23-784 See What News Is Online for July 2023
Date: 08/04/23
Go to the Provider Library for the latest information that can help you do business with us
The table below outlines communications that have been posted in the Provider Library in July 2023. It includes the posting date, material number and title, type of communication, applicable audience and counties, and a summary of the communication.
Date, Number and title | Type of notice | Audience1 | Lines of business2 | Summary |
|---|---|---|---|---|
July 14, 2023 23-674m, Get Paid Faster: Bill Correctly When Members Have Other Health Coverage | Regulatory | Physicians PPGs Hospitals Ancillary providers
| Fresno Kings Madera | The communication reminds providers that if a patient has Medi-Cal and other health coverage (OHC), providers can avoid claims delays by billing OHC as the primary insurance. |
July 17, 2023 23-680m, Improve Quality Metrics While Helping Members Manage Asthma | News & Announcements | Physicians PPGs
| Fresno Kings Madera | This communication helps participating providers improve care for members who have asthma and thereby improve quality metrics. |
July 31, 2023 23-753m, Reminder About Timely Response to Enrollee Appeals and Grievances | Contractual | Physicians PPGs Hospitals Ancillary Providers ECM/CS Providers
| Fresno Kings Madera | The communication was developed to remind providers of the California regulations about the appeals and grievances process which includes type of requests, requirements and time frames to respond. |
1 ECM – Enhanced Care Management; CS – Community Supports
Additional information
If you have additional questions regarding the information contained in this update, contact CalViva Health at 888-893-1569.
This information applies to Physicians, Participating Physician Groups (PPGs), Hospitals, Ancillary providers, Community Supports (CS) Providers, and Enhanced Care Management (ECM) Providers.
This information applies to Medi-Cal in Fresno, Kings and Madera counties.