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Affiliated Health Plan Delegated Utilization Management - Reporting

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)
  • Hospitals
  • Ancillary

Counties Covered

  • Los Angeles

Primary care physicians (PCPs) participating with Molina Healthcare, directly or through a participating physician group (PPG), must send utilization reports directly to Molina detailing Medi-Cal services to members in this plan. Molina then sends copies of these reports to Health Net.

Report

Frequency

Description

California Children's Services (CCS)

 --

Report of Health Net members referred to CCS at time of occurrence to initiate care coordination.

Comprehensive Perinatal Services Program (CPSP)

Case-by-case at time of occurrence

Report of Health Net members referred to CPSP at time of occurrence, to initiate care management.

Last Updated: 10/31/2019