Provider memos

This page contains important memos for SCFHP providers. You will need Adobe Acrobat Reader to view these PDFs.

Memos by year

2023

May 31, 2023 - Video Remote Interpreting (VRI) Services for American Sign Language
May 25, 2023 - Invitation to the Diabetes Mellitus Documentation and Coding Webinar
May 11, 2023 - Quality Standard Requirements for Interpreting Services
April 20, 2023 - 2023 DualConnect Wellness Rewards Program
April 3, 2023 - Updated 2023 Medical Benefit Drug Prior Authorization Grid
March 29, 2023 - 3 - New Adult and Youth Behavioral Health Screening and Transition of Care Tools
March 29, 2023 - 2 - 2023 Medi-Cal Wellness Rewards Program for VHP, PMG, PAMF, & PCNC
March 29, 2023 - 1 - 2023 Medi-Cal Wellness Rewards Program
March 22, 2023 - Initial Health Appointment (IHA) effective January 1, 2023
March 15, 2023 - 2023 Provider Performance Program Guide now available online
March 13, 2023 - Department of Heath Care Services (DHCS) All Plan Letter (APL) 22-025
February 24, 2023 - SCFHP DualConnect (HMO D-SNP) Operational Reminders
February 21, 2023 - Invitation to the 2023 Continuing Medical Education (CME) & Dinner
February 15, 2023 - Kaiser Permanente Delegated for Long Term Care
February 10, 2023 - $200 Incentive for Completing Trauma Screening Training
February 7, 2023 - SCFHP DualConnect Part B vs Part D Vaccination Billing
February 2, 2023 - Available now, updated SCFHP Health Risk Assessment form
February 1, 2023 - Kaiser Permanente (KP) is delegated for CBAS Services effective January 1, 2023
January 27, 2023 - 2 - New 2023 SCFHP materials for Medi-Cal and DualConnect (HMO D-SNP) are now available online
January 27, 2023 - 1 - Santa Clara Family Health Plan members can now join YMCA of Silicon Valley at no cost
January 20, 2023 - Admissions, Discharge and Transfer (ADT) Data Files
January 10, 2023 - 2 - Annual Wellness Visit Incentive for Providers and SCFHP DualConnect Members
January 10, 2023 - 1 – Invitation to the Medicare Annual Wellness Visit Webinar
January 6, 2023 - Medical Review Process for CY2022 HEDIS
January 3, 2023 - 2 - New Community Supports Launching Jan. 2023
January 3, 2023 - 1 - New ECM Populations of Focus Launching Jan. 2023

2022

December 30, 2022 - Health Risk Assessment Requirement for New Authorization Requests
December 30, 2022 - 2023 Medical Benefit Drug Prior Authorization Grid
December 22, 2022 - Balance Billing Reminder
December 20, 2022 - Provider Performance Program updates for calendar year 2023
December 20, 2022 - APL 22-014 Electronic Visit Verification Implementation Requirements for Medi-Cal
December 15, 2022 - Updated Physicians Certification Statement (PCS) Form
December 2, 2022 - 2022 Provider Packet Education Training Invite for December 6, 2022
November 28, 2022 - New Claims Editing Software
November 22, 2022 - New APL 22-017 Facility Site Review and Medical Record Review
November 17, 2022 - Cal MediConnect to Dual Connect Transition Notices
November 17, 2022 - DSNP Contract Reminder
November 15, 2022 - After Hours Accessibility Survey
November 3, 2022 - Invitation to the 2022 Provider Packet Education & Dinner
November 2, 2022 - Diabetes Prevention Program (DPP) by YMCA
November 1, 2022 - All Plan Letter 22-015 policy: Enforcement Actions for Administrative and Monetary Sanctions
October 27, 2022 - Behavioral Health Provider interviews for the Student Behavioral Health Incentive Program (SBHIP)
October 20, 2022 - Billing update: Denied claims for ECM exceeding benefit limit
October 12, 2022 - Get Ready for Flu
September 23, 2022 - Provider Appointment Availability Survey (PAAS) Arriving Soon
August 25, 2022 - Long Term Care (LTC) benefits and services guidance update
August 15, 2022 - CBAS benefits and in-person services updates
August 9, 2022 - SCFHP D-SNP Medicare Medi-Cal Plan Enrollment Begins October 15
August 5, 2022 - Updated - 2022 Medical Benefit Drug Prior Authorization Grid
August 4, 2022 - Few updates for the following: Proposition 56 supplemental payment program, additional family planning codes, $200 trauma screening incentive, and end of Value Based Payments
August 1, 2022 - Revised Enhanced Care Management Flyer
August 1, 2022 - New Community Supports Available
July 28, 2022 - Invitation to participate in a provider satisfaction focus group or one-to-one virtual interview
July 15, 2022 - Information on 2022 Breathe California Summer Camps
July 5, 2022 - Administration of Long-Acting Injectable Antipsychotics
June 22, 2022 - SCFHP Direct, NEMS, regarding 2022 Medi-Cal & Cal Medi-Connect Wellness Rewards Program
June 22, 2022 - Valley Health Plan, PMG, PAMF, PCNC, regarding 2022 Medi-Cal & Cal Medi-Connect Wellness Rewards Program
June 16, 2022 - Availability of Health Education Resources for Members
May 27, 2022 - Updated IHA Technical Specifications
May 18, 2022 - New FSR & MRR - Effective July 1, 2022
May 11, 2022 - Provider Satisfaction Survey Extension! We want to hear from you: Take the Provider Satisfaction Survey by May 20, 2022
May 9, 2022 - Transitional Care Management with Medication Reconciliation for CM
May 6, 2022 - MC and DSNP Contracting
May 6, 2022 - Childhood Lead Screening
April 15, 2022 - SCFHP COVID-19 Vaccination Provider Incentive Program ending April 30, 2022
March 28, 2022 - ARPA and Post-Partum Care
March 21, 2022 - Collecting SDOH Data-Coding Tip Sheet
March 18, 2022 - Continuing Medical Education (CME)
March 15, 2022 - ECM and Community Supports Marketing Materials Requirement
February 7, 2022 - COVID-19 Safety - Temporary Substitution for Face-to-Face Enhanced Case Management and Community Supports Services
February 4, 2022 - New Clinical Diabetes Program for members with A1C greater than 9%
January 28, 2022 – Introducing the SCFHP COVID-19 Vaccination Provider Incentive Program: Earn $25 per completed outreach and $75 per vaccination gap closure
January 14, 2022 – California Advancing and Innovating Medi-Cal Implementations as of January 1, 2022
January 12, 2022 - 2 – HHP/WPC Members Transitioning to Community Supports Housing Navigation
January 12, 2022 - 1 – Provider Performance Program updates for the calendar year 2022

2021

December 17, 2021 - New payment system Payspan FAQ
December 2, 2021 - Enhanced Care Management - A New Medi-Cal benefit for high-risk beneficiaries
November 30, 2021 - Preparing for Medi-Cal Rx
November 10, 2021 - Action Required for Next Week’s Payment System Transition
October 21, 2021 - Importance of Transitional Care Management for Cal MediConnect Members
October 1, 2021 - 2 - Resume Initial Health Assessment Activities
October 1, 2021 - 1 - SCFHP's Healthy Moms, Healthy Babies Program
July 30, 2021 – New SNF reference guide
July 1, 2021 – 2021 Medical Benefit Drug Prior Authorization Grid
June 17, 2021 – Improving Medi-Cal Member-PCP Alignment, Changes to Auto-Assignment Timing
June 16, 2021 – Free ACEs webinars part 2
June 2, 2021 – Social Determinants of Health Survey - chance to win $100 gift card
May 25, 2021 – 2021 Medi-Cal Wellness Rewards Program
May 24, 2021 – Timely access to care standards
May 5, 2021 – 2021 Medi-Cal Healthy Moms, Healthy Babies Program
April 22, 2021 – APL 20-016 - Blood lead screening of young children and provider expectations
April 20, 2021 – New SCFHP Medi-Cal member ID card
April 13, 2021 – $150 incentive per AWV encounter in CY2021
April 8, 2021 – How providers, provider staff, and members can get COVID vaccinations
April 2, 2021 – Home health agency resource list for skilled nursing facility providers
March 12, 2021 – Free medical-grade personal protective equipment (PPE)
March 8, 2021 – $100 incentive for completing trauma screening training
March 4, 2021 – Incentive for completing certified ACE training
March 1, 2021 – Invitation to register for 2021 Provider Performance Program training in March
February 25, 2021 - 2 – Family therapy as treatment for Medi-Cal beneficiaries
February 25, 2021 - 1 – Free ACEs webinars
February 10, 2021 – Weekly COVID-19 positive case outreach
January 29, 2021 - 2 – HEDIS MY 2020 medical records retrieval
January 29, 2021 - 1 – 2021 Provider Performance Program Guide now available online
January 19, 2021 – Member rights and responsibilities reminder
January 13, 2021 – Read the latest Provider e-News
January 12, 2021 – Upcoming Department of Health Care Services (DHCS) audit

2020

December 18, 2020 – New Care Compare tool by CMS
December 14, 2020 – 2021 Provider Performance Program updates and new patient auto-assignment algorithm
December 11, 2020 – Read the latest Provider e-News
November 13, 2020 – Read the latest Provider e-News
November 6, 2020 – Long-term care discharge, hospice notification, and admission date requirements
November 3, 2020 – New video remote interpreting services for American Sign Language
October 29, 2021 - 2 – Phone system transition Friday night
October 29, 2020 - 1 – Billing guide for drugs, medical supplies, and durable medical equipment effective 1/1/2021
October 27, 2020 – Blood pressure monitor for SCFHP patients diagnosed with hypertension
October 26, 2021 - 2 – Preventive medical care via telehealth and in-person visits
October 26, 2020 - 1 – Get $100 for completing certified ACE training
October 16, 2020 – Read the latest Provider e-News
October 8, 2020 – Register for the Medi-Cal Rx web portal
September 22, 2020 – Get ready for flu
September 11, 2020 – Read the latest Provider e-News
August 31, 2020 – Medi-Cal members with other health coverage (Medi-Cal as secondary payor)
August 14, 2020 – Billing skilled nursing facility claims requirements and reminders
August 4, 2020 – Read the latest Provider e-News
August 3, 2020 – Temporary rate increase for skilled nursing facility claims
July 31, 2020 – Quality standard requirements for interpreting services
July 28, 2020 – Relief funds available for Medi-Cal providers
July 23, 2020 – Weekly COVID-19 positive case calls to skilled nursing facilities
July 16, 2020 – Incentive for completing certified ACE training
July 15, 2020 – Behavioral health guidance from the Department of Health Care Services
July 9, 2020 – Read the latest Provider e-News
June 26, 2020 – Catch up on missed/rescheduled well-child/well-care visits
June 23, 2020 - 2 – Timely access to care standards
June 23, 2020 - 1 – Home health agency resource list for skilled nursing facility providers
June 5, 2020 – End-date for payment add-on for COVID-19 patients in LTC/custodial stays
June 2, 2020 – Read the latest Provider e-News
June 1, 2020 – Prioritizing childhood immunization visits amidst COVID-19
May 14, 2020 – New billing process for Medicare crossover claims through COBA
May 11, 2020 – Read the latest SCFHP Provider e-News
May 8, 2020 – Payment add-on for COVID-19 patients in LTC/custodial stays (COVID-19 authorization requests)
April 29, 2020 – Updates related to COVID-19 adjustments
April 20, 2020 – Facility authorization covers SNF primary care and podiatry services
April 17, 2020 – Temporary alternative services (TAS) and plan of operation
April 9, 2020 – COVID-19 guidance from Santa Clara County
April 8, 2020 – CBAS services and activities during the COVID-19 public health emergency
April 6, 2020 – Facility authorization covers SNF primary care and podiatry services
March 31, 2020 – Suspension of prior authorization requests extended until April 30, 2020
March 27, 2020 – Reimbursement for telehealth & virtual care for Medi-Cal & Cal MediConnect
March 20, 2020 – Reimbursement for telehealth services
March 19, 2020 – Prior Authorization requests suspended until March 31, 2020
March 9, 2020 – Updates and reminders regarding the Novel Coronavirus (COVID-19)
February 28, 2020 – HEDIS 2020 Medical Records Retrieval
February 10, 2020 – Updated Prior Authorization Request Form for Medical Services
February 6, 2020 – Read the latest SCFHP Provider e-News
January 15, 2020 – Reminder: Medication Reconciliation Post Hospitalization

2019

December 31, 2019 – 2020 Prior Authorization Grids
December 2, 2019 – Read the latest SCFHP Provider eNews
November 4, 2019 – New Decoding Billing: Developmental Screening in the First Three Years of Life (DEV-CH) now available as a resource to providers
October 9, 2019 – Prior Authorization Submission During PG&E Power Outage
October 3, 2019 - Santa Clara Family Health Plan (SCFHP) Is Rolling Out IVR System Enhancements
October 1, 2019 – Read the latest SCFHP Provider eNews
September 27, 2019 – Healthy Kids Members Transition to Medi-Cal and Healthy Kids Program Closes
September 25, 2019 – New Initial Health Assessment Codes and Resources Available to Providers
September 20, 2019 - 2 – Opioid Safety Point-of-Sale Edits for Medi-Cal
September 20, 2019 - 1 – Medi-Cal Formulary Changes: Added Fluticasone/Salmeterol and Removed Symbicort
August 05, 2019 – Authorization Line - Fax Line Outage
July 26, 2019 – Durable Medical Equipment Transitions
July 18, 2019 – Introducing SCFHP Wellness Rewards
July 17, 2019 - 3 – Read the latest SCFHP Provider eNews
July 17, 2019 - 2 – Requirement to include NDC codes in Claims and Encounter Submissions
July 17, 2019 - 1 – Termination of Optum EFT/ERA Services
July 1, 2019 – Health Homes Program – A New Benefit for High Risk SCFHP Medi-Cal Members
June 7, 2019—SCFHP Sponsors YMCA Summer Day Camp
May 2, 2019—Read the latest SCFHP Provider e-News
May 1, 2019 - 2—Timely Access to Care Standards
May 1, 2019 - 1—Provider Appointment Availability Survey (PAAS) Arriving Soon
March 28, 2019—Implementation of New CBAS Individual Plan of Care (IPC) Form
March 18, 2019—Update on AB 1629 Long-Term Retro Claims Adjustments
March 15, 2019—Updated 2019 Prior Authorization Requirements
February 22, 2019—Read the latest issue of our Provider eNews
February 19, 2019—Updated Initial Health Assessment Billing Codes and Requirements
February 6, 2019—HEDIS 2019 Medical Records Requests Arriving Soon
January 17, 2019—Updated SCFHP/Valley Health Plan Responsibility—Long-Term Care Member
January 2, 2019—SCFHP/Valley Health Plan Responsibility—Long-Term Care Member Update

2018

December 27, 2018—2019 Prior Authorization Grids
December 10, 2018—Opioid Safety Point-of-Sale Edits for Cal MediConnect
November 20, 2018—Read the latest issue of our Provider eNews
November 8, 2018—CBAS H2000 Authorizations
October 22, 2018—New Member Incentive Program—Microalbumin Urine Test for Diabetics
October 4, 2018—New Member Incentive Program—Vaccines for Children by Age 2
October 1, 2018—Update on AB1629 Long-Term Care Retro Claims Adjustments
September 12, 2018—Signatures Required on Physician Orders
September 11, 2018—SCFHP Provider Dispute Process
August 31, 2018—Physician Signatures required on Care Plans and Physician Orders
August 22, 2018—CHME Community Liaisons available to assist members with DME Needs
August 17, 2018—New SCFHP Member ID Cards Issued
August 16, 2018—New Long-Term Care Authorization Form
August 15, 2018—Cal MediConnect Vaccination Billing Information
July 30, 2018—Notification of UM Fax Disruption
July 25, 2018—SCFHP Change of Business and Mailing Address
July 12, 2018—SCFHP Medical Records Requests from Verscend Technologies
July 3, 2018—Read the latest issue of our Provider eNews
June 14, 2018—Medi-Cal and Healthy Kids Formulary Changes
June 13, 2018—Provider Appointment Availability Survey
May 18, 2018—SNF Bed Availability Weekly Reporting (Revised)
May 2, 2018—Read the latest issue of our Provider eNews
May 1, 2018—IHA Billing Codes and Requirements
February 28, 2018—Read the first issue of this year's Provider eNews
February 12, 2018—HEDIS Medical Records Request Season
February 6, 2018—Proposition 56 Provider Payments
February 2, 2018—Procedural Changes for LTC Prior Authorization Requests
January 30, 2018—Process for Issuing NOMNC to Members—Skilled Nursing Facilities
January 5, 2018—SCFHP Provider Portal Update

2017

December 21, 2017 – 2018 Prior Authorization Grid
December 8, 2017 – Mandatory Revised Drug Prior Auth Form—Medi-Cal and Healthy Kids
December 7, 2017 - Bed Availability Weekly Reporting—Skilled Nursing Facilities (Revised)
November 14, 2017 – Read the final issue of this year's Provider eNews
November 13, 2017 – When Antibiotics Are Not the Answer
November 10, 2017 - Medi-Cal and Cal MediConnect Transportation Benefits Changes
September 13, 2017 – Read the fourth issue of the Provider eNews
September 12, 2017 – Provider Preventable Conditions: New DHCS Requirements
September 1, 2017 – Guidelines for LTC Nursing Facility Claims Submission
July 31, 2017 – SCFHP Launches New Provider Portal
July 24, 2017 – Critical Incident Reporting for MLTSS Providers
July 19, 2017 – SCFHP Partners with Advance Health for CMC Member Assessments
July 12, 2017 - 2 – Medi-Cal and Healthy Kids Formulary Changes
July 12, 2017 - 1 – Read the third issue of Provider eNews, a newsletter for you
June 30, 2017 – CMC Vaccination Billing
June 29, 2017 – News Claims Platform for Medi-Cal and Healthy Kids
June 28, 2017 – Fax Machine Date/Time Setting
June 21, 2017 – New Long-Term Care Discharge Notification Form—Skilled Nursing Facilities
June 20, 2017 – CHDP Claims Conversion
June 19, 2017 – Payment Methods for Providers
June 7, 2017 - 2 – Bed Availability Weekly Reporting—Skilled Nursing Facilities
June 7, 2017 - 1 – Request for Inter-facility Transfer/Discharge Forms—Skilled Nursing Facilities
May 24, 2017 – AB1629 Long-Term Care Claims—Retroactive Update for 2015-2016
May 17, 2017 – Read the second issue of Provider eNews, a newsletter for providers
March 8, 2017 - SCFHP launches Provider eNews, a newsletter for providers
March 7, 2017 – Payments Disputes & Claims Submission
February 14, 2017 – Specialty Pharmacy Change for Medi-Cal and Healthy Kids
February 13, 2017 – SCFHP DHCS Audit
February 1, 2017 – SCFHP Celebrates 20th Anniversary

2016

December 30, 2016 - 2—2017 Prior Authorization Grid for Medi-Cal and Healthy Kids
December 30, 2016 - 1—2017 Prior Authorization Grid for Cal MediConnect
November 16, 2016—Medicare Sequestration and Medi-Cal AB1629
November 15, 2016—Updated SCFHP Cultural Competency Toolkit
November 4, 2016—New Payment Methods for Providers
October 20, 2016—Timely Access to Non-Emergency Health Care Services
October 13, 2016—OTC Cough and Cold Formulary Exclusion
September 12, 2016—Important Information for Physicians Regarding Timely Access Regulations & Upcoming Surveys
July 15, 2016 - 2—Illegal Balance Billing
July 15, 2016 - 1—Electronic Billing Guidelines
July 1, 2016—Medical Transportation Code Conversion
May 13, 2016—Medi-Cal Expands to Cover Undocumented Children
April 26, 2016—Changes to Prior Authorization Requirements—Effective 5/1/16
January 27, 2016—New 'Find a Doctor' Tool Available at www.scfhp.com
January 19, 2016—Prior Authorization Process and Turnaround Times

2015

December 15, 2015—CMS to enforce Medicare prescriber enrollment requirement: Enroll today!
October 14, 2015—O'Connor Hospital Services Agreement
August 24, 2015—ICD-10 Impact on Authorizations and Claims Payments
July 16, 2015—New Emdeon Web Portal for Cal MediConnect Claims
July 6, 2015—St. Louise Hospital Services Agreement
June 30, 2015—Implementation of Second Phase of National Correct Coding Initiative
June 26, 2015—Update to PCP Auto Assignment and ID Card Processes
June 23, 2015—Audiologist for Skilled Nursing Facilities
June 3, 2015 - 2—Contracted Home Health Agencies
June 3, 2015 - 1—Prior Authorization Guidelines for Behavioral Health Treatment (BHT) Coverage for Children Diagnosed with Autism Spectrum Disorder
May 11, 2015—Medical Transportation Code Conversion
April 20, 2015 - 2—DME Provider Update—Delegated Networks
April 20, 2015 - 1—DME Provider Update—Contracted Providers
March 30, 2015—Notice of Medicare Non-Coverage Requirements, Process, and Timeline—Skilled Nursing Facilities
March 5, 2015—Important Information for Physicians Regarding Timely Access Regulations
March 3, 2015—SBIRT Training Sessions
February 27, 2015—Sign Up for Cal MediConnect Provider Webinars
February 23, 2015—Prior Authorization Process, Turnaround Times for SNF Notification
February 19, 2015—Weekly Therapy Updates—Skilled Nursing Facilities
January 29, 2015—Podiatric and Chiropractic Services at Federally Qualified Health Centers and Rural Health Clinics
January 5, 2015—Clarification on Medi-Cal Billing

2014

December 30, 2014—Cal MediConnect Effective January 1, 2015
December 18, 2014—Medical Records Standards
December 9, 2014—Universal Pharmacy Prior Authorization (PA) Form per Senate Bill (SB) 866
November 26, 2014—Important Information about Cal MediConnect Program
November 21, 2014—Timely Filing Limits for Claims - Delegate Medical Groups and Health Plans
November 18, 2014 - 2—New Medi-Cal Language Thresholds—Delegated Medical Groups
November 18, 2014 - 1—New Medi-Cal Language Thresholds—Delegated Health Plans
November 17, 2014—SCFHP Transition to Abbott Test Strips and Meters
November 12, 2014—NEW Minimum Requirements for Comprehensive Tobacco Cessation Services—Effective 11/1/14
October 29, 2014—Change to Timely Filing Limits for Claims
October 27, 2014—Sign up for Cal MediConnect Provider Webinars
October 16, 2014—Influenza Vaccine Rates for the 2014–2015 Season
September 24, 2014—Affordable Care Act (ACA) Payments
September 10, 2014—Interim Policy for the Provision of Behavioral Health Treatment (BHT) Coverage for Children Diagnosed with Autism Spectrum Disorder
August 8, 2014—Important message from CDPH Director on PERTUSSIS