Alliance recognized for outstanding performance
The California Department of Health Care Services (DHCS) recognized the Alliance for exceeding standards set by the Measurement Year 2024 (MY24) Managed Care Accountability Set (MCAS). We achieved every measure in the four MCAS domains, including:
- Children’s Health.
- Reproductive Health & Cancer Prevention.
- Behavioral Health.
- Chronic Disease Management.
MCAS is a set of performance measures selected by DHCS for annual reporting by Medi-Cal managed care plans.
High performance in each of these areas is a result of collaborative efforts between Alliance staff, our provider network and community-based organizations. We want to thank our valued providers and partners for their steadfast commitment to improving health outcomes and offering the best possible care for our members across Mariposa, Merced, Monterey, San Benito and Santa Cruz counties.
The Alliance supports providers in achieving high measure performance by offering:
- A variety of provider trainings.
- Funding opportunities through the Medi-Cal Capacity Grant Program.
- Financial incentives through the Care-Based Incentive program.
We also tailor communications for members to encourage service utilization using channels including media campaigns, in-person outreach, our texting program, Facebook page, blog and member newsletter.
In 2025, the Alliance also earned full Health Plan and Health Equity Accreditation from the National Committee for Quality Assurance. This year, the Alliance celebrates 30 years of providing trusted care to local communities. We look forward to continuing to improve health outcomes by providing accessible, quality health care for years to come!
You can read more about specific MCAS measures and performance in the DHCS fact sheet.
Reminder: No member fees for forms or providing information
The California Department of Health Care Services (DHCS) reminds contracted providers that, under California Health & Safety Code Section 123114, Medi-Cal members may not be charged for completing forms or providing information that supports a claim or appeal for a public benefit program.
Medi-Cal members have the legal right to access their medical records. Providers may charge:
- $0.25 per page for paper copies, plus a reasonable clerical fee.
- $0.50 per page for copies of microfilm records, including diagnostic images.
- A reasonable fee not to exceed actual costs for copies of diagnostic films, such as x-ray, MRI, CT and PET scans.
For more information, see the Medical Board of California’s page on Patient Access to Medical Records.
What to know about TotalCare billing requirements
TotalCare (HMO D-SNP) is the Alliance’s Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) for members eligible for both Medicare and Medi-Cal.
Submitting claims
- TotalCare providers must follow Medicare billing requirements to avoid delayed or denied claims.
- Claims may be submitted electronically using the same payer IDs.
- Providers are encouraged to review billing practices to ensure alignment with Medicare requirements when serving TotalCare members.
More information is available on our Claims webpage. For billing support, call the TotalCare Claims Customer Service line at 831-430-5503, option 3, Monday – Friday, 8:30 a.m. to 4:30 p.m.
