21-285m Quest HealthConnect Provides Select Services to Members at Home
Date: 04/27/21
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, and Ancillary providers.
For Medi-Cal, this information applies to Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.
Refer your patients who have transportation and scheduling barriers today
Your patients now have a convenient choice for annual well-care visits and chronic disease screenings. In-home health assessments, including diagnostic screenings, are available to eligible Health Net Medi-Cal patients in select counties as indicated in the table below. Health Net is partnering with Quest HealthConnect™ (formerly known as MedXM) to provide these services.
Health care specialists
Quest HealthConnect has a network of health care specialists, such as primary care physicians (PCPs), nurse practitioners, technicians, and other skilled health care professionals, to provide assessments and conduct needed screenings. These health care specialists are not involved in the care or treatment of patients and do not prescribe medication. They will urge members to make an appointment with you for:
- Follow-up on the screening results.
- Treatment recommendations.
- Continued care.
In-home services
Eligible Health Net members can get annual well-care visits and diagnostic screenings listed in the table below through the Quest HealthConnect in-home health assessment program.
Referral form
Refer members who may have trouble making it to your office today by completing the Quest HealthConnect Referral Form (PDF)1. Complete all fields on the Quest HealthConnect Referral Form (PDF) and fax it to 888-353-6442.
Note: You can make copies of the form for office use, as needed. A fax cover sheet must accompany all fax transmissions of protected health information. The cover sheet must be labeled “PROTECTED HEALTH INFORMATION.”
Additional information
Providers are encouraged to access the provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.
If you have questions regarding the information contained in this update, contact the Health Net Medi-Cal Provider Services Center within 60 days at 800-675-6110.
1 Members have the right to refuse in-home screenings even when referred by their PCP.
| Well-care visits | Chronic disease screening |
Program goals | The goal of the Quest HealthConnect well-care visit program is to work with providers to increase annual well-care visits. Increase the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®) rates for the following measures:
| Quest HealthConnect supports PCPs with patients who have chronic diseases by offering in-home screenings. Quest HealthConnect provides you with medical information on the member’s health condition. Services are provided at no cost to the member. |
In-home services | Quest HealthConnect will contact eligible Medi-Cal members ages 18–21 who are in need of a well-care visit to receive assessments at their home2. Provides one in-home well-care visit per measurement year to:
Quest HealthConnect providers will communicate findings with the member and PCP. | Quest HealthConnect will contact eligible Medi-Cal members who are in need of an HbA1c test to receive diagnostic screenings at their home. Provides one of the following methods for HbA1c testing for diabetes monitoring:
|
2 Members have the choice of completing their well-care visit with their PCP or through the Quest HealthConnect Well-Care Visit Programrm