalViva) 

19-020 – Claims Rejection Letters to Be Sent Beginning December 26, 2018 (PDF)

19-023 – Alcohol Misuse: Screening and Behavioral Counseling Interventions (PDF)

19-024 – Alcohol Misuse: Screening and Behavioral Counseling Interventions (PDF)  (CalViva) 

19-030 – Continuity of Care Changes for Medi-Cal Members (PDF)  (CalViva) 

19-031 – Continuity of Care Changes for Medi-Cal Members (PDF)

19-032 – PHDP/EPP Contract Validation (PDF)

19-033 – PHDP/EPP Contract Validation (PDF)  (CalViva) 

19-036 – Medi-Cal Diabetes Prevention Pgrm SHP 247 (PDF) (CalViva)

19-037 – Medi-Cal Diabetes Prevention Pgrm SHP 247 (PDF)

19-039 – Nonopioid Medication Options & Nonpharm Treatment (PDF)

19-040 – Nonopioid Medication Options & Nonpharm Treatment (PDF) (CalViva) 

19-043 – Sign Up for 2019 Educational Webinars (PDF)

19-044 – Sign Up for 2019 Educational Webinars (PDF)  (CalViva) 

19-055 – Childrood Blood Lead Screening (PDF) (CalViva) 

19-056 – Childhood Blood Lead Screening (PDF)

19-064 – W-9 Form Needed for Prop 56 Supplemental Payments (PDF)

19-065 – W-9 Form Needed for Prop 56 Supplemental Payments (PDF) (CalViva) 

19-066 – DHCS and DMHC Audit Notification (PDF)

19-067 – Transitioning Delegated Functions (PDF)

19-068 – Transitioning Delegated Functions (PDF) (CalViva) 

19-071 – Medi-Cal Provider Appeals and Disputes Mailing Address (PDF)

19-072 – Medi-Cal Provider Appeals and Disputes Mailing Address (PFD) (CalViva)

19-074 – Inpatient Notification Requirements (PDF)

19-077 – Inpatient Notification Requirements (PDF) (CalViva) 

19-080 – Encounter Data Submission Validation (PDF)

19-081 – Encounter Data Submission Validation (PDF) (CalViva) 

19-087 – Use of Tamper-Resistant Controlled Substance Prescription Forms Delayed (PDF)

19-089 – Use of Tamper-Resistant Controlled Substance Prescription Forms Delayed (PDF)  (CalViva) 

19-094 – Support for Providers Treating Pattients with Opiod Use Disordejr (PDF)

19-097 – Support for Providers Treating Pattients with Opiod Use Disorder (PDF)  (CalViva) 

19-098 – Updates to Family Planning (PDF)

19-100 – Updates to Family Plannin (PDF)  (CalViva) 

19-102 – Medi-Cal Diabetes Prevention Pgrm SHP 247-Molina (PDF) (Molina)

19-110 – Expanded Criteria for Co-Prescribing Naloxone (PDF)

19-113 – Expanded Criteria for Co-Prescribing Naloxone (PDF)  (CalViva) 

19-120 – Medi-Cal Provider Appeals and Disputes Mailing Address - CORRECTION (PDF)

19-121 – Medi-Cal Provider Appeals and Disputes Mailing Address - CORRECTION (PDF) (CalViva) 

19-127 – Medical Policies - 4th Quarter 2018 (PDF)

19-129 – Medical Policies - 4th Quarter 2018 (PDF) (CalViva) 

19-131 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table - Updated 1st Quarter 2019 (PDF)

19-133 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table - Updated 1st Quarter 2019 (PDF)  (CalViva) 

19-135 – Sharing Medical Records at the Health Plan’s Request (PDF)

19-136 – Sharing Medical Records at the Health Plan’s Request (PDF)  (CalViva) 

19-143 – Discontinuing MedXM In Home Postpartum Assessment (PDF)

19-146 – Health Net Medi-Cal Provider Telephone Access Survey (PDF)

19-147 – Health Net Medi-Cal Provider Telephone Access Surve (PDF) (CalViva) 

19-149 – Avoid Authorization Denials by Submitting Requested Medical Records to NIA (PDF)

19-150 – Avoid Authorization Denials by Submitting Requested Medical Records to NIA (PDF)  (CalViva) 

19-155 – Contract Status Validation Needed by March 15, 2019, for Hospital Directed Payment Programs - Hosp (PDF)

19-156 – Contract Status Validation Needed by March 15, 2019, for Hospital Directed Payment Programs - Cap PPGs (PDF)

19-157 – Contract Status Validation Needed by March 15, 2019, for Hospital Directed Payment Programs - Hosp (PDF)  (CalViva) 

19-158 – Contract Status Validation Needed by March 15, 2019, for Hospital Directed Payment Programs - Cap PPGs (PDF)  (CalViva) 

19-161 – Fit Families for Life - Be in Charge! Weight Control Program Update (PDF)

19-162 – Fit Families for Life - Be in Charge! Weight Control Program Update (PDF) (LA-Molina) 

19-163 – Fit Families for Life - Be in Charge! Weight Control Program Update (PDF)  (CalViva) 

19-164 – Discontinuing MedXM In Home Postpartum Assessment (PDF)

19-167 – Requesting Medical Records from PPGs' Individual Practitioners (PDF) (CalViva) 

19-168 – Requesting Medical Records from PPGs' Individual Practitioner (PDF)

19-171 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer (PDF)

19-172 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer (PDF) (CalViva) 

19-178 – State of Emergency: Counties Across California Due to Winter Storms (PDF)

19-181 – State of Emergency: 4 Additional Counties Across California Due to Winter Storms (PDF)

19-198 – New Medi-Cal Benefit for Pediatric Palliative Care (PDF)

19-199 – New Medi-Cal Benefit for Pediatric Palliative Care (PDF) (CalViva) 

19-238 – AB 2193 Requires Maternal Mental Health Screening (PDF)

19-239 – AB 2193 Requires Maternal Mental Health Screening (PDF) (CalViva) 

19-242 – Best Practices Prescribing and Managing Opioid Medications (PDF)

19-243 – Best Practices Prescribing and Managing Opioid Medications (PDF) (CalViva) 

19-246 – Access to Freestanding Birth Centers and Midwife_SHP 265 APL 18-022 (PDF) (CalViva)

19-248 – Access to Freestanding Birth Centers and Midwife_SHP 265 APL 18-022 (PDF)

19-255 – Timely Provider Demographic Data Validation Reminder (PDF)

19-256 – Timely Provider Demographic Data Validation Reminder (PDF) (CalViva)

19-258 – 2019 Member Incentives (PDF)

19-259 – CBAS Update and Ops Manual Changes (PDF)

19-262 – CBAS Update and Ops Manual Change (PDF) (CalViva) 

19-272 – Preferred Drug List Changes - May 1, 2019 (PDF)

19-273 – Preferred Drug List Changes - May 1, 2019 (PDF) (CalViva) 

19-282 – Prop 56 Rates for 2018-2019 (PDF)

19-283 – Prop 56 Rates for 2018-2019 (PDF) (CalViva) 

19-285 – DHCS Audit Notification (PDF)

19-294 – Preferred Drug List Changes Moved to May 13, 2019 (PDF)

19-295 – Preferred Drug List Changes Moved to May 13, 2019 (PDF) (CalViva) 

19-303 – Nonpar Hospital ER Admission Post-stabilization Notification (PDF)

19-304 – Nonpar Hospital ER Admission Post-stabilization Notification (PDF) (CalViva) 

19-310 – Ultomiris™ Approved by FDA (PDF)

19-313 – Ultomiris™ Approved by FDA (PDF) (CalViva) 

19-314 – Ultomiris™ Approved by FDA (PDF) (LA-DHS)

19-347 – Member Incentive Flyer (PDF)

19-362 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 2 (PDF)

19-363 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 2 (PDF) (CalViva) 

19-370 – Call to Action: DHCS Study on Appointment Availability (PDF)

19-371 – Call to Action: DHCS Study on Appointment Availability (PDF) (CalViva)

19-373 – Timely Response Needed: DHCS to Confirm Executed Contract (PDF)

19-374 – Timely Response Needed: DHCS to Confirm Executed Contract (PDF) (CalViva)

19-376 – Submit Data for Payment Programs by May 31, 2019 (PDF)

19-377 – Submit Data for Payment Programs by May 31, 2019 (PDF)

19-381 – Health Net Laumches the Medi-Cal Health Homes Program (PDF)

19-384 – New Medi-Cal Providers Must Show Proof of DHCS Application (PDF)

19-385 - New Medi-Cal  Providers Must Show Proof of DHCS Application (PDF)  (CalViva)

19-387 – Q2 Injectable Medication HCPCS/DOFR Crosswalk (PDF)

19-388 – Q2 Injectable Medication HCPCS/DOFR Crosswalk (PDF) (CalViva) 

19-391 – Pertussis Death in California (PDF)

19-393 – Pertussis Death in California (PDF) (CalViva) 

19-395 – Measles Outbreak Plagues California (PDF) (CalViva) 

19-397 – Measles Outbreak Plagues California (PDF)

19-400 – Fax Your PNIP Forms by July 12 to Get $50 Incentive Payment (PDF)

19-401 – Fax Your PNIP Forms by July 12 to Get $50 Incentive Payment (PDF) (CalViva) 

19-406 – Fax Your Wait-Time Log the First Tuesday of Each Month (PDF) (CalViva) 

19-410 – Contat the Right Source to Get Enteral Nutrition for Your Patient (PDF)

19-411 – Contat the Right Source to Get Enteral Nutrition for Your Patient (PDF) (CalViva) 

19-418 – Measles Outbreak Plagues California (PDF)

19-419 – Measles Outbreak Plagues California (PDF) - CalViva

19-430 – Patient Education Tips for Opioid Therapy (PDF)

19-431 – Patient Education Tips for Opioid Therapy (PDF) (CalViva) 

19-438 – Medication Trend Updates and Formulary Changes – 2nd Quarter 2019 (PDF)

19-439 – Medication Trend Updates and Formulary Changes – 2nd Quarter 2019 (PDF) (CalViva)

19-442 – Medi-Cal Operations Guide (PDF)

19-443 – Member Rights and Responsibilities (PDF)

19-444 – Pharmacy Information (PDF)

19-445 – Provider Library Brochure (PDF)

19-446 – Provider Portal Brochure (PDF)

19-450 – Medi-Cal Operations Guide (PDF) (CalViva)

19-451 – Member Rights and Responsibilities (PDF) (CalViva)

19-452 – Pharmacy Information (PDF) (CalViva)

19-453 – Provider Library Brochure (PDF) (CalViva)

19-454 – Provider Portal Brochure (PDF) (CalViva)

19-458 – Newly Contracting Medi-Cal Providers: Take Training and Sign Attestation Form (PDF)

19-459 – Newly Contracting Medi-Cal Providers: Take Training and Sign Attestation Form (PDF) (CalViva)

19-462 – Improve Your HEDIS Quality Scores Flyer (PDF) (CalViva)

19-466 – LA County Measles Outbreak (PDF)

19-483 – Send Medical Records If Requested for Emergency Claims to Avoid Delays (PDF)

19-486 – Taper Off Opioids to Avoid Harm (PDF)

19-487 – Taper Off Opioids to Avoid Harm (PDF) (CalViva) 

19-501 – New Hours for the Health Net Medi-Cal Provider Services Center (PDF)

19-502 – Encounters Training for Providers (PDF)

19-503 – Encounters Training for Providers (PDF)

19-505 – MedXM In-Home Health Assessment Program (PDF) (Medi-Cal)

19-506 – MedXM In-Home Health Assessment Program (PDF) (CalViva)

19-509 – MedXM Well Child Outreach Program (PDF)

19-523 – Achieve Better Heatlh Outcomes for Your Patients (PDF)

19-524 – Achieve Better Heatlh Outcomes for Your Patients (PDF)

19-525 – Medical Policies - 1st Quarter 2018 (PDF)

19-527 – Medical Policies - 1st Quarter 2018 (PDF) (CalViva) 

19-530 – CBAS Treatment Request Forms - Revised (PDF) (CalViva)

19-531 – CBAS Treatment Request Forms - Revised (PDF)

19-533 – Advanced Access Flyer (PDF)

19-534 – Advanced Access Flyer (PDF) (CalViva Health)

19-537 – Timely Provider Demographic Data Validation Reminder (PDF)

19-538 – Timely Provider Demographic Data Validation Reminder (PDF) (CalViva)

19-549 – Free CME and MOC Credits (PDF)

19-550 – Supplemental Payment for Medical Pregnancy Termination Services (PDF)

19-551 – Supplemental Payment for Medical Pregnancy Termination Services (PDF) (CalViva) 

19-555 – Improve Your Access and Availabiltiy Provider Online Trainging Flyer (PDF) (CalViva) 

19-556 – Improve Your Access and Availabiltiy Provider Online Trainging Flyer (PDF)

19-563 – Language Assistance Program and Cultural Competency Services (PDF) (CalViva) 

19-564 – Language Assistance Program and Cultural Competency Services (PDF)

19-567 – Get ready for the CAHPS survey (PDF)

19-568 – Get ready for the CAHPS survey (PDF) (CalViva) 

19-571 – Pain Management and Opioids CME flyer (PDF)

19-572 – Pain Management and Opioids CME flyer (PDF) (CalViva) 

19-576 – Labcorp- Walgreen Draw Sites (PDF)

19-578 – Initial Health Assessment Requirements (PDF) (CalViva)

19-580 – Initial Health Assessment Requirements (PDF)  

19-591 – ADA Diabetes and Overcoming Therapeutic Workshop (PDF) (CalViva)

19-592 – ADA Diabetes and Overcoming Therapeutic Workshop (PDF)  

19-603 – Reminder: Physician’s Office Lab Testing Policy Change (PDF)

19-605 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 3 (PDF)

19-606 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 3 (PDF) (CalViva) 

19-613 – Molina PAAS and PAHAS Results (PDF) (LA Molina)

19-626 – Improve Quality of Care and Reduce Readmissions through Safe Hospital Discharge (PDF)

19-639 – Health Net Community Doula Program (PDF) - Medi-Cal LA

19-643 – Refer Patients to myStrength.com for Pregnancy and Early Parenting Support (PDF)

19-645 – Refer Patients to myStrength.com for Pregnancy and Early Parenting Support (PDF) (CalViva) 

19-647 – Capitated PPGs Pay Public Health Departments for Sensitive Services (PDF)

19-648 – Capitated PPGs Pay Public Health Departments for Sensitive Services (PDF) (CalViva) 

19-651 – Reduce the Number of Heart Attacks and Strokes (PDF)

19-652 – Reduce the Number of Heart Attacks and Strokes (PDF) (CalViva) 

19-658 – Medi-Cal NDC Encounter (PDF)

19-660 – Medi-Cal NDC Encounter (PDF) (CalViva) 

19-666 – Prior Authorization Requirement Changes (PDF)

19-668 – Prior Authorization Requirement Changes (PDF) (CalViva)

19-669 – Prior Authorization Requirement Changes (PDF) (LA-DHS)

19-678 – Review Access to Care Standards (PDF)

19-680 – Review Access to Care Standards (PDF) (CalViva)

19-695 – Medi-Cal 2018 Provider Appointment Availability and After-Hours Access Survey Results (PDF) (CalViva)

19-696 – Medi-Cal 2018 Provider Appointment Availability and After-Hours Access Survey Results (PDF)

19-698 – Changes for New Medi-Cal Provider Proof of DHCS Application (PDF) (CalViva)

19-699 – Changes for New Medi-Cal Provider Proof of DHCS Application (PDF)

19-701 – Medication Trend Updates and Preferred Drug List Changes – 3rd Quarter 2019 (PDF)

19-702 – Medication Trend Updates and Preferred Drug List Changes – 3rd Quarter 2019 (PDF) (CalViva) 

19-705 – To Help You End Opioid Abuse: Preferred Drug List Changes Focus on Opioid Pain Medications (PDF)

19-706 – To Help You End Opioid Abuse: Preferred Drug List Changes Focus on Opioid Pain Medications (PDF) (CalViva) 

19-725 – Timely Provider Demographic Data Validation Reminder Q3 (PDF) 

19-726 – Timely Provider Demographic Data Validation Reminder Q3 (PDF) (CalViva)

19-734 – Help Patients Better Control their Asthma and its Triggers (PDF)

19-735 – Help Patients Better Control their Asthma and its Triggers (PDF) (CalViva) 

19-738 – Feedback Needed – 2019 Provider Satisfaction Survey (PDF)

19-739 – Feedback Needed – 2019 Provider Satisfaction Survey (PDF) (CalViva)

19-745 – Choose the Right Address for Provider Disputes Sent on Behalf of a Member (PDF) (CalViva) 

19-746 – Choose the Right Address for Provider Disputes Sent on Behalf of a Member (PDF)

19-748 – Diabetes Workshop Extended Deadline (PDF) (CalViva)

19-749 – Diabetes Workshop Extended Deadline (PDF)

19-754 – Prepare for the 2019 Provider Appointment Availability and After-Hours Access Survey (PDF)

19-755 – Get Ready for the 2019 Provider Appointment Availability and After-Hours Access Surveys (PDF) (CalViva)

19-761 – Financial Incentive Policy Reminder for FQHCs and RHCs (PDF)

19-762 – Financial Incentive Policy Reminder for FQHCs and RHCs (PDF) ( CalViva)

19-768 – Extra Payment for Ground Emergency Medical Transport (PDF)

19-769 – Extra Payment for Ground Emergency Medical Transport (PDF) (CalVIva) 

19-788 – Avoid Claims Issues by Knowing Which Services Will Not Be Covered as of January 1, 2020 (PDF)

19-789 – Avoid Claims Issues by Knowing Which Services Will Not Be Covered as of January 1, 2021 (PDF) (CalViva) 

19-792 – Go Online for Updated Medi-Cal Provider Materials (PDF)

19-793 – Go Online for Updated Medi-Cal Provider Materials (PDF) (CalViva)

19-794 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update – 3rd Quarter 2019 (PDF)

19-796 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update – 3rd Quarter 2019 (PDF) (CalViva)

19-797 – Medi-Cal Member Reward Cards Program (PDF)

19-799 – Access Standards Correction Update (PDF) (CalViva) 

19-805 – November Provider Online Training (PDF) (CalViva)

19-806 – November Provider Online Training (PDF)

19-809 – December Provider Online Training (PDF) (CalViva)

19-810 – December Provider Online Training (PDF)

19-815 – Improve Treatment of OUD in Pregnancy with these Resources (PDF)

19-816 – Improve Treatment of OUD in Pregnancy with these Resources (PDF) (CalViva) 

19-819 – Health Education Materials (PDF) (Statewide)

19-820 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 4 (PDF)

19-821 – ASAM Treatment of Opioid Use Disorder Communications Campaign Flyer-Wave 4 (PDF) (CalViva) 

19-824 – Prior Authorization Requirement Changes (PDF)

19-825 – Prior Authorization Requirement Changes (PDF) (CalViva)

19-827 – Prior Authorization Requirement Changes (PDF) (LA-DHS)

19-834 – Medical Policies - 2nd Quarter 2018 (PDF)

19-836 – Medical Policies - 2nd Quarter 2018 (PDF) (CalViva) 

19-838 – HEDIS Annual Medical Record Collection (PDF)

19-839 – HEDIS Annual Medical Record Collection (PDF) (CalViva) 

19-845 – Submit Professional Anesthesia Encounters with MJ Qualifier (PDF)

19-846 – Submit Professional Anesthesia Encounters with MJ Qualifier (PDF)

19-869 – State of Emergency: Fires in Los Angeles and Sonoma Counties (PDF)

19-872 – State of Emergency Declared throughout the State of California (PDF) (CalViva Health)

19-871 – State of Emergency Declared throughout the State of California (PDF)

19-879 – Get Ready for the Great American Smokeout on November 21, 2019 (PDF)

19-880 – Get Ready for the Great American Smokeout on November 21, 2019 (PDF) (CalViva)

19-907 – Bill Telehealth Services Correctly to Receive Timely Payment (PDF)

19-908 – Bill Telehealth Services Correctly to Receive Timely Payment (PDF) (CalViva) 

19-913 – UseModifier33 for Perinatal Counseling SessionClaims (PDF)  

19-914 – UseModifier33 for Perinatal Counseling SessionClaims (PDF) (CalViva Health) 

19-916 – Medication Trend Updates and Formulary Changes - 4th Quarter 2019 (PDF) 

19-917 – Medication Trend Updates and Formulary Changes - 4th Quarter 2019 (PDF) (CalViva Health) 

19-923 – Medical Policies 3rd Qtr 2019 (PDF)   

19-925 – Medical Policies 3rd Qtr 2019 (PDF) (CalViva Health)

19-927 – Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update -4th Quarter 2019 (PDF)  

19-929 –  Injectable Medication HCPCS/DOFR Crosswalk Reference Table Update -4th Quarter 2019 (PDF)  (CalViva Health) 

19-930 – EPSDT Service Reminder (PDF)  

19-931 – EPSDT Service Reminder (PDF) (CalViva Health)

19-933 – Submit additional Claims Info to PPG When PPG is Financially Responsible (PDF)  

19-934 – Submit additional Claims Info to PPG When PPG is Financially Responsible (PDF) (CalViva Health)

19-949 – Your working to treat opioid misuse. Let us help. (PDF) 

19-950 – Your working to treat opioid misuse. Let us help. (PDF) (CalViva Health) 

19-958 – First Prenatal Visit Availability Time Frame Change (PDF)    

19-959 – First Prenatal Visit Availability Time Frame Change (PDF) (CalViva Health)

19-969 – Update Your Demographic Information (PDF) 

19-970 – Update Your Demographic Information (PDF) (CalViva Health) 

19-980 – Earn an Extra Bonus with the 2020 CalViva Health Physician Incentive (PDF) (CalViva Health) 

19-992 – Refer your Health Net Patients to Adventist Health Tulare (PDF) 

19-996 – Apply for CalHealthCares Loan Repayment Program! (PDF)  

19-997 – Apply for CalHealthCares Loan Repayment Program! (PDF) (CalViva Health) 

19-1001 – Continuity of Care for Maternal Mental Health Conditions (PDF)

19-1002 – Continuity of Care for Maternal Mental Health Conditions (PDF) (CalViva Health) 

19-1005 – Improve Your Medi-Cal Patients' Behavioral Health and Earn a Reward (PDF) 

19-1006 – Improve Your Medi-Cal Patients' Behavioral Health and Earn a Reward (PDF) (CalViva Health) 

19-1010 – Include ASD Screening during Well-Child Visits (PDF) 

19-1013 – Send Prior Authorization Requests for Musculosketel Surgical Procedures to Health Net (PDF)  

    UPDATES AND LETTERS FOR 2020 AND BEYOND

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    Last Updated: 05/20/2021