Welcome to California Health & Wellness. We thank you for being part of our network of participating physicians, hospitals and other healthcare professionals.
At California Health & Wellness, we recognize the important role healthcare providers play in ensuring member access to high quality services. We are dedicated to providing resources and support for you, when and how you need it. We invite you to participate in our webinars to learn more about California Health & Wellness and trending healthcare topics. Please check this page often as our webinar schedule is updated regularly. If you have any questions, please contact your Provider Relations Representative or call Provider Services at 1-877-658-0305.
Provider Webinar: Medi-Cal Rx Prior Authorization Reinstatement
Watch this webinar to learn about Medi-Cal Rx reinstatement of prior authorization for several drug classes. No registration is needed. View a prerecorded webinar if you can’t attend the live version.
- Prerecorded webinar – On-demand, 13 minutes in length
- Live webinar – September 23, 2022, noon–1:00 p.m.
For more information about the reinstatement, go to Provider News to access provider update 22-709m, Find Out What Changed: Reinstatement of Prior Authorizations for Several Drug Classes Under Medi-Cal Rx, distributed on August 31, 2022.
This webinar shares the quick and convenient ways that PCPs use eConsults, a no-cost specialty care resource that California Health & Wellness offers to providers serving Medi-Cal members. Learn about eConsults, which are digital dialogues between PCPs and CA-licensed specialists to provide rapid support to the PCP. Our eConsult Provider, ConferMED, uses native referral workflows and has a network of 30+ adult and pediatric specialties available to share expertise to enhance member care.
Diabetes Prevention Program (DPP)
DPP is an evidence-based, lifestyle change program that promotes and focuses on emphasizing weight loss through exercise, healthy eating and behavior modification. The program is designed to assist Medi-Cal beneficiaries diagnosed with prediabetes in preventing or delaying the onset of type 2 diabetes.
Watch recording: Diabetes Prevention Program (duration: 13 min.)
Facility Site and Medical Record Review Training
California Collaborative Site Review Training workgroup is comprised of 22 Medi-Cal plans in California that have come together to create one comprehensive training to educate Our Primary Care Network providers. This training has been mandated by the Department of Health Care Services (DHCS) as directed through All Plan Letter (APL) 20-006. the updated standards to take affect as soon as the Public Health Emergency defined by Governor Newsom has been lifted for California. These revised Tools and Standards are in response to the growing number of Preventative measures set forth from a multitude of organizations such as the CDC, USPSTF, OSHA, AAP to name a few.
These trainings comprise of a Facility portion and a Medical Records portion. Our goal is to update these training videos as our industry changes. DHCS has made it their mission to revise these tools about every 2 years to aid in the health of California’s Medi-Cal recipients and provide the highest quality of service.
HEDIS Improvement Program (HIP)
HIP recognizes and rewards open-panel and participating PCPs and clinics for their improvement in quality outcomes. The improvement measures are derived from the Managed Care Accountability Set (MCAS) from the Department of Health Care Services (DHCS).
We invite you to participate in one of our webinars to learn more about California Health & Wellness. For your convenience, we will offer the webinar multiple times. Some of the topics that will be covered include:
- Benefits Explanation
- Billing and Claims Submission
- Medical Management Processes
- California Children's Services (CCS)
- Grievances and Appeals Process
- And much more
CalAIM Provider Training
CalAIM (California Advancing and Innovating Medi-Cal) is a multi-year initiative by DHCS to improve the quality of life and health outcomes of our population by implementing broad delivery system, program and payment reform across the Medi-Cal program.
We have developed a thorough optional training program designed to ensure the successful deployment of CalAIM. The trainings includes the following topic:
- General managed care 101 overview and how it impacts CalAIM
- Member engagement and data sharing process with our plan for Enhanced Care Management (ECM)
- Referrals, Authorization, and Claims process for ECM and Community Supports (CS)
- And more
Enhanced Care Management
- ECM Member Engagement and Data Sharing Overview (recording)
- ECM Data Exchange Files Review (recording)
- Referrals and Auths Guidance for ECM Providers (recording)
- Claims and Invoice Guidance for ECM Providers (recording)
- findhelp walkthrough for ECM Providers (recording)
- Medi-Cal New Provider Resources
During this session, our SMEs will be available to answer questions you have on:
- Signing up for sFTP and sFTP troubleshooting
- Member Information File
- Return Transmission File
- Outreach Tracker File
Join the CalAIM Provider Training webinar here
Office Hour Schedule
- July 6, 2022 11:30 a.m.
- August 5, 2022 11:30 a.m.
- September 6, 2022 11:30 a.m.
- October 6, 2022 11:30 a.m.
- November 4, 2022 11:30 a.m.
- December 6, 2022 11:30 a.m.
- January 6, 2023 11:30 a.m.
- February 6, 2023 11:30 a.m.
- March 6, 2023 11:30 a.m.
findhelp and CalAIM
California Health & Wellness expanded our partnership with findhelp, formerly known as Aunt Bertha, to support our CalAIM work for members and Community Supports (CS) providers. The platform will help increase the visibility of CS program and creates an efficiency for Enhanced Care Management (ECM) providers to search directly for no-cost or low-cost CS programs to support members with social determinants of health needs. The platform makes it easy to use when referring members to CS providers and closing the loop on referrals.
Watch recording: findhelp and CalAIM (duration: 35 minutes)
Clinical Provider Trainings
California Health & Wellness network providers and their stakeholders have access to take part in free specialized behavioral health clinical trainings. Providers interested in training may register for training here.
Available training topics include but are not limited to the following:
- Evidence-based practices, promising practices and emerging best practices
- Cultural Competency
- Suicide Risk and Assessment
- Integrated physical and behavioral health
- Substance Related and Addictive Disorders overviews
- Strengths Based Treatment
- Mental Health First Aid for Youth and Adults
- Provider Screening tools for screening behavioral health symptoms
- For continuing training on behavioral health and substance use, please refer to this Training and Education Course Catalog (PDF). The courses cover several behavioral health and substance use topics, across multiple age groups and populations.