Updates
Provider Updates are published when we need to communicate any important health plan information to our Providers.
If you would like a printed copy of our most current issues or if you need assistance, please use our online Contact Us form.
VHP Access - The New Provider Portal Is Now Live
VHP Access, the new provider portal is live. See trainings and quick start guides on the VHP Access provider portal page.
As a VHP network provider, how does this benefit you?
Through VHP Access, you will be able to:
- Submit prior authorization requests
- Verify health coverage and benefits information
- Submit and view claims
- Receive status notifications regarding claims and authorizations
If you have any questions, please contact VHP Provider Relations at 408-885-2221 or email: [email protected].
Timely Access MY2022 Provider Survey Results
Below are links to the following 2022 Provider and Practitioner Survey Reports:
MY2022 Provider Satisfaction Summary Report
MY2022 Practitioner After-Hours Summary Report
MY2022 Provider Appointment and Availability Summary Report
Access To Care Health Disparities Report
To better inform future quality improvement efforts, VHP seeks to identify if there is a health disparity represented by the regulatory survey results in order to understand the respondent's perception of their barriers to accessing health services by race/ethnicity.
Assess Disparities CAHPS QHP RE Provider Publication
AAAHC Survey Notice
Valley Health Plan (VHP) will be undergoing a re-accreditation survey by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) on July 11-13th, 2023 for all Commercial Lines of Business. This survey is conducted on a three-year cycle to ensure the health plan continues to provide quality services to its members in alignment with AAAHC's national standards of care. All interested individuals holding pertinent and valid information about the organization’s compliance with AAAHC standards may request a presentation with AAAHC surveyors or may communicate such information in writing or by telephone to AAAHC for consideration. Any additional information can also be provided and discussed with the Valley Health Plan Accreditation Director, Carley Flores at [email protected]
Public Notice of AAAHC 2023 Reaccreditation Survey
CAHPS/QHP Progress
Valley Health Plan contracted with SPH Analytics an NCQA certified vendor to field the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for Commercial Members and Qualified Health Plan (QHP) member experience survey for Covered California members.
Click here for more information
Get Certified for Adverse Childhood Events (ACEs)
California is leading the way to screen for Adverse Childhood Events (ACEs) that impact health and well-being. VHP will reimburse for ACE screening. ACEs Aware (https://www.acesaware.org/learn-about-screening/training/) provides free training and a link to Medi-Cal attestation. Training and certification is strongly encouraged for all providers for proper reimbursement.
Medi-Cal codes: Commercial codes:
HCPCS: G9919 99420
HCPCS: G9920 96161
VHP will reimburse for ACEs for all VHP members. Get trained and certified now!
Every Visit is an Opportunity to Recommend the Flu Shot
Now that flu season is here, it’s more important than ever to recommend the flu vaccine to your patients. VHP is endorsing the *SHARE method as an effective way to communicate with patients about the flu shot during every encounter.
- Share the reasons: avoid getting sick, hospitalization and even death from the flu virus (for some)
- Highlight positive experiences: spending time with friends and family, enjoying your favorite hobbies, feeling healthier
- Address patient questions: Is the flu shot safe? Can I get the flu shot at the same time as my COVID-19 booster?
- Remind patients that flu shots help protect them and their loved ones: especially older adults, children and those with health issues
- Explain the potential costs of getting influenza: getting ill for 1-2 weeks, missing work and activities
*SHARE method – Centers for Disease Control and Prevention (CDC)
Thank you in advance for sharing this information with your patients.
Behavioral Health Update – Effective January 1, 2022
Outpatient visits with VHP in-network contracted psychiatrists do not require prior authorization as of January 1, 2022. Please note: Stanford and LPCH require prior authorization as out-of-network quaternary providers.
Provider Update - Effective September 2021
AAAHC Accreditation Survey
Valley Health Plan (VHP) will be undergoing a re-accreditation survey by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC) on October 26-28th, 2021 for all Commercial Lines of Business. This survey is conducted on a three-year cycle to ensure the health plan continues to provide quality services to its members in alignment with AAAHC's national standards of care. All interested individuals holding pertinent and valid information about the organization’s compliance with AAAHC standards may request a presentation with AAAHC surveyors or may communicate such information in writing or by telephone to AAAHC for consideration. Any additional information can also be provided and discussed with the Valley Health Plan Accreditation Director, Carley Flores at [email protected]
Public Notice Posting - AAAHC Re-Accreditation Survey 2021
Acupuncture/Chiropractic Benefits Update – Effective 8/1/21
Click here for more information
MY2020 Provider Survey Results - Issued April 15, 2020
Below are links to the following 2020 Provider and Practitioner Survey Reports:
MY2020 Provider Satisfaction Summary Report
MY2020 Practitioner After-Hours Summary Report
MY2020 Provider Appointment and Availability Summary Report
CAHPS/QHP Progress
Valley Health Plan contracted with SPH Analytics an NCQA certified vendor to field the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for Commercial and Qualified Health Plan (QHP) survey for Exchange plans.
Click here for more information
How to Bill for Blood Lead Screening Given to Medi-Cal Recipients
Information on when to perform periodic health assessments on children and how to bill for Blood Lead Screening
Click here for more information
COVID-19 Vaccine Update for VHP's Covered California, Individual & Family Plans, and Commercial Employer Group
This Provider Update includes important information about the rapidly evolving news regarding the COVID-19 vaccines’ availability, the individuals prioritized in each phase to receive it, and the steps VHP is taking to help you process vaccine-related reimbursement claims.
Click here for more information
How the Quality Management (QM) Team is Working for You
The Quality Management program is centered on Valley Health Plan’s (VHP) vision and mission. The scope and content of the quality program represent the entire VHP delivery system. The team’s monitoring and evaluation activities involve a planned, systematic, and ongoing process to improve the quality of care, and service members receive.
Click here for more information
Non-Contracted Provider Reimbursement Policy
Commencing October 1, 2021, non-contracted provider claims are paid in accordance with VHP's Non-Contracted Provider Reimbursement Policy set forth below. Click below for more policy and regulation information.
Provider Reimbursement Policies and Procedures Operating Manual 2022
COVID-19 Related Updates and Guidance
-
COVID-19 Vaccine Update for VHP's Covered California, Individual & Family Plans and Employer Group Classic and Preferred Plans. Issued 12/11/2020
- VHP directive and instructions for telephone and telehealth (video-enabled) patient care during Coronavirus (COVID-19) health emergency. Issued 04/13/2020
- Coronavirus (COVID-19) Guidance for Providers gives information on how VHP is directing Providers to handle possible Coronavirus (COVID-19) cases. Issued 03/12/2020
- DHCS Guidance related to the COVID-19 Emergency. Issued on 04/03/2020