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Tsis txhob nco qhov hloov tshiab. Sau npe kom tau txais xov xwm Alliance tus kws kho mob.

Tus Muab Kev Digest | Qhov teeb meem 5

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Cov tshuaj tiv thaiv COVID-19 rau cov tswv cuab tiv thaiv kab mob  

Lub Alliance zoo siab tshaj tawm tias Evusheld™ muaj rau Alliance cov tswv cuab 12 xyoo thiab laus dua nrog cov mob me me mus rau cov kab mob tiv thaiv kab mob hnyav. Evusheld™ yog muab rau hauv ob txoj kev txhaj tshuaj thiab raug pom zoo txhua rau lub hlis. Nws muaj rau cov tswv cuab ntawm tsis muaj nqi rau cov tswv cuab.  

Hom tshuaj Evusheld™ yog siv rau leej twg? 

Evusheldyog rau cov neeg uas muaj kev pheej hmoo siab dua rau tus kab mob COVID-19 hnyav thiab muaj teeb meem. Cov tswv cuab tuaj yeem tau txais Evusheld tshuaj yog tias lawv tsis tau raug tus kab mob COVID-19 tsis ntev los no thiab lawv: 

  • Lub cev tsis muaj zog tua kab mob me ntsis lossis mob hnyav vim ib yam mob. 
  • Tsis tuaj yeem tau txais COVID-19 thawj koob lossis tshuaj txhawb zog vim tias lawv muaj keeb kwm ntawm qhov tshwm sim hnyav rau cov tshuaj tiv thaiv COVID-19 lossis cov khoom siv tshuaj tiv thaiv COVID-19. 
  • Tau noj tshuaj lossis siv tshuaj kho lub cev koj muaj zog tua tau kab mob.  

Leej twg yuav tsum tsis tau txais hom tshuaj Evusheld™? 

Cov tswv cuab yuav tsis tuaj yeem tau txais Evusheld kev kho mob yog tias lawv: 

  • Muaj cov kev tsis haum (allergies). 
  • Muaj mob ntshav los tsis tu. 
  • Muaj ntshav daj tsawg. 
  • Muaj mob yav dhau los lossis muaj pheej hmoo mob plawv nres lossis mob hlab ntshav hlwb txhaws. 
  • Xeebtub lossis npaj siab yuav muaj menyuam. 
  • Tab tom muaj kev pub niam mis. 

Alliance nthuav qhia rau cov tswv cuab 

Ntawm kev taw qhia ntawm California Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS), Lub Koom Haum yuav hu rau cov tswv cuab uas yuav muaj cov xwm txheej uas yuav ua rau lawv tsim nyog rau Evusheld™. Peb yuav hu rau cov tswv cuab no hauv xov tooj kom ceeb toom rau lawv tias lawv yuav tsim nyog thiab pom zoo kom lawv hu mus rau lawv pab neeg saib xyuas thawj zaug los tham seb Evusheld™ yog qhia. 

Cov kws kho mob tseem ceeb tuaj yeem nrhiav cov khw muag tshuaj Evushel siv US Department of Health & Human Services COVID-19 Therapeutics Locator. Yog tias koj muaj lus nug, thov hu rau koj Tus Neeg Saib Xyuas Kev Sib Raug Zoo ntawm 800-700-3874, ext. 5504 ib.

Koj puas tau ua tiav koj qhov kev cob qhia ACEs thiab ua pov thawj? 

California Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom saib xyuas tag nrho Medi-Cal cov phiaj xwm kev noj qab haus huv kev ua tau zoo ntawm kev kuaj xyuas menyuam yaus tsis zoo (ACEs). Cov kws kho mob thawj zaug yuav tsum ua kom tiav cov kev tshuaj ntsuam no. Ua ntej xa daim ntawv thov rau kev pabcuam, koj yuav tsum ua kom tiav cov kev cob qhia uas yuav tsum tau ua thiab ua pov thawj rau tus kheej. Cov kws kho mob tsim nyog tau txais cov qhab nia CME thaum ua tiav.  

Ua kom tiav qhov kev cob qhia 

Ua kom tiav cov kev cob qhia ACEs uas xav tau. Nws yog dawb thiab siv sijhawm li ob teev kom tiav. 

Txhawm rau pib koj qhov kev cob qhia, koj yuav tsum tau mus ntsib nplooj ntawv kawm ACEs Aware. Nkag mus lossis sau npe, tom qab ntawd mus rau Kuv Cov Chav Kawm kom ua tiav qhov kev cob qhia.  

Ua kom tiav koj daim ntawv pov thawj  

Thaum koj ua tiav koj qhov kev cob qhia, ua kom tiav daim ntawv pov thawj tus kheej yog li koj tuaj yeem tau txais kev them nyiaj rau kev tshuaj ntsuam ACE tom ntej uas koj ua. 

Koj yuav xav tau koj li: 

  • National Provider Identifier (NPI). 
  • Clinic lub npe thiab chaw nyob. 

Thov xyuas kom tseeb tias koj cov ntaub ntawv pov thawj tiav thiab raug.  

Cov ntaub ntawv them nqi thiab kev them nyiaj 

Thaum koj ua tiav koj qhov kev cob qhia thiab kev lees paub, Alliance yuav tau txais kev ceeb toom ntawm kev ua tiav thaum pib ntawm lub hlis tom ntej. Koj tuaj yeem pib sau nqi rau Alliance rau cov kev tshuaj ntsuam no tom qab thawj lub hlis tom ntej. Piv txwv li, yog tias koj ua tiav kev cob qhia thiab ua pov thawj rau Lub Xya Hli 5, 2022, tom qab ntawd cov kev tshuaj ntsuam koj ua tiav tom qab Lub Xya Hli 5 tuaj yeem xa mus rau Alliance tom qab Lub Yim Hli 1. Txwv tsis pub, cov lus thov yuav raug tsis lees paub.  

Cov kws kho mob yuav tau txais kev them nyiaj ntawm $29.00 rau txhua qhov kev tshuaj ntsuam los ntawm Prop 56 nyiaj. Tsoom Fwv Teb Chaws Muaj Peev Xwm Saib Xyuas Kev Noj Qab Haus Huv (FQHCs) tsim nyog tau txais $29.00 them nyiaj rau ACE kev tshuaj ntsuam ntxiv rau lawv cov kev them nyiaj Prospective Payment System uas twb muaj lawm. Txawm li cas los xij, kev mus ntsib tus neeg mob yuav tsum tau them nqi rau kev thov cais kom tsim nyog rau kev kuaj ACEs. 

 Care-Based Incentive (CBI) ntsuas 

Kev tshuaj ntsuam ACEs yog ib feem ntawm 2022 CBI program ua Kev Tshawb Fawb Kev Ntsuas. Qhov kev ntsuas no tau raug suav tias yog kev ntsuas them nyiaj rau 2023 qhov kev pab cuam. Yog xav paub ntxiv txog kev them nqi, cov peev txheej thiab cov ntaub ntawv ntsuas, thov mus saib CBI ACEs Kev Ntsuam Xyuas Hauv Cov Menyuam Yaus thiab Cov Hluas Cov Lus Qhia 

Yog tias koj muaj lus nug txog ACEs kev cob qhia thiab kev tshuaj ntsuam xyuas, thov xa email rau Alliance ntawm [email protected] 

Medi-Cal Rx hloov tshiab: Hloov pauv mus rau cov phiaj xwm rov qab mus rau theem 

Reject Code 88 rov ua dua 

Pib txij Lub Xya Hli 22, 2022, DHCS pib Phase I, Wave I ntawm Medi-Cal Rx Reinstatement Plan.  

Thaum xub thawj, Wave I yuav tsum rov ua dua ob qhov kev thov rov qab: DUR Reject Code 88: Kev Tshuaj Xyuas Kev Siv Tshuaj Tsis lees paub qhov yuam kev thiab tsis lees paub Code 80: Kev kuaj mob Code xa tsis tau raws li Cov Cai Kev Pabcuam Tshuaj. Txawm li cas los xij, raws li kev txheeb xyuas ntawm cov neeg koom nrog cov lus tawm tswv yim thiab cov ntaub ntawv thov, DHCS tau ncua sijhawm rov qab los ntawm Reject Code 80 vim nws tuaj yeem xav tau kev tso cai ua ntej ua ntej hnub rov ua haujlwm. Yog li, nyob rau hauv lub nthwv dej tam sim no, Reject Code 88 tau rov ua dua, thaum Reject Code 80 tsis tau. 

Yog xav paub ntxiv, thov mus saib hauv Lub Xya Hli 22 Medi-Cal Rx cov ntawv xov xwm (txog Reject Code 88) thiab Lub Xya Hli 12 Medi-Cal Rx cov ntawv tshaj tawm (txog Reject Code 80) 

Rov ua dua cov ntawv tso cai ua ntej (PAs) rau 11 chav kawm tshuaj pib lub Cuaj Hlis 16 

Phase I, Wave III xav kom cov kws kho mob xa PAs rau cov tshuaj pib tshiab hauv 11 chav kawm tshuaj, suav nrog: 

  • Diuretics. 
  • Lipotropics, suav nrog statins thiab omega-3 fatty acids. 
  • Hypoglycemics, suav nrog glucagon. 
  • Coronary vasodilators (nitrates thiab pulmonary arterial hypertension agents). 
  • Cov kab mob plawv, nrog rau cov tshuaj tiv thaiv arrhythmics thiab inotropes. 
  • Anticoagulants thiab antiplatelets. 
  • Niacin, Vitamin B, thiab vitamin C cov khoom.   

Nco ntsoov tias qhov no tsis suav nrog cov tshuaj tshiab rau cov menyuam yaus thiab cov hluas hnub nyoog 21 xyoos thiab qis dua.  

Yog xav paub ntxiv, tshuaj xyuas lub Lub Xya Hli 26 Medi-Cal Rx tshaj tawm 

Puas muaj lus nug? 

Rau kev pab nrog kev thov lossis PAs: 

  • Hu rau Medi-Cal Rx Lub Chaw Pabcuam Cov Neeg Siv Khoom (CSC) ntawm 800-977-2273. Koj tseem tuaj yeem xa cov lus nug hauv email rau Medi-Cal Rx Education & Outreach ntawm [email protected].