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Provider Digest | Issue 1

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Medi-Cal eligibility redetermination

During the pandemic, those who had Medi-Cal were able to keep their health care coverage without going through the usual process of reapplying each year to determine eligibility. However, once the declared COVID-19 public health emergency (PHE) ends, DHCS will resume the annual redetermination process. This applies to all Alliance members in Merced, Monterey and Santa Cruz counties.

How do Medi-Cal members keep their health care?

For most members, Medi-Cal is automatically renewed. If the member’s county cannot confirm all of their information to automate the renewal, a packet will be mailed to the member. All forms inside this packet must be filled out and returned. The requested information can be returned to the county via phone, mail, fax or in person.

If a member does not receive a renewal packet, they can reach out to their county office to ensure their information is up to date. This is especially critical if anything has changed, such as:

  • Contact information, including address changes.
  • Disability status.
  • If someone moves into the member’s household.
  • If someone in the member’s household becomes pregnant.

Communicating with members

The Alliance is partnering with county offices to ensure member information is up to date and to ensure that members are informed of the eligibility redetermination requirements. However, we also need your help! Please let your Alliance patients know of the upcoming changes and that they will need to take action to keep their health care coverage.

Additionally, please take a look at the following resources we have for Alliance members to ensure they retain coverage:

You can also find more information on the DHCS website via their PHE Outreach Toolkit page.

Eligibility redetermination timeline

Alliance members have 90 days to reapply for Medi-Cal benefits following the end of the public health emergency. Currently, the end of the PHE is scheduled for July 15, but DHCS expects this may get delayed until October. We will continue to keep you updated on any developments in the eligibility redetermination process.

Changes to Alliance provider communications

You may have noticed that this email looks a little different! We’ve made a few upgrades to our provider communications to better differentiate our publications. For example, this newsletter, formerly called the Provider E-Newsletter, is now called the Provider Digest. Additionally, our Provider Fax Blast will now be called the Provider Flash.

We will continue to inform you about upcoming trainings, Medi-Cal updates, Alliance health campaigns and resources, regulatory requirements and more.

Here’s a quick summary of all provider publications and what to keep an eye out for:

  • The Provider Bulletin is published digitally and in print every quarter. Providers receive a copy in the mail and via email. You can read previous issues on our website.
  • The Provider Digest, formerly known as the Provider E-Newsletter, is a biweekly digital publication sent to your email and posted on our website..
  • The Provider Flash, formerly the Provider Fax Blast, shares timely alerts via fax and email. These are also posted on our website.

For more information on what to expect in Alliance publications, please visit our Provider News page.

If you are not on our mailing list or do not currently receive all of these publications, please use our mailing form to sign up.

Alliance Provider Satisfaction Survey coming later this month

We want to hear from you! As one of our valued providers, we appreciate your thoughtful feedback and insights. Be on the lookout: SPH Analytics will be mailing out the Provider Satisfaction Survey beginning in June, followed by telephone surveys in July and August. Responses are due by August 17.

The survey measures overall provider satisfaction with the Alliance, as well as satisfaction in areas such as:

  • Claims payment and processing.
  • Health care services.
  • Coordination of care.
  • Health plan call center staff.
  • Provider relations.
  • Access to urgent and routine care.
  • Cultural and Linguistic Services.
  • Community care coordination.
  • The Provider Portal.

Key findings and trends are closely tracked, and we use feedback to inform short-term and long-term initiatives.

Thank you in advance to all provider offices taking the time to participate in the survey. We appreciate your candid feedback and for partnering with us to provide accessible, quality health care guided by local innovation!

COVID-19 treatments available through Test to Treat program

The federal government has launched a Test to Treat program, whereby participating locations will offer COVID-19 testing and subsequent treatment prescriptions at the same site.

Use the U.S. Department of Health & Human Services (HHS) COVID-19 Therapeutics Locator to find participating Test to Treat program sites by address or zip code.

For information on COVID-19 treatment resources, visit the California Department of Public Health page, or for the latest guidance, please visit the National Institutes of Health’s (NIH) COVID-19 Treatment Guidelines page.

The Alliance COVID-19 Information for Providers page has information on how to register and participate in the Test to Treat program, locate and order government-supplied treatments and more. You can also directly contact your local health jurisdiction for information.