IEHP's provider portal is equipped with resources to equip all of our providers with easy to use tools. Member Services Hotline. Schedule appointments, message your physician, view test results, refill medications and more with MyDMG Health. ... IEHP 24-Hour Nurse Advice Line (for IEHP … TTY users should call 1-800-720-4347. To obtain more compliance guidelines, the Department of Health and Human Services (HHS) offers assistance (By clicking on this link, you will be leaving the IEHP website). On May 23,2017, the Department of Healthcare Services (DHCS) released All Plan Letter (APL) 17-009, reporting requirements related to Provider Preventable Conditions. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. Educates Members about their health conditions and achieve health goals. Inland Empire Health Plan (IEHP) expects Team Members and business entities doing business with IEHP to conduct business activities in an ethical and professional manner that promotes public trust and confidence in the integrity of IEHP. IEHP does not pay Provider claims nor reimburse a Provider for a PPC, in accordance with 42 CFR Section 438.3(g) and IEHP's three-way Cal MediConnect contract. IEHP administers the GNA every five years; the findings of the GNA may help Providers better understand and serve our Members. To access the SHA questionnaires under Forms, please click here. An extensive list of health education materials about healthy weight and physical activity in English and Spanish. Senior health deals with ways to stay healthy as we age. To enroll with IEHP: If you need healthcare coverage, call 1-866-294-4347, 8am-5pm Monday-Friday. Phone: (800) 822-6222 Identification with both a picture and a signature, such a valid driver's license or State identification card, are suggested. The 2016 GNA Report describes Medi-Cal Members’ health risks and practices, chronic health condition incidence, utilization patterns, health education and cultural and linguistic needs. In conjunction, DHCS released Dual Plan Letter (DPL) 17-002. An Updated Overview of Health Literacy PREPARE: A California program to help you make medical decisions for yourself and others. Providers must complete the SHA Training. RANCHO CUCAMONGA, Calif., Nov. 19, 2020 /PRNewswire/ -- Inland Empire Health Plan (IEHP) received the 2020 Health Equity Award for their ability to engage and connect with members via … Physicians may also give treatment advice, refill select prescriptions and refer Members for in-person care. Fax: (909) 477-8536 Fenway Health is one of the largest providers of LGBTQIA+ health care and HIV primary care in the country; as such, it is a leader in the field of LGBTQIA+ health and informs much of the promising practices and innovative models that the Education Center disseminates to health centers nationwide. IEHP has created UM Subcommittee Approved Authorization Guidelines to serve as one of the sets of criteria for medical necessity decisions. If you need IEHP to direct the referral, please indicate that on the form. A monthly review of the Department of Health Care Services Medi-Cal Suspended and Ineligible list. Contacting the Office of the Inspector General (800) 720-4347 (TTY). During the first 6 months, you will meet weekly with a small online group to learn how to make healthy choices into your life. Since medical technology is constantly evolving, our clinical guidelines are subject to change without prior notification. Our Plans Medi-Cal Plan. This commitment extends to our business associates and delegated entities that support IEHP’s mission to improve the delivery of quality, accessible, and wellness based healthcare services for our community. IEHP administers the GNA every five years; the findings of the GNA may help Providers better understand and serve our Members. Make A Difference! What’s an Advanced Care Directive and why do I need someone else to help me? For questions please contact IEHP Health Education Department at (866) 224-4347. You will also be paired with a health coach for one year to help you set your goals, such as how to: Studies have shown that those who finish the program can lose weight and prevent Type 2 Diabetes. Knowingly billing for services or prescriptions not furnished or supplies not provided, Knowingly altering claim forms for a higher payment, Selling medicine, medical equipment, or other things received through IEHP, Writing excessive prescriptions or ordering excessive tests, Prescribing more medications than necessary for the treatment of a specific condition, Billing for unnecessary medical services or medical equipment, Billing for brand name drugs when generics are dispensed. Pay For Performance (P4P) Learn more about IEHP’s incentive programs offered to qualified Practitioners, including traditional P4P and Global Quality P4P. Quarterly educational presentations - offered as targeted Provider Outreach and education on varying utilization review topics. For example, do not store prescription pads in exam room cabinets or leave on office counters. For example, “Who will be responsible for communicating with your family?” or “In the final stages of living, do you want to be at home?”. All original … IDPH has launched a new website. The IEHP Compliance, FWA, and Privacy Training Program focuses on the elements of an effective Compliance Program, conduct & ethics, and the Fraud, Waste and Abuse and Privacy Programs. Providers are encouraged to refer Members to IEHP for these programs. Team Member benefits include: CalPERS Retirement; 457(b) option with contribution match; Health … Securely manage your healthcare online from anywhere in the world. Let's start living the best version of you and living the life you love. Master’s degree in Public Health, in Health Education, or in a related field equivalent to public health or health promotion experience from an accredited institution required. Paying a "kickback" in exchange for a referral for medical services or goods, Allowing unauthorized individuals to use ID card to obtain benefits, Falsifying residence information to obtain benefits, Drug seeking or doctor shopping to obtain narcotics. E-mail: compliance@iehp.org, Online: (By clicking on the following links, you will be leaving the IEHP website), Report a Privacy Incident/Breach Click Here. IEHP offers free Advanced Care Directive Workshops to help you. The Staying Healthy Assessment (SHA) forms consist of seven age-specific pediatric questionnaires and two adult questionnaires. Click below to learn more about age milestones, immunization and Well Baby Visits Schedule, and teen health support. In April 2008 he was appointed to the IEHP Governing Board and served as the Vice-Chair from January 2018 - December 2020. All content has been reviewed by IEHP to align with the standards practiced by leading health organizations. Format: Online (small group) Providers may obtain information about criteria, either in general or relating to specific UM decisions, from IEHP upon request by contacting the IEHP UM Department. For any questions, please contact Care Directives at (888) 621-4383 or email support@caredirectives.org. The guidelines contained on this page are recommended by IEHP with the intent to enhance Member care. The Medi-Cal Learning Portal provides extensive resources and a broad range of topics for all types of Providers with questions regarding billing requirements and claims processing guidelines. Health Education Classes; Community =====TEXT INFOPANEL. (866) 294-4347 (888) 244-4347 IEHP also has the following resources available for reporting fraud, waste or abuse, Privacy issues, and other compliance issues: Compliance Hotline: (866) 355-9038 Welcome to the Utilization Management Clinical Criteria page. The Fenway Institute (TFI) is an interdisciplinary center for research, training, education, and policy development that works to ensure access to quality, culturally affirming medical and mental health care for traditionally underserved communities, including LGBTQIA+ people and those affected by HIV/AIDS. IEHP, through its Delegation Oversight process, will monitor the IPAs’ compliance with documentation and reporting requirements, as outlined in Policy 25A2, “Delegation Oversight Audit.”, (0-36 months): Head Circumference-For-Age And Weight- For-Length Percentiles, (0-36 months): Length and Weight-For-Age Percentiles, (2-20 years): Stature and Weight-For-Age-Percentiles, (2-20 years): Body Mass Index For-Age Percentiles. Inland Empire Health Plan (IEHP) is prohibited from issuing payment for services provided, ordered, or prescribed by an individual or entity that is excluded, ineligible, or terminated from participation in State and Federal health care programs in accordance with regulatory and contractual requirements. Advanced Care Directive Guide (PDF) (866) 294-4347 IEHP Compliance Officer Here, you will find links to the Pharmacy Program Manual, Communications, DTM Program, Prior Authorization Criteria, Clinical Practice Guidelines, Forms, IEHP Formulary, and Safety Resources with drug recall information. Inland Empire Health Plan (IEHP) Select. (800) 720-4347 (TTY). 44 Inland Empire Health Plan jobs in Rancho Cucamonga, CA. IPAs are required to provide data elements specific to this measure, as outlined in Policy 25F1, “Encounter Data Reporting - Medicare MMP Reporting Requirements – IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan)" and Attachment, “Medicare Provider Reporting Requirements Schedule” in Section 25. Prior to contracts and monthly thereafter, review of the GSA System for Award Management (SAM), the Department of Health Care Services Medi-Cal Suspended and Ineligible list, and the Office of Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE) that are excluded from participation in government health care programs (42 CFR §10011901). IEHP … 2016 Group Needs Assessment (GNA) Report (PDF) This includes making a plan to improve safety and taking routine tests and health screenings to detect health problems and treat them early. The mission of Fenway Health is to enhance the wellbeing of the LGBTQIA+ community as well as people in our neighborhoods and beyond through access to the highest quality health care, education, research, and advocacy. Provider Login =====TEXT INFOPANEL. This generally means that a breach occurs when PHI is accessed, used, or disclosed to an individual or entity that does not have a business reason to know that information. Hmong, Korean, Russian, Tagalog, Vietnamese. 1-800-440-4347 (TTY 1-909-890-0731 or 1-800-718-4347) www.iehp.org. (800) 440-4347 Resources are not limited to webinars, computer based training, and webinars. Resources are reviewed regularly and updated to reflect changes from a regulatory and clinical standpoint. Reporting results to Compliance Committee, Governing Body, and IEHP as necessary. Review of professional license status for sanctions and/or adverse actions. Advanced Care Directive is a specific type of power of attorney or health care proxy, in which the person authorizes someone (an agent) to make decisions on their behalf when they are unable to do so. You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. As outlined in both the APL/DPL - Reporting Requirements related to Provider Preventable Conditions, the following classify as PPCs and must be reported: Any unintended foreign object retained after surgery, A stage III or stage IV pressure ulcer that developed during the patient's stay in the hospital, A significant fall or trauma that resulted in fracture, dislocation, intracranial injury, crushing injury, burn, or electric shock, A catheter-associated urinary tract infection, Any of the following manifestations of poor glycemic control: diabetic ketoacidosis; nonketotic hyperosmolar coma; hypoglycemic coma; secondary diabetes with ketoacidosis; or secondary diabetes with hyperosmolarity, Coronary artery bypass graft (CABG) - mediastinitis, Bariatric surgery; including laparoscopic gastric bypass,gastroenterostomy, laparoscopic gastric restrictive surgery, Orthopedic procedures; including spine, neck, shoulder, elbow, Cardiac implantable electronic device procedures, Deep vein thrombosis/pulmonary embolism following total knee replacement or hip replacement, Latrogenic pneumothorax with venous catheterization, Wrong surgical or other invasive procedure performed on a patient, Surgical or other invasive procedure performed on the wrong body part, Surgical or other invasive procedure performed on the wrong patient, Add physical activity into your daily life, Improve problem-solving and coping skills, Call Skinny Gene Project at (909) 922- 0022, Monday - Friday 8am – 5pm., or. Easy-to-read handouts in English, Spanish and other languages on nutrition, diabetes, depression and other topics related to women’s health. At IEHP, we make a difference. You’ll speak to one of our friendly bilingual Enrollment Advisors. E-mail: Htips@oc.dhhs.gov, DHCS MEDI-Cal Fraud Hotline Mail: No-cost or low-cost health care coverage for low-income adults, families with children, seniors, and people with disabilities. Version: 2.2.0.26 To learn about AHRQ’s tools to address health literacy, visit Health Literacy Topics at https://www.ahrq.gov/health-care-information/topics/topic-health-literacy.html You may want to ask for another form of identification in addition to the IEHP Member identification card. Download Adobe Acrobat Reader. Our bodies and mind change as we get older. Select the growth chart form that you need by clicking on the link below: To submit a referral to IEHP, please fill out the referral form below, include all clinical notes and fax it to IEHP. (877) 273-4347 Do not leave prescription pads, which include a Provider's identification and license number, out in the open. Health education. For example, “Who will be responsible for communicating with your family?” or “In the final stages of living, do you want to be at home?”. Search job openings at Inland Empire Health Plan. Misusing codes on a claim, such as upcoding and unbundling codes. Resource: website, These files contain the Level II alpha-numeric HCPCS procedure and modifier codes, their long and short descriptions, and applicable Medicare administrative, coverage, and pricing data. RANCHO CUCAMONGA, Calif., Nov. 17, 2020 /PRNewswire/ -- Inland Empire Health Plan (IEHP) honored San Bernardino County Supervisor Josie Gonzales during its Nov. 9 board meeting, … Further  information is available on the following pages: Medicare and Medi-Cal lines of business must follow the instructions below: Category 1 - HCACs (For Any Inpatient Hospital Setting in Medicaid), Category 2 - Other Provider Preventable Conditions (For Any Health Care Setting). Resource: website, Information on services covered by the Medicare Physician Fee Schedule (MPFS). Pharmacies. Periodically perform internal audits of billing practices and compare billing records with payments received. IEHP Medi-Cal Member Services (800) 440-4347 (800) 718-4347 (TTY) IEHP DualChoice Member Services (877) 273-4347 (800) 718-4347 (TTY) IEHP 24-Hour Nurse Advice Line (for IEHP Members only) 2. Please contact the IEHP Provider Relations Team at (909) 890-2054 to be connected to the UM Department. First, document your suspicions. ©2020 Inland Empire Health Plan All Rights Reserved. E-mail: stopmedicalfraud@dhs.ca.gov. We serve almost 1.25 million residents of Riverside and San Bernardino … The Department of Health and Human Services supports work completed by the USPSTF. If you suspect that errors in billing may have occurred, contact your IEHP Provider Services Representative at (909) 890-2054. Pamphlets, newsletters, health education … Report a Privacy Incident/Breach Click Here (By clicking on this link, you will be leaving the IEHP website). All Rights Reserved. OptumHealth Education is issuing continuing education credit for taking the AHRQ-developed Health Literacy Knowledge Self-Assessment. Fax: (909) 477-8536 Listen to the board meeting live! Rancho Cucamonga, CA 91729-1800. Listen in. The Centers for Medicare and Medicaid Services (CMS) is requiring IEHP and its IPAs to document and report the efforts made to coordinate the care of IEHP DualChoice Cal MediConnect Plan (Medicare-Medicaid Plan) Members receiving specialty mental health services through the County Mental Health Plans. The call is free and the caller may remain anonymous. RANCHO CUCAMONGA, Calif., Nov. 20, 2020 /PRNewswire/ -- Inland Empire Health Plan will provide two flu vaccine and grocery distribution events for the communities of Riverside, San … (866) 577-8355 (TTY), To Enroll with IEHP Easy to read “Handouts and Visual Aids” in color on diabetes care and nutrition to help patients eat the right foods to control blood sugar. Search job openings, see if they fit - company salaries, reviews, and more posted by Inland Empire Health Plan employees. To find out about other free AHRQ continuing education opportunities, go to www.ahrq.gov. MyDMG Health is the secure patient portal for DuPage Medical Group. Abuse includes actions that may, directly or indirectly, result in unnecessary costs and improper payment or services. Small changes can have big results! The Code is meant to provide guidance about the compliance culture at IEHP and the role that each Team Member, including management, Chief Officers and the Governing Board, plays in building and preserving that culture. The following numbers are to be used for after hour requests: A listing of LabCorp Patient Service Centers around the Inland Empire can be found below: Any of your IEHP Members needing medical attention may visit an Urgent Care Clinic after regular business office hours and on weekends. Can be large and small '' for further detail the AHRQ-developed Health Literacy link ( optumhealtheducation.com ) 2 the Institutes... 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Reimbursement rates payable by the Medicare Physician Fee Schedule ( MPFS ) by the Medi-Cal program for covered described... Reviewed regularly and Updated to reflect changes from a regulatory and clinical standpoint (. You suspect that errors in billing may have occurred, contact IEHP Health Education is!, `` Obstetrical Services '' for further detail and unbundling codes of ’! Room cabinets or leave on office counters IEHP is dedicated to your child’s Health at stage! Up, simply go to indicate such small Group ) Duration: one year Ages 18... After hours by using the menu below perform internal audits of billing practices and compare billing records with received. They fit - company salaries, reviews, and Russian using the menu below quarterly educational presentations - offered targeted. To direct the referral, please click Here ( by clicking on links... Access Care after hours Phone Numbers for coverage Determination and Expedited Appeals, allows to! 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Of Medicine: seniors ' Health, IEHP may request additional information that necessary... Indicate that on the IEHP Member identification card, are suggested our goal in creating page! Easily accessible electronic versions of IEHP ’ s Health payment or Services not prescription! Copies, simply go to the National Practitioner Databank ( NPDB ) contact the IEHP ).... Doctors you can go to https: //cccm.thinkculturalhealth.hhs.gov/, U.S. Department of Health Education at!

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