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Thank you, healthcare heroes!
Santa Clara Family Health Plan (SCFHP) would like to recognize Empress Care Center and Grant Cuesta Sub-Acute and Rehabilitation Center for their outstanding work as skilled nursing facilities. Their communication, timely reporting of COVID-19 information, and ongoing collaboration have been superb. A special shout out to Grant Cuesta for cohorting COVID-19 positive cases at your facility! Thank you for your support as well as your continued dedication to providing excellent care to our members.
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2020 update to standards of medical care in diabetes
The American Diabetes Association (ADA) published a new report, Standards of Medical Care in Diabetes – 2020, which reviews current evidence around diabetes care, general treatment goals, and tools to evaluate quality of care. Read more about this on the ADA and the DHCS websites.
Download the ADA Standards of Care app to get the most up-to-date standards along with interactive tables and algorithms. The app is available as a web-based tool and as an application for iOS and Android platforms.
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Breast cancer awareness month
According to the American Cancer Society (ACS), 1 in 8 women in the United States will develop breast cancer in their lifetime, and for every 276,480 cases diagnosed, approximately 42,170 women (15.3%) will die. In recent years, incidence rates have increased slightly (by 0.3% per year). However, when detected early, women have more treatment options and the highest rate of success for beating breast cancer.
In honor of Breast Cancer Awareness Month, we ask that you take this opportunity to educate your patients on the importance of mammograms. Give your patients information on how mammograms work and how they can self-check. If your patients need more information to prepare for the screening, you can share this article from our health library with them: Mammograms – Tips for your ease, comfort, and an accurate exam.
Find out more about the importance of breast cancer screenings and the different screening tools on the ACS website.
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Modified initial health assessments during the pandemic
In June 2020, DHCS published APL 20-004, which included language about initial health assessment (IHA) completion timeframes*. Although there are no updates from DHCS, we would like to remind providers to review telehealth guidelines to work towards completing as much of the IHA as possible (SHA, health history, etc.) and complete the remainder of the IHA when possible.
Questions?
Contact SCFHP Provider Performance Program team at ProviderPerformance@scfhp.com.
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*APL 20-004 states: For any members newly enrolled in the MCP between December 1, 2019, and the end of the public health emergency, DHCS is temporarily suspending the requirement to complete an Initial Health Assessment (IHA), as described in the MCP contract with DHCS, within the timeframes outlined in the contract (120 days for most members). MCPs are permitted to defer the completion for these members until the COVID-19 emergency declaration is rescinded; however, DHCS will require the completion of the IHA for these members once the public health emergency is over.
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Refer your patients to health education!
Santa Clara Family Health Plan (SCFHP) is dedicated to helping patients lead healthy lives. We partner with a number of community-based organizations to offer health education classes and programs at no cost to SCFHP patients. We offer classes on the following topics:
- Chronic disease management
- Stress and anger management
- Parenting
- Weight management
- Prenatal education
- Smoking cessation
Many of our programs are offered in other languages. They are also being offered virtually. Patients can call the organization directly to register. Be sure to say that they are an SCFHP member! SCFHP does not require prior authorization for health education.
To see a list of available health education programs, visit our website at: https://www.scfhp.com/for-members/health-education/.
If you would like to request health education for your patient, you can do one of the following:
- Login to Provider Link at providerportal.scfhp.com and submit a Request Health Education for Patient form.
- Download the PDF version, complete and fax it to Health Education at 1-408-874-1959.
Our Health Education team will reach out to the patient to provide more information about the class.
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Screenings for Medi-Cal members
In the June issue of Provider e-News we included information about screenings for Medi-Cal members. You may be eligible for Proposition 56 payments when completing childhood developmental, blood lead level, and trauma screenings as part of a routine wellness visit.
Questions?
Contact SCFHP Provider Performance Program team at ProviderPerformance@scfhp.com.
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Provider Link
Visit providerportal.scfhp.com to download your member roster, check authorizations and claims status, and check member eligibility.
Interactive Voice Response (IVR)
Call our IVR line at 1-408-874-1473 to verify member eligibility, check claims status based on your TIN, and request confirmation of eligibility verification or claim(s) processed.
Resources on our website
Resources from the County
Questions? Please email Provider Services at ProviderServices@scfhp.com.
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Memo round up
We are dedicated to keeping our providers informed about operational and regulatory changes. Below are important memos that were sent recently:
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Providers (unique NPIs)
Primary care
Medi-Cal: 830
Cal MediConnect: 545
Specialists
Medi-Cal: 4,263
Cal MediConnect: 2,970
Ancillary
Medi-Cal: 831
Cal MediConnect: 230
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Members
Medi-Cal: 253,252
Cal MediConnect: 9,428
Total: 262,680
Pharmacies
Medi-Cal: 142
Cal MediConnect: 147
As of September 2020 |
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