Provider Digest | Issue 25

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Dementia webinar, your feedback + drug benefit updates 

Complete Provider Satisfaction Survey by Sept. 15!

We want to hear from you! As one of our valued providers, we appreciate your thoughtful feedback and insights.

Be on the lookout: Press Ganey, formerly known as SPH Analytics, will be mailing out the Provider Satisfaction Survey beginning in June, followed by telephone surveys from August through September. Responses are due by Sept. 15.

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 partnership to provide accessible, quality health care guided by local innovation!

Dementia webinar: Cognitive Health Assessment for Adults Experiencing Homelessness

Please join us for the Dementia Care Aware initiative’s next webinar, “Adapting the Cognitive Health Assessment for Adults Experiencing Homelessness.”

June 23, 2023

2–3 p.m. on Zoom


About the webinar

Serggio Lanata, MD, MS, associate professor of clinical neurology at the University of California, San Francisco and director of the UCSF Memory and Aging Center Community Outreach Program, will join us to speak on the topic.

Those who participate in the live webinar are eligible to receive 1 Continuing Medical Education (CME) credit, California Association of Marriage and Family Therapists (CAMFT) credit, American Academy of Family Physicians (AAFP) credit and Maintenance of Certification (MOC) credit.

Physician-administered drug changes effective June 1, 2023

Effective June 1, 2023, the Alliance will be implementing changes to the physician-administered drug benefit. These changes have been reviewed and approved by the Pharmacy & Therapeutics (P&T) Committee. The changes are as follows:

HCPCS Code Drug Change
J1437 Ferric derisomaltose Require a prior authorization
J7336 Capsaicin 8% Require a prior authorization
Q5111 Pegfilgrastim-cbqv (Udenyca) Require a prior authorization
J2506 Pegfilgrastim (Neulasta) Modified prior authorization criteria
Q5127 Pegfilgrastim-fpgk (Stimufend) Modified prior authorization criteria
Q5130 Pegfilgrastim-pbbk (Fylnetra) Modified prior authorization criteria
J2778 Ranibizumab (Lucentis) Modified prior authorization criteria
Q5128 Ranibizumab-eqrn (Cimerli) Modified prior authorization criteria

Prior authorization criteria can be found on the Alliance website.

If you have questions, please contact the Alliance Pharmacy Department at 831-430-5507.