Limited Change Healthcare Reconnection Happening in May |
Change Healthcare has scheduled CalOptima Health to be part of a third wave of reconnections for clearing house products happening in early May.
Change Healthcare is currently in the process of the initial two waves of limited reconnections to test and validate its systems following the February cyberattack.
Providers should be aware that even after this reconnection the Remittance Advice (RA) Application Programming Interface (API) used in the CalOptima Health Provider Portal and the Contract Manager will still not be available. Change Healthcare is determining the timeline to restore these additional services.
CalOptima Health understands the inconvenience this may cause providers, and we thank you for your unwavering commitment to our members. We continue to work diligently with Change Healthcare to resolve this issue as swiftly as possible.
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CalOptima Health Members Can Access Behavioral Health Telehealth Service |
On April 1, 2024, CalOptima Health launched telehealth services for behavioral health care through contracted vendor TeleMed2U.
This service will improve options and access to care for routine outpatient services and support timely post-hospitalization follow-up appointments. TeleMed2U behavioral health professionals will treat a range of mild to moderate conditions for our Medi-Cal and OneCare members, delivering services for outpatient mental health evaluation, medication management, therapy and more.
TeleMed2U can provide therapy services to all CalOptima Health members 13 years and older and medication management services to members 5 years and older. Members can access these services by calling CalOptima Health’s Behavioral Health Line at 855-877-3885 or by directly dialing 562-268-0955.
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UCI Health Acquires Tenet Healthcare Facilities |
CalOptima Health received notification from the University of California, Irvine dba UCI Health that it has acquired six Tenet Healthcare hospitals and other affiliated entities as of March 27, 2024. These facilities are:
- Los Alamitos Medical Center Inc.
- Fountain Valley Regional Hospital & Medical Center
- Lakewood Reginal Medical Center Inc.
- Placentia-Linda Hospital Inc.
- Pacific Endoscopy and Surgery Center LLC
- First Choice Physician Partners, OCLA
CalOptima Health currently holds a contract with the following hospitals and entities:
- Los Alamitos Medical Center Inc.
- Fountain Valley Regional Hospital & Medical Center
- Placentia-Linda Hospital Inc.
- Pacific Endoscopy and Surgery Center LLC
- First Choice Physician Partners, OCLA
What does this mean for providers?
- Following this acquisition, providers can still refer patients to any of the three CalOptima Health-contracted Tenet hospitals (Los Alamitos Medical Center, Fountain Valley Regional Hospital & Medical Center and Placentia-Linda Hospital).
- Providers can still refer members to the same specialists who provide services at any of the three contracted Tenet hospitals.
- There is no impact on already scheduled procedures. UCI Health has agreed to honor all previously scheduled procedures.
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CalOptima Health has created this FAQ about the acquisition to help providers.
If providers have additional questions regarding the acquisition of these facilities by UCI Health, please contact your Provider Relations representative at 714-246-8600 or providerservicesinbox@caloptima.org.
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Provider Trainings Available for Mental Health Awareness Month |
For Mental Health Awareness Month in May, CalOptima Health is partnering with the Orange County Health Care Agency to host a series of mental health trainings.
All trainings will be held on-site at CalOptima Health, 505 City Parkway West, Orange, CA 92868. Providers, office staff and community-based organizations are encouraged to sign up for the following sessions:
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May 8, 9 a.m. to 4:30 p.m., Conference Room 108–109 — Adult Mental Health First Aid: This training covers how to help a person who may be experiencing a mental health-related crisis or problem.
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May 14, 9 a.m. to 3 p.m., Conference Room 107–108 — Youth Mental Health First Aid: This training covers how to help young people experiencing mental health challenges or crises.
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May 23, 10 a.m. to Noon, Conference Room 108–109 — Understanding Adverse Childhood Experiences (ACEs): This training covers how ACEs affect people’s lives and what we can do to improve health and resilience for present and future generations.
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Continuing Education Webinar to Cover Treatment of Heart Failure |
Providers are invited to learn about the topic of heart failure during a continuing education webinar on Wednesday, May 8 at Noon.
The 90-minute course will cover the definition, prevalence and causes of heart failure, along with its medical and surgical management. Providers can earn 1.5 continuing medical education and continuing education credits for attending.
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Virtual Lunch and Learn Training to Cover Mental Health Apps |
Providers can learn more about new mental health apps for children, teenagers and young adults during a virtual training on Tuesday, May 21 at Noon.
The 45-minute session will cover the Soluna and BrightLife Kids apps, launched in January 2024 as a collaboration between the Department of Health Care Services (DHCS) and developers Kooth and Brightline. Representatives from Kooth and Brightline will answer questions and explain how the free apps can improve mental health.
Providers interested in attending can join the webinar using this this link. To find out more about the Soluna and BrightLife Kids apps, please visit the CalHOPE website.
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Dementia Care Aware Continuing Education Class Coming in June |
CalOptima Health invites providers to a continuing education webinar on the basics of Dementia Care Aware on Wednesday, June 12 at Noon.
The 90-minute course will cover the cognitive health assessment for patients aged 65 years and older and how to identify early indicators of cognitive impairment. Providers can earn 1.5 continuing medical education and continuing education credits for attending.
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Help CalOptima Health Support Providers by Joining Advisory Committee |
CalOptima Health invites providers interested in shaping how the health plan serves both our members and health care partners to serve on our Provider Advisory Committee (PAC).
The PAC is a 15-member committee representing diverse provider constituencies, including health plans, hospitals, physicians, nurses, allied health professionals, long-term care services and community health centers. PAC members serve as liaisons to CalOptima Health’s Board of Directors and advise the Board and staff on provider issues. The committee meets every other month in conjunction with the Member Advisory Committee (MAC).
Service on the PAC is voluntary with no salary. All appointments to the committee are subject to Office of Inspector General/General Services Administration (OIG/GSA) verification and possible background checks.
If you are interested in serving on this committee, please visit our PAC page on our website to learn about current openings and download an application.
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Policies and Procedures Monthly Update |
Click on the link below to find an outline of changes made to CalOptima Health policies and procedures during March 2024. The full description of the policies below is available on CalOptima Health’s website at:
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Health Education: Trainings and Meetings |
Click below for training webinars and meetings happening in May 2024:
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- CalOptima Health Board of Directors: May 2 at 2 p.m.
- Joint Meeting of the Provider and Member Advisory Committees: June 13 at Noon
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Follow Us on Social Media |
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CalOptima Health regularly posts on social media to engage members with health tips, community resources, event dates, program updates and other pertinent information. Follow the agency on Facebook, Instagram, X and LinkedIn.
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CalOptima Health, A Public Agency www.caloptima.org
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