COVID-19 Information for Providers
To address commonly asked questions from members, the Alliance has developed the COVID-19 webpage for members. We have also provided our member-facing staff with talking points to help them answer questions. We will continue to update these materials as new information becomes available.
Members are encouraged to contact their provider to discuss their symptoms and next steps. If members are unable to reach their provider, we are encouraging them to contact the Alliance's 24-hour Nurse Advice Line (NAL) to speak to a registered nurse. The number is 844-971-8907.
Members can receive a 90-day supply, including free standard delivery, for most prescription medications mailed to them through MedImpact Direct. To set up mail order for medications, they may visit https://www.medimpactdirect.com/ or call 855-873-8739.
Additionally, the Alliance has added a few options to our pharmacy network, including SortPak, a mail order pharmacy. Visit their website to learn more at www.sortpak.com.
To find an in-network pharmacy, use MedImpact's online Pharmacy Directory.
The Alliance is committed to delivering culturally and linguistically appropriate health care services to our diverse membership, especially during this time. The Alliance offers Language Assistance Services at no cost to all eligible Limited English Proficiency (LEP) members or members who are deaf and/or hard of hearing when accessing the Alliance covered services. The Alliance offers two types of interpreting services that providers can access with communicating with Alliance members in our tri-county service areas:
- Telephone interpreter services are available on a 24-hour basis at all key points of contact, including medical and non-medical care settings to Alliance providers. No prior approval is required. Refer to the Alliance Interpreter Service Provider Quick Reference Guide for more information on how to access this service. We do encourage our providers to continue to utilize the Alliance telephonic interpreting services when communicating with our members.
- On-site face-to-face interpreter services requests can be made by providers according to established criteria and timeframes. Prior approval is required. Please ensure requests are submitted to the Alliance within a timely manner for prior approval and to ensure timely coordination of service. Use the Face-to-Face Interpreter Service Form.
Visit the Cultural and Linguistic Services page to learn more about how to access these services for your patients. You can also call the Alliance Health Education Line at 800-700-3874 ext. 5580.
We’ll continue to monitor and work with our interpreting vendors to ensure the health and safety of their staff and if there are any changes to this service, providers will be notified immediately.
If members need hard copies of materials, Alliance staff will mail copies or send electronic links as requested.
We will work with our providers to ensure that we are supporting the provision of medically necessary care. We understand that some providers are providing patient consultations over the phone (including telehealth, if appropriate) to minimize potential virus exposure. Required codes for telehealth services include:
- Existing face-to-face codes apply when a Medi-Cal provider/clinician is billing the Alliance for video/telephonic visits. Example codes for the PCP Setting: 99201-99204, 99212-99214.
- The CPT or HCPCS code(s) must be billed using:
- Place of Service Code “02”
- Use appropriate telehealth modifiers:
- Synchronous, interactive audio and telecommunications systems: Modifier 95.
- Asynchronous store and forward telecommunications systems: Modifier GQ.
We stand with you during this unprecedented time and are here to answer any questions you may have.
As our members continue to be affected by the COVID-19 pandemic, you are likely busy screening patients and prescribing COVID-19 laboratory testing. We want you to know that the Alliance covers both laboratory testing and screening for COVID-19.
To ensure you receive appropriate reimbursement, you must submit COVID-19 related claims using the following procedure codes:
|U0001||2019-Novel Coronavirus [2019-nCoV diagnostic p]|
|U0002||COVID-19 lab test non-CDC|
|87635||SARS-COV-2 COVID-19 AMP PRB|
For a listing of contracted labs, providers may reference the Alliance Provider Directory or contact their Provider Relations Representative.
We are aware that there are concerns about the availability of COVID-19 testing and the process for testing. We remain in close contact with local health departments as they assess their resources and develop plans for testing. The Alliance will update providers once additional information is available.
We understand that providers are extremely busy as they focus on providing patient care. In order to support our providers in prioritizing member access to care and to follow social distancing guidelines, we have suspended in-person provider visits. All interactions and provider follow-up discussions will occur by webinar, phone and email. All provider relations efforts will focus on supporting our providers in the most efficient way possible during this time.
Yes, we are maintaining business operations. Our mission is to ensure our members in Monterey, Santa Cruz and Merced counties continue to access needed health care. Over 320,000 Medi-Cal members rely on the services we provide, and our commitment to these people will not waver despite this public health crisis. However, to help reduce exposure to the illness and to maintain social distancing requirements, the public areas and member service counters for the Central California Alliance for Health are currently closed.
In order to maintain social distancing requirements, we have transitioned to fulltime work from home for employees currently set up to work remotely. Fortunately, the Alliance already had a robust work-life balance program in place, allowing work from home opportunities for over three-quarters of our workforce. This approach has well prepared us to seamlessly support business operations and provide member and provider support in times of crisis. In addition, the Alliance has a business continuity plan in place to maintain business operations and continue providing core services in the event of a mandatory public health quarantine.
We continue to monitor the situation by staying in touch with public health and government officials, and we are following their guidance as the situation continues to evolve.
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