A Newsletter for SCFHP's Providers

    Vol. 2, Issue 4 -- September 2018

In This Issue

Website Content

Keep Up With Us

Call us at 1-408-874-1788
 Help Your Patients Get Ready for Flu Season
It’s the end of summer, beginning of a new school year, and flu season is not far behind. It is the perfect time to remind your patients about the importance of getting a flu shot. One way to encourage flu shots is to offer the vaccination at each visit, if your patient has not already gotten one.

Flu shots are covered by SCFHP, and we encourage members to get their shots from their assigned PCP. If the PCP is unable to provide the shot, SCFHP members can get one at most chain pharmacies. Members will not be charged for the shot as long as they present an SCFHP member ID card and they are currently eligible for coverage. Please refer members to the SCFHP website and Facebook page for additional information regarding flu shots.

If you see pregnant patients, please encourage them to get their Tdap shot in addition to their flu shot. The Centers for Disease Control and Prevention (CDC) recommends that pregnant women get the Tdap shot between 27 and 36 weeks of each pregnancy, preferably in the earlier part of this time period. The American College of Obstetricians and Gynecologists and the American College of Nurse-Midwives support this recommendation.
For more information about immunizations, please visit the following links:
a. CDC information about flu for health professionals
b. CA Department of Public Health information about flu
 CHME Community Liaisons Can Assist with Care Transitions
SCFHP’s contracted provider, California Home Medical Equipment, Inc. (CHME), is committed to alleviating the challenges associated with transitioning members from a hospital setting back to the community and eliminating any delays in timely receipt of DME supplies. CHME Community Liaisons are available to facilitate such transitions.

Please see the DME Ordering Guide for more information on how to access CHME’s Community Liaisons. If you have any questions, please email SCFHP Provider Network Management at
HEDIS 2018 Results
SCFHP thanks our providers for participating in a successful Healthcare Effectiveness Data and Information Set (HEDIS) season. Results show continued improvements from previous HEDIS performance, due in part to SCFHP’s strong provider network. 3 reported measures decreased from the previous reporting year, and are receiving additional focus. 
National Committee for Quality Assurance (NCQA) Health Care Effectiveness Data and Information Set 2017 Rate for SCFHP Medi-Cal 2018 Rate for SCFHP Medi-Cal
Cervical Cancer Screening
CCS 57.42% 54.26%
Controlling High Blood Pressure
CBP 66.91% 65.94%
Comprehensive Diabetes Care
HbA1c Testing 88.32% 88.32%
HbA1c Poor Control (>9.0%)* 37.23% 34.06%
HbA1c Control (<8.0%) 53.77% 54.50%
Eye Exam (retinal) 62.29% 63.02%
Medical Attention for Nephropathy 88.81% 86.62%
Blood Pressure Control (<140/90 mm Hg) 59.37% 62.53%
Childhood Immunization Status
CIS-3 77.37% 77.62%
Prenatal & Postpartum Care
Timeliness of Prenatal Care 82.48% 83.70%
Postpartum Care 68.61% 69.10%
Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life
W34 73.97% 72.75%
*Lower rate indicates better performance.
For additional information on HEDIS, please visit:
A Warm Welcome to Our Recently Contracted Providers
SCFHP regularly contracts with new providers to better serve our members. We strive to offer a robust network of providers so members may select doctors that best meet their needs. Below is a list of hospitals and providers who came on board in the last two months.
Provider Name Specialty Line of Business
Katki Windsor (LMFT) Behavioral Health MC, HK
Karla Brown (LMFT) Behavioral Health MC, HK
Pro Transport-1 NEMT (Ambulance) MC, HK, CMC
 SCFHP New Business and Mailing Addresses
A reminder that SCFHP has moved to a new office building in South San Jose and also launched a new corporate logo.

Our commitment to improving community health is at the center of this transition. SCFHP's new office building accommodates the growing team and helps us better serve our members, provides, and the community.

Please update your systems and databases with our new address information:
New physical address: New mailing address for general correspondence: New mailing address for submitting claims*:
6201 San Ignacio Ave
San Jose, CA 95119
PO Box 18880
San Jose, CA 95158
PO Box 18640
San Jose, CA 95158
*There are no changes to the electronic claims submission process. Electronic claims should continue to be sent to SCFHP's clearinghouse, Change Healthcare, Payor ID 24077.

Communicating with Our Providers
SCFHP is committed to providing timely communication to our providers. We use a variety of channels to keep you informed. Fax, email, our website, and this digital newsletter are some of the tools we use to stay connected with you. The Provider Resources and Provider Memos pages on SCFHP’s website are updated on a regular basis to provide fresh, helpful content. Please feel free to share relevant communications with your staff.

We encourage you to sign up for the Provider e-News, and check the Provider Memos page periodically for updates.

If you have questions, please feel free to email Provider Network Management at
SCFHP By the Numbers
Santa Clara Family Health Plan Members (As of September 2018)
Medi-Cal 245,884
Cal MediConnect 7,600
Healthy Kids HMO 3,163
Total 256,647
Santa Clara Family Health Plan Providers (As of July 2018)
Primary Care Providers Medi-Cal Healthy Kids HMO Cal MediConnect
Total 771 754 538
Specialists Medi-Cal Healthy Kids HMO Cal MediConnect
Total 3,927 3,920 2,524
Ancillary Providers Medi-Cal Healthy Kids HMO Cal MediConnect
Total 699 729 602
Copyright © 2018 Santa Clara Family Health Plan, all rights reserved.

Our mailing address is:
6201 San Ignacio Ave. San Jose, CA 95119.
Reach our Customer Service Department at (408) 874-1788.

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