22-155 DHCS Audit Notification

Date: 02/18/22

This information applies to Physicians and Participating Physician Groups (PPGs).

This information applies to Medi-Cal in Fresno, Kings and Madera counties.

Be prepared for your onsite visit

The Department of Health Care Services (DHCS) is conducting an onsite audit of CalViva Health to evaluate the plan’s compliance with contractual and regulatory requirements. As part of the audit, DHCS may visit provider sites any time during April 18, 2022, through April 29, 2022.

Audit review period

The audit review period is April 1, 2020, through March 31, 2022.

DHCS notification of visit

DHCS is going to visit select provider offices. If selected, a nurse evaluator will contact you directly to schedule an onsite visit. Cooperation with DHCS staff is required.

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 CalViva Health at 888-893-1569.