News
Provider Screening Enrollments
Date: 04/11/2018
This notification is a call to action regarding screening and enrollment of all Medi-Cal network providers based on All Plan Letter (APL) 17-019, which is available in full on the Department of Health Care Services (DHCS) website at www.dhcs.ca.gov/formsandpubs/Pages/AllPlanLetters.aspx.
In accordance with APL 17-019, effective January 1, 2018, Medi-Cal Managed Care Plans (MCPs) must either develop and implement a managed care provider screening and enrollment process or direct their network providers to enroll through the DHCS screening and enrollment process. To comply with this requirement, CHWP has opted to direct network participating providers to complete the DHCS screening and enrollment process, as described below.
To remain in Cenpatico’s Medi-Cal network, providers must apply for enrollment in Medi-Cal through DHCS as soon as possible but no later than 60 calendar days of receipt of this communication and must provide Cenpatico with official verification that enrollment has been received by DHCS. Submit verification by email to JOINCBHCA@centene.com or by fax to 1-855-463-4257
After the application has been submitted to DHCS, enrollment must be approved by DHCS within the DHCS required enrollment time frame to continue participation in CHWP’s state-sponsored program. CHWP must be able to confirm enrollment via the DHCS website. Enrollment in the DHCS Medi-Cal program does not affect the reimbursement terms of the Provider Participation Agreement (PPA). In addition, enrollment with DHCS is not an obligate to participate in Medi-Cal fee-for-service (FFS).
HOW TO APPLY
Most providers may register and enroll electronically by logging in to the DHCS Provider Application and Validation for Enrollment (PAVE) system portal at https://pave.dhcs.ca.gov/sso/login.do with a 40-day turnaround time for review and approval expected. Enrollment status can be tracked directly through the PAVE portal. PAVE technical
support is available at 1-866-252-1949, Monday through Friday, 8:00 a.m. to 6:00 p.m. Pacific time, except holidays. The following online resources are available for your reference:
· Available and upcoming PAVE implemented provider types www.dhcs.ca.gov/provgovpart/Documents/PAVE_Project_for_Provider_Enrollment_Division/PAVE-Implementation-Roll-Out-113017.pdf
· PAVE frequently asked questions (FAQs) www.dhcs.ca.gov/provgovpart/Documents/PAVE_Project_for_Provider_Enrollment_Division/PAVE_FAQ.pdf
If the PAVE system enrollment is not an option for your provider type at this time, DHCS application packages can be located by provider type on the DHCS website at www.dhcs.ca.gov/provgovpart/Pages/ApplicationPackagesAlphabeticalbyProviderType.aspx.
Providers may check the status of their non-PAVE enrollment on the California Health and Human Services Open Data Portal on the DHCS website at www.dhcs.ca.gov/provgovpart/Pages/ContactPED.aspx. Please submit your application within 60 calendar days of this notice as DHCS could take 120 days to review and approve your non-PAVE enrollment application.
CHWP requires that your enrollment with DHCS be approved by September 30, 2018. If CHWP cannot verify your enrollment by September 30, 2018, termination proceedings will begin in accordance with the terms of your PPA and impacted members will be informed of your termination from CHWP’s network.
For enrollment questions, contact the DHCS Provider Enrollment Message Center at
1-916-323-1945 or via email at PEDCorr@dhcs.ca.gov.
If you have questions regarding the information contained in this letter, contact Customer Service at 1-877-658-0305, or reach out to your Provider Relations or Contracting Representative.
Sincerely,
Carol Aroyan
Health Plan Development & Contracting Officer
California Health & Wellness