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COMMUNITY HEALTH PLAN

1.

Forwards appropriate upload file to L.A.Care and MRMIB, and updates the PMS and provider network databases.

2.

Produces reports of all CHP providers at the beginning of each month. Reports to be produced include: 1) Primary Care Providers listed by IPA/Medical Group/DHS Facility; 2) Primary Care Providers listed alphabetically; 3) Supplemental report summarizing all changes to the CHP provider network listed by IPA/Medical Group/DHS Facility and includes a description of all changes made (i.e., from/to); 4) Specialty Care Providers listed by IPA/Medical Group/DHS Facility; 5) Specialty Care Providers listed alphabetically; 6) Supplemental report summarizing all changes to the CHP Specialty Care Provider network listed by IPA/Medical Group/DHS Facility and includes a description of all changes made (i.e., from/to); 7) Alphabetical listing by

Affiliated Hospital by PCP Name; and 8) Supplemental report summarizing all changes to the CHP provider network listed by affiliated hospital by PCP name and includes a description of all changes made (i.e., from/to).

3.

Forwards reports to Provider Relations for distribution and an electronic file to Alert Communications.

1.

Sends a copy of the above reports No. 1, No. 3, No. 7, and No. 8 to the DHS Facility/Contract Liaison for each IPA/Medical Group/ DHS Facility.

2.

Sends a copy of the above reports No. 4 and No. 6 to DHS Facilities that provide specialty care and IPA/Medical Groups that have a full-risk contract with CHP.

INFORMATION SYSTEMS

INFORMATION SYSTEMS

PROVIDER RELATIONS

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