Central California Alliance For Health

 

COVID-19: Information for Providers


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Updated April 21, 2020


Member support


How has the Alliance responded to member inquiries about COVID-19?


To address commonly asked questions from members, the Alliance has developed a webpage with resources and information and a flyer , which is posted on our website. We have also provided our member-facing staff with talking points to help them answer questions. We will continue to update these materials as new information becomes available.


If members think they may have contracted COVID-19, what guidance is the Alliance providing them?


Members are encouraged to contact their provider to discuss their symptoms and next steps. If members are unable to reach their provider, we are encouraging them to contact the Alliance's 24-hour Nurse Advice Line (NAL) to speak to a registered nurse. The number is 844-971-8907.


How should members fill their prescriptions during this time?


Members are encouraged to be sure they have at least a 30-day supply of their prescriptions on hand. In addition, providers should remind members that they can receive a 90-day supply, including free standard delivery, for most prescription medications mailed to them through MedImpact Direct. To set up mail order for medications, they may also visit https://www.medimpactdirect.com/ or call 855-873-8739.


In addition, Walgreens and CVS pharmacies are now offering free delivery for all eligible medications. Providers should encourage members to talk to their pharmacist or call their localWalgreens or CVS for more information.


Additionally, the Alliance has added a few options to our pharmacy network, including Alisal Pharmacy in Salinas, Soledad Pharmacy and Wellness Center in Soledad and SortPak, a mail order pharmacy. Visit their website to learn more at www.sortpak.com.


To find an in-network pharmacy, use MedImpact's online Pharmacy Directory using the link below.


MedImpact Pharmacy Search


Will members be able to access interpreting services?


The Alliance is committed to delivering culturally and linguistically appropriate health care services to our diverse membership, especially during this time. To ensure the health and safety of the interpreting staff, on-site face-to-face interpreting services will not be available in Santa Cruz and Monterey counties at this time. While our on-site face-to-face interpreting services are currently unavailable in these areas, our telephonic interpreter services and the California Relay Service (CRS) remain open and accessible for our members. We encourage our providers to utilize our telephonic interpreting services and the CRS while interacting with our members. For more information on this and to view CRS access information, click here to view the full update on the Alliance website.


How will the Alliance provide materials to members?


If members need hard copies of materials, Alliance staff will mail copies or send electronic links as requested.


Billing/Authorization Updates


How is the Alliance supporting patient consultations over the phone, including telehealth?


We will work with our providers to ensure that we are supporting the provision of medically necessary care. We understand that some providers are providing patient consultations over the phone (including telehealth, if appropriate) to minimize potential virus exposure. Required codes for telehealth services include:



Click here for additional guidance on telehealth services. We stand with you during this unprecedented time and are here to answer any questions you may have.



How should providers bill for COVID-19 testing?


As our members continue to be affected by the COVID-19 pandemic, you are likely busy screening patients and prescribing COVID-19 laboratory testing. We want you to know that the Alliance covers both laboratory testing and screening for COVID-19.



To ensure you receive appropriate reimbursement, you must submit COVID-19 related claims using the following procedure codes:



CodeDescription
U00012019-Novel Coronavirus [2019-nCoV diagnostic p]
U0002COVID-19 lab test non-CDC
87635SARS-COV-2 COVID-19 AMP PRB

For a listing of contracted labs, providers may reference the Alliance Provider Directory or contact their Provider Relations Representative.



We are aware that there are concerns about the availability of COVID-19 testing and the process for testing. We remain in close contact with local health departments as they assess their resources and develop plans for testing. The Alliance will update providers once additional information is available.



Has the Alliance changed its authorization process during COVID?


In order to expedite services by our providers to Alliance members during the COVID-19 pandemic, we have implemented the following authorization updates and changes:



Provider support


Is the Alliance continuing to conduct in-person provider visits during this time?


We understand that providers are extremely busy as they focus on providing patient care. In order to support our providers in prioritizing member access to care and to follow social distancing guidelines, we have suspended in-person provider visits. All interactions and provider follow-up discussions will occur by webinar, phone and email. All provider relations efforts will focus on supporting our providers in the most efficient way possible during this time.


Is the Alliance remaining open during the outbreak?


Yes, we are maintaining business operations. Our mission is to ensure our members in Monterey, Santa Cruz and Merced counties continue to access needed health care. Over 320,000 Medi-Cal members rely on the services we provide, and our commitment to these people will not waver despite this public health crisis. However, to help reduce exposure to the illness and to maintain social distancing requirements, the public areas and member service counters for the Central California Alliance for Health are currently closed.


In order to maintain social distancing requirements, we have transitioned to fulltime work from home for employees currently set up to work remotely. Fortunately, the Alliance already had a robust work-life balance program in place, allowing work from home opportunities for over three-quarters of our workforce. This approach has well prepared us to seamlessly support business operations and provide member and provider support in times of crisis. In addition, the Alliance has a business continuity plan in place to maintain business operations and continue providing core services in the event of a mandatory public health quarantine.


How is the Alliance staying up-to-date on COVID-19 developments?


We continue to monitor the situation by staying in touch with public health and government officials, and we are following their guidance as the situation continues to evolve.


Prescription information


Can hydroxychloroquine or chloroquine be prescribed for COVID-19?


There are no currently available data from randomized controlled trials to inform clinical guidance on the use, dosing or duration of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection. There are no currently available data from randomized controlled trials in humans to support recommending any investigational therapeutics for patients with confirmed or suspected COVID-19. At present, clinical management includes infection prevention and control measures and supportive care. Go here for CDC clinical guidance for patient management or here for CDC information regarding therapeutic options for COVID-19 patients.



Is there a shortage of generic albuterol HFA inhalers? What other inhalers are on Alliance formulary?


There is a known shortage of albuterol HFA inhalers (generic ProAir, Ventolin, Proventil). In response to the shortage, brand ProAir, Ventolin and Proventil HFA inhalers can be dispensed without prior authorization. In addition, levalbuterol HFA inhaler (generic Xopenex) and albuterol nebulized solutions are on formulary and do not require prior authorization.


 

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