Provider News Posts
The Health Services Advisory Group (HSAG) will be conducting their annual Department of Health Care Services (DHCS) encounter data (claims) audit starting in February 2020.
The Alliance is required to submit encounter data to the Department of Health Care Services (DHCS).
In order to comply with Department of Health Care Services (DHCS) requirements, inpatient claims must only bill for services dated within the statement date.
The annual Healthcare Effectiveness Data and Information Set (HEDIS®) project is underway!
Department of Health Care Services (DHCS) has informed the Alliance of new incentives available as a result of the California Healthcare, Research and Prevention Tobacco Tax Act of 2016 (Prop 56).
Medi-Cal routinely adjusts reimbursement rates and recently issued an adjustment to rates for Radiology services.
The Department of Health Care Services (DHCS) will conduct a routine medical audit of the Alliance in November.
The Department of Health Care Services (DHCS) recently notified the Alliance of new measures that the plan is required to report for 2020.
The Alliance is seeing a significant increase in women diagnosed with sexually transmitted infections (STIs) in all three counties, with chlamydia being one of the most common STIs diagnosed in young women
DHCS has announced a Value-Based Payment program that will provide incentive payments to qualifying providers for meeting specific measures aimed at improving care for certain high-cost or high-need populations.
In order to ensure the provision of timely services in urgent or emergent situations, the Alliance offers referrals for certain conditions directly from the Emergency Department without referral from a PCP.
The Critical Role of Prenatal Tdap Immunization
Under the direction of Governor Gavin Newsom, the Department of Health Care Services (DHCS) recently notified Medi-Cal managed care health plans of the new Quality Measures that are required to be reported in 2020.
The Alliance has assembled a Depression Toolkit as a resource for primary care physicians and office staff.
Ensuring timely access to care is a priority of the Alliance, our providers, and the Department of Health Care Services (DHCS).
This year in the United States, more than 500 cases of measles have been confirmed. This is the second highest number of cases since measles was eradicated in the United States in 2000.
The Alliance’s April 1, 2019 pharmacy benefit change, listed below, has been reviewed and approved by the Pharmacy & Therapeutics (P&T) committee.
Providers can now submit Diabetic Retinal Exam data via the Provider Portal Data Submission Tool (DST).
All Alliance members are eligible to receive the Influenza vaccine. Members who are linked to your practice or to another PCP do not need a referral to receive vaccines.
Contact Provider Services
| General | 831-430-5504 |
| Claims Billing questions, claims status, general claims information |
831-430-5503 |
| Authorizations General authorization information or questions |
831-430-5506 |
| Authorization Status Checking the status of submitted authorizations |
831-430-5511 |
| Pharmacy Authorizations, general pharmacy information or questions |
831-430-5507 |
