Chinese Community Health Plan
Chinese Community Health Plan announced on May 10th that the Chinese Community Health Care Association of doctors will no longer accept Chinese Community Health Plan insurance as of July 21, 2016. Chinese Community Health Care Association (CCHCA) is a non-profit association of doctors serving the San Francisco region since 1982. According to Chinese Community Health Plan, CCHCA’s exit out of health plan affects individual and family plans (including Covered California), small group plans and their Medicare Advantage plans. The Chinese Community Health Plan provider search tool lists approximately 325 doctors associated with CCHCA.
The Chinese Hospital will still be a network provider for Chinese Community Health Plan (CCHP) members. Hill Physicians Group, with approximately 505 doctors, will still be a network provider. If a plan member is currently undergoing treatment with a CCHCA physician they can file a continuity care request to maintain that relationship until their treatment has finished.
If you have an individual and family plan through Covered California you may be eligible for a Special Enrollment Period to change health plans because your doctor left the provider network.
Your provider left the health plan network while you were receiving care for one of the following conditions:
– Pregnancy.
– Terminal illness.
– An acute condition.
– A serious chronic condition.
– The care of a newborn child between birth and age 36 months.
– A surgery or other procedure that will occur within 180 days of the termination or start date.
From the CCHP website-
Continuity of Care
How to Request Continuity of Care
Keeping your doctor/patient relationship is important. When a Primary Care Physician( PCP) or specialist resigns or is terminated from the medical group, the plan will notify the Member in writing to assist the Member in transitioning care to another medical group physician. If the contract between The Plan a provider group or an acute care hospital terminates, the plan will also notify the affected Members. Members who contact CCHP to request continued Care from a terminated provider will be sent a Continuity of Care request packet by the Member Services Center. The packet includes a Continuity of Care request form. Members must submit a Continuity of Care request form and related documents to the Utilization Review/Care Management Department (attn: UM Director) within 30 calendar days (however, an exception to this 30-day deadline will be made for good cause) of:
- The terminated provider’s effective date of termination, or
- The newly enrolled Member’s effective date of coverage with the plan.
Utilization review is a process that monitors the use of a comprehensive set of integrated components including: pre-certification review, admission review, continued stay review, retrospective review, discharge planning, and individual medical case management as required to determine medical necessity.
For complete information, click here
Continuity of Care request form for Chinese Community Health Plan.
| Platforms: | Windows 8 |
| Category: | Chinese Community Health Plan |
| License: | Freeware |
| Date: | May 11, 2016 |
Chinese Community Health Plan announcement
Your CCHP Covered California members may have received a letter from us informing them about a change to one of our physician groups.
Effective July 21, 2016 Chinese Community Health Care Association (CCHCA) the medical group will no longer accept CCHP coverage. CCHCA’s new management has decided to terminate our 30-year relationship. They have not stated their reason. This means doctors working under the CCHCA medical group will not be allowed to continue to see CCHP members.
This termination does not impact the CCHP network of hospitals, only physician services provider under CCHCA. We will continue to have an adequate network in place after the termination of CCHCA becomes effective.
You can rest assured that CCHP continues to have a sufficient network of providers to serve our members. You may already know, we have added Hill Physicians Medical Group (HPMG), the largest medical group in the Bay Area. Some of your clients’ PCP may already be with HPMG, in which case they don’t have to do anything.
If you hear from your Covered California clients about this notice and want to change PCPs, please direct your client to CCHP’s member service center at 1-888-775-7888. Staff have been trained on how to handle this and have the latest information on their PCPs.