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A newsletter for SCFHP's providers
Vol. 5, Issue 3  March 2021 
In this issue

We're in the top health plans in CA for timely access!



      

Timely access to care means that members can get an in-person appointment or telephone advice within specific timeframes. Timely access to care is an important part of health equity. It means members get access to the care they need, when they need it.

The California Department of Managed Health Care (DMHC) issues annual reports on Timely Access to Care ratings for all California health plans. In the December 2020 report based on 2019 data, Santa Clara Family Health Plan (SCFHP) is among the top plans for ensuring its Medi-Cal members receive timely access to urgent and non-urgent appointments across all provider types (primary care, specialty, non-physician mental health, and ancillary). SCFHP ranked 3rd out of 38 health plans that offer commercial, individual/family, and Medi-Cal coverage and ranked 5th out of 19 plans that offer Medi-Cal coverage. 

These ratings show that overall, our dedicated network of providers and their caring staff are doing a good job ensuring our members receive timely access to care. Thank you for all you do for our members and your patients.

Get $100 for completing trauma screening training 

Eligible SCFHP providers can receive a $100 one-time payment for completing ACEs training available at www.acesaware.org through June 30, 2021. Here’s how:

  1. Get trained: https://www.acesaware.org/screen/provider-training/

  2. Complete the attestation on the DHCS website: https://www.medi-cal.ca.gov/TSTA/TSTAattest.aspx

  3. Submit the following information to Rosa Perez, Provider Network Representative:

    • Provider name

    • Provider TIN

    • Provider NPI

    • Proof of ACEs training course completion 

Eligible SCFHP providers may also receive $29 Proposition 56 payments, paid on a quarterly basis, for each applicable trauma screening. For more information about Proposition 56, see the related training for specifics.

Where to get COVID vaccines

If you are seeking the COVID vaccine for yourself or would like to enroll to become a COVID-19 vaccine provider, please visit Santa Clara County Public Health Department for more information.

You're invited!

We cordially invite you to register for one or more training sessions on Santa Clara Family Health Plan’s Provider Performance Program for the following dates and times:

Each training session will feature prepared remarks followed by a question and answer segment to address any general questions you may have. For more information, see the provider memo or contact ProviderServices@scfhp.com.
2021 provider packet is online!

The provider packet has been updated. Click here to find a copy on our website.

Medi-Cal Rx transition paused


The Department of Health Care Services (DHCS) has informed us that the pharmacy benefit carve out to Medi-Cal Rx is on hold until further notice. No new information will be shared until May. We will continue to keep an eye on the situation and inform you when new information is released.

HEDIS MY 2020 medical records retrieval

It's that time of the year! We have contracted with Guardian Angel to retrieve medical records for HEDIS. Soon, Guardian Angel will contact your office to request the necessary records and set up the most efficient way to retrieve them. We appreciate your cooperation with this medical record review and will work with you to minimize any operational disruptions.

For more information, see the provider memo.

Questions?
Contact Cecilia Le, HEDIS Project Manager, at CLe@scfhp.com.  

Office closures

The SCFHP office will be closed on the following date(s):
  • May 31, 2021 in observance of Memorial Day

Provider Link

Visit providerportal.scfhp.com to download your member roster and report cards, 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
Find important updates, the COVID-19 case report form, information about PPE, and much more on the Santa Clara County website.

Questions?
Please contact Provider Services at ProviderServices@scfhp.com.

Memo roundup

We are dedicated to keeping our providers informed about operational and regulatory changes. Below are important memos that were sent recently:
Memo archive

SCFHP by the numbers

Providers (unique NPI)
Primary care
Medi-Cal: 831
Cal MediConnect: 544
 
Specialists
Medi-Cal: 4,331
Cal MediConnect: 3,078
 
Ancillary
Medi-Cal: 807
Cal MediConnect: 243
Pharmacies
Medi-Cal: 145
Cal MediConnect: 148
 
Members
Medi-Cal: 265,095
Cal MediConnect: 9,888
Total: 274,988
 
As of March 2021
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