Central California Alliance for Health

 

Provider News

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2017

Facilities Billing on the UB04 Claim Form
Hepatitis A Outbreak
Non-Medical Transportation Benefit
Non-Emergency Medical Transportation Benefit
Corrected Information: E780.0 Billing Code Update
Medi-Cal Capacity Grant Program to Sunset Two Funding Opportunities Effective 7/17/17
New Provider Manual Effective 7/2/17
Medicaid Managed Care Final Rule Effective July 1, 2017
CHDP Transition – Important Information
Medical Transportation Benefit Documentation Requirements
Smoking Cessation Benefit Documentation Required
Save the Date! Upcoming Webinars
eConsult Program Available to PCPs
Provider Preventable Conditions: New Reporting Requirements
• Upcoming Webinars – Click Here
Corrected Information: Pediatric Developmental Screenings
CBI Measure: SBIRT Claims Update
New Provider Manual Effective 7/1/17
Intrauterine Contraceptive Billing Requirement Updates
IHA Incentive Reminder
EpiPen and EpiPen Jr. Recall
Upcoming CBI Webinar Series
90-Day Provider Portal Password Change
2016-2017 Flu Vaccine Rate Change
CHDP Code Conversion Update
Rate Updates for Codes 88112 and 88333
Termination of Local Dialysis Codes
HCPCS 2016 Code Changes for Intrauterine Contraceptives
Billing Updates for Allergy Injections
CBI for Advance Care Planning
CBI Program Updates
Face-to-Face Interpreting Service Requests
Billing for Newborn Medi-Cal Members
2017 HEDIS Season is Here
Clarification: Lab Services Diagnosis Codes
HEDIS 2017 FAQs
Important Synagis Information
Behavioral Health Referral Form Updates
Updated Flu Vaccine Guidelines
Cervical Cytology Screening Measure: Submit Additional Data
Cervical Cytology Screening Template
Enhanced Primary Care Pain Management Program
CBI Reporting: Cervical Cancer Screening
Custom FFS forms for CBI
DME Quarter Rate Update
Updated Provider Manual Effective April 1, 2017
90-Day Provider Portal Password Change
Tobacco Cessation Counseling Benefit
CBI Program: 2017 Changes

2016

HEDIS 2017 – Provider Medical Record Location and Contact Form
Changes to Face-to-Face Interpreting Services
New Face-to-Face Interpreting Services Request Form
New Reporting Requirements for Provider Preventable Conditions
January 1, 2017 Provider Manual Available
New Claims Processing System Highlights
New Claims Processing System
New Claims Adjudication System
Same Day Exception to PCP Change
October 1, 2016 Provider Manual Available
2016 CPT-4/HCPCS Updates for Home Health
2016/2017 Flu Vaccine Guidelines
CPT-4/HCPCS Updates
Weight Watcher’s Scholarship Application Available on Alliance Provider Website!
Provider Portal Changes Coming on October 5, 2016
Updates to the Alliance Clinical Health Education Benefits
Reporting Unauthorized Disclosures of Alliance Member Information
New California Vaccine Requirements
Billing for Time Based Anesthesia Services
Reimbursement for EHR Services Available through DHCS
Oral Nutrition Supplements
Specialists: Direct Referrals to Physical Therapists
End of Life Services
Antigen Therapy Services Code Conversion
Changes to Provider Directory Information & Updates
Alliance Hand Specialists Referrals
July 1, 2016 Provider Manual Available
Update on the Alliance’s Authorization Process
TRUEresult® and TRUE2go® Blood Glucose Monitoring Systems Discontinued
Correction: HPV-9 Billing Code
Correction: CLIA Waived Labs Modifier
Medi-Cal Coverage for All Children Implementation Coming Soon
Expanded Medi-Cal Capacity Grant Program: New Funding Opportunities
Specialist to Specialist Referrals
Specialist Referrals for Physical Therapy
Emergency Department Referrals to Orthopedic Surgeons
April 1, 2016 Provider Manual
Healthy Kids Coverage Ends 6/30/16
Provider Portal Update: New Processes for Referrals and Authorizations
Increased Payment for Specialty and Primary Care Services
2016 HEDIS Season is Here
HEDIS 2016: FAQs
New Quantity Limits for Opioids
HPV-9 Benefit Update
Vision Resources for Members with Diabetes
Change in Reimbursable Antepartum Visits
Carved Out Antipsychotics Drugs
Effective 3/10/16: Electromyography and Nerve Conduction Studies Will Require Prior Authorization
Expanded Acupuncture and Chiropractic Benefits
Overrides for Medication Dose Changes


2015

New E-Prescribing Tool
Case Management Referral Form
New Initial Health Assessment Billing Codes
2016 Care Based Incentives Workshop Dates
Changes to 2016 Case Managed Code
HPV-9 Billing Update
Pharmacy Formulary Change: Budesonide Respules Age Limit
January 1, 2016 Provider Manual
New Provider Portal Reports Track ED Visits and Inpatient Admissions
Frequently Asked Questions About ICD-10: Treatment Authorizations
ICD-10 Testing Extended Until 12/31/15
Flu Vaccine Guidelines 2015 - 2016
PCP Billing for Mental Health Screenings for Medi-Cal Members
ICD-10 Transition: How to Handle Existing Authorizations and Referrals
Post-pregnancy Contraception
Recommendations for Synagis: 2015-2016 Season (Monterey/Santa Cruz)
Recommendations for Synagis: 2015-2016 Season (Merced)
Opportunity for Alliance-Funded PCMH Consulting
Expansion of Pregnant Member Benefits
Prenatal Immunizations Combat Pertussis Risk
Public Health Advisory Regarding Meningitis
Medi-Cal Capacity Grant Program
Alliance Nurse Advice Line is Here!
Medical Transportation Code Conversion Table
Annual Monitoring for Patients on Persistent Medications - HEDIS Results
New Provider Portal Report: Open/Unused Referrals
Changes in Coverage of Hepatitis C Medications (PA Checklist and PA Request Form included)
Change in Pharmacy Authorization Process - Effective 8/1/15
Initial Health Assessment Coding and Billing Updates for PCPs
Adult Preventative Services Benefit Expansion
ACA Attested and Eligible Specialists ACA 1202 Claims Readjudication
Guidelines for Use of Psychotropic Medications in Foster Care
Reimbursement for Alcohol and Substance Disorder Services
New Inpatient Hospital Discharge Form
Postpartum (PP) Incentive: Changes to the PP Form
New Form for Reporting Provider Preventable Conditions
2015 CPT-4 and HCPCS Codes Not Yet Adopted for Medi-Cal
CHDP Billing for Purchased Vaccines
Weight Watchers Support Program Prior to Bariatric Surgery Referral
Medi-Cal Access Program - AIM Eligibility Change
Measles Tools for Clinicians
Procedure Codes for Physical Therapy
Effective 4/1/15: Sleep Studies Will Require Prior Authorization
Bariatric Surgery Referral Process


2014

Change in Benefit for EKG Rates
Guidelines for Treatment of Chronic Non-Cancer Pain
ViaCare and Medi-Cruz Advantage Claims and Disputes
Oral Nutrition Supplement for Adults (Criteria for Coverage)
Influenza Vaccine Updates and Recommendations (2014/2015)
Tobacco Cessation Webinar: The Provider Quitkit
Weight Watchers Support Program
Santa Cruz County PCPs: Lithotripsy Referral Process
Screening Checklist for Autism Spectrum Disorder Available
Modifier 99 Not Recognized
Electronic Crossover Claims
New Benefit for Behavioral Health Treatment for Autism Spectrum Disorder
2015 Provider Manual Available
Comprehensive Tobacco Cessation Services for Medi-Cal Members
Coverage to Care - Helpful Resource for Your New Alliance Patients
Important Information Regarding Timely Access Regulations
SBIRT Training for PCPs: CE Available
UPDATED: Helpful Hints to Improve Cervical Cancer Screening Reporting
Recommendations for Synagis: 2014-2015 Season (Monterey/Santa Cruz)
Recommendations for Synagis: 2014-2015 Season (Merced)
Exceptions to ICD Indicator Reporting
State Medi-Cal Erroneous Payment Corrections
Reclassification of Hydrocodone Combination Products to Schedule II
Helpful Hints to Improve Cervical Cancer Screening Reporting
Exceptions to ICD Indicator Reporting
OTC Contraceptives Covered for Healthy Kids, IHSS and
    Medi-Cal Access Program - AIM
New Guidelines for Hepatitis C Medication Coverage
Updated Provider Manual Available
Name Change: AIM Program is Now Medi-Cal Access Program
New Billing Code for Depo Provera
Pertussis is Widespread in California
ACA Payment Update
Physician Satisfaction Survey Mailing
SBIRT Benefit Expansion to all Alliance Programs
Alliance ACA Payment Update - Provider Action Items
Benefit Update: Enteral and Oral Nutrition Products
Clean Credentialing File Notification
CHDP Alliance Billing for Seasonal Influenza Vaccination
ACA Payments to be Released to Attested & Eligible
    Providers in June 2014
Glucose Test Strips Quantity Limit
Credentialing for Locum Tenens
FCN Overpayment Letter Update
CBI Submission Deadlines & Reducing Denied Submissions
Provider Manual Update
LIHP Transition into Medi-Cal
IHA/SHA Resources & Training Module

2013

Memo: New Mental Health Benefits for Alliance Medi-Cal Members
New Corrected Claim Instruction
LIHP Authorization Transition
Seasonal Influenza Vaccination V.2
Formulary Change
Self-Referral Services
Synagis Recommendations for Santa Cruz & Monterey Counties
Synagis Recommendations for Merced County
Modifier 59 and Required Documentation
LIHP Transition Provider Webinar
Seasonal Influenza Vaccination
New Staying Healthy Assessment Questionnaires released by DHCS
State Attestation Process
Healthy Families transition to Medi-Cal Pharmacy Information
Aid Code 80 Now Payable and Retroactively to July 1, 2012.
Credentialing of Non-Physician Medical Practitioners
Healthy Families Program Transition FAQs for Providers
Medi-Cal Provider-Preventable Conditions Reporting Form
Cervical Cancer Age Update
Provider Satisfaction Survey 2013
Change in Blood Glucose Test Strips
Alliance to Subsidize AB97 Medi-Cal Cuts
Hearing Aid Benefit
Clarification of Complaint Procedure
Conversion of Certain Physician Administered Drugs (PAD) from X Codes to J Codes
Ophthalmology and Vision Care/Professional Services Billing Update
HEDIS Kick Off
Notification of In-Patient or SNF Admissions
Foot Orthotic and Prosthetic Appliances Benefit Update
Change in Authorization Requirements for Unclassified Drugs J3490 and J3590
Provider Portal (Web Account) Password Change Required on January 28, 2013
MediCare D Coverage Change Rx Benzodiazephines


2012

New Pharmacy Benefits Manager: MedImpact
Recommendations for Synagis 2012-2013 Santa Cruz/Monterey Counties
Recommendations for Synagis 2012-2013 Merced County
Site Review Tools and Guidelines Update
Billing Guidelines for Seasonal Influenza Vaccination 2012-2013
The Alliance and DHCS Announce Final Deadline for Required HIPAA 5010 Compliance
Rx Notification New Auth Form Change
Influenza Clinical Recommendations
Verify Eligibility for State Fee for Service
Provider Manual July 2012 Update
Retroeligibility Policy Change
CBI Forms Require Practice NPI
Physician Satisfaction Survey 2012
Alliance Medi-Cal Members with Other Health Coverage (OHC)
Anesthesia Billing
Resources for Care Based Incentives 2012
Care Coordination Survey
MediCruz Advantage Occupational Therapy
Well Care 2011 Frequency Change
Denials for Rendering FQ Providers
MediCruz Advantage Physician and Facility Administered Drugs
Paper Referral Improvements Referral Consultation Request
New Interpreter Service Pacific Interpreter
Update to Dental Anesthesia Policy
7B Denials to Billing
HIPPA 2010 transaction 5010_835 RA
LTC Rate Increase
Fee For Service Care Based Incentive Forms
Care Based Incentives 2012 New Resources Available
MediCruz Advantage Pharmacy Authorizations
HEDIS 2012 Kickoff Santa Cruz and Monterey
HEDIS 2012 Kickoff Merced
EDI 997_999 File Update
Rendering Provider Must be Included on Claim


2011

Memo: Observation Codes are no Longer Benefits
Synagis Merced County
Memo: 2012 Care Based Incentive Program
Memo: Well Care 2011 Frequency Change
Memo: What To Do When Your Child Gets Sick
Memo: 2010-2011 Seasonal Flu Vaccine
Alliance Incentive Guide for PCPs


2010

2010 Remittance Advice Guide
Ophthalmology Providers Billing CPT 92015; Determination of Refractive State
Fluzone High-Dose (90662)
Breast Pumps
Slings
Blister Packaging
PENICILLIN, Code Conversion
Optometry Service Reinstated as Medi-Cal Covered Benefit
Modifier ZS
2010 Pertussis Update
Nebulizers
Incontinence Supply AR Limits
Fluoride Varnish Application
HPV for Females and Males
HPV updates for Females
Ceravix HPV Vaccine
Timely Referral Submission


2009

Memo: Physician Admin Drugs Update
Memo: Seasonal & H1N1 Flu Vaccine
Memo: California's H1N1 Vaccine Website
Memo: Contracted Labs
Memo: HF Co-Payment Memo
Memo: 340B Drug Pricing Program Billing Requirements
Memo: Merced Providers - Where To Send Claims
Memo: List of Planned approved CLIA Waived labs
Memo: When to Refer to CCS for Audiology Services
Registered Warrants Issued to Specific Providers (IOU’s)
Memo: Optional Benefits Cuts
Memo: Alliance Clinical Lab Changes
Memo: BMI New Measure for QBI
Memo: Laparoscopic Gastric Lapbanding
Memo: Nutritional Supplements Payment and Authorizations
Memo: Medical Supplies and HIPAA Compliance
Memo: DME and Ostomy Supplies
Memo: Highlighting EOBs May Delay Claims Payment
Memo: Healthy Families
Memo: Timely Referrals to CCS for Eligible Conditions
Memo: Infliximab
Memo: Medical Supplies and HIPAA Compliance
Memo: Orthotic Insert Policy & Procedure
Memo: DTaP-Hib-IPV, DTap-IPV and Rotarix Vaccines
Memo: Healthy Families
Memo: Alliance Care AIM
Memo: New Salinas Office Location

2008

Memo: BMI New Measure for QBI
Zosters Vaccine
State Budget for September
Billing for Influenza 2008-2009
Announcement: New Lab Vendor - LabCorp
Convert Blood Derivative Codes to National Standard Codes
Non Split-Billable Lab & Radiology Codes
Referrals to Providers Out of Santa Cruz and Monterey Counties
Online Linked Member List Instructions
Memo NPI
Reporting Requirements for CPT-4 Codes 88141
Reimbursement for 90772 Injection
Reimbursement for Clinical Lab Services
Memo Tamper Resistant Rx Pads

2007

2007 CPT-4 and HCPCS Updates
Medi-Cal Billing for Influenza Vaccination
Tamper Resistant RX pads extension
Tamper Resistant RX pads
Orthotics Policy: Therapeutic Diabetic Shoes and Inserts
CPT-4 Codes 76376 and 76377 Non-covered for Medi-cal
Digital Mammography
Echo cardiology Documentation for CPT Code 93350

2006

Submitting your NPI/New CMS 1500 Claim Form

 

 

 

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