The Alliance is committed to growing our network of talented doulas and increasing member access to essential birth support services. This scholarship program is designed to help doulas further their education and training and/or invest in resources to enhance their services. For more information regarding the scholarship program, please click here.

The California Department of Health Care Services (DHCS) covers certain drug classifications carved out from Medi-Cal Managed Care Plans (MCP), including the Alliance. Carved-out drugs must be billed to FFS Medi-Cal. For more information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We have important information to share with you. We previously announced the Alliance is working to launch a new Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) on Thursday, January 1, 2026. Contracting with providers for D-SNP as soon as possible is a vital component of preparing for this launch. For more information regarding this update, please click here.

Effective Sunday, December 1, 2024, the Alliance will upgrade to the 28th edition of the Milliman Care Guidelines (MCG) to learn more about the modules that have been updated, please click here.

We have an important announcement regarding a change in the turnaround time for decisions on inpatient concurrent review. Starting Friday, November 1, 2024, the Alliance will notify providers of decisions within 72 hours of receiving a request with necessary clinical information. To learn more about this change, please click here.

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community. We have important information that we want to share with you regarding Doula services and recommendation form. For more information regarding this update, please click here.

The Alliance is pleased to cover the flu shot for eligible Alliance Group Care and Medi-Cal members. Eligible Alliance members can get a flu shot if supplies are available at your office. For more information regarding this update, please click here. 

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We have an important update about Targeted Rate Increases (TRI) billing that we are sharing with you. For services rendered on or after Monday, January 1, 2024, the Alliance will comply with the TRI minimum fee schedule guidelines per All Plan Letter (APL) 24-007, published by the California Department of Health Care Services (DHCS) on Thursday, June 20, 2024. For more information regarding this update, please click here.

This communication provides an update on the Child Health and Disability Prevention (CHDP) Program Transition starting Monday, July 1, 2024. For more information regarding this update, please click here.

This communication provides an update on Utilization Management (UM) Medications (physician-administered drugs, PAD) codes that require prior authorization for in-network providers. For more information regarding this update, please click here.

To help ensure our members receive timely access to care and to remain compliant with the California Department of Health Care Services (DHCS), we require certain documents to perform our medical necessity review. For more information regarding this update, please click here.

Alameda Alliance for Health (Alliance) providers and their staff are welcome to join us for a virtual townhall to discuss building and sustaining a quality infrastructure in your clinic. For more information regarding this virtual townhall, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We are sharing urgent information regarding the global Microsoft 365 application outage created by the CrowdStrike disruptions. For more information regarding this update, please click here.

We are excited to let you know the Alliance will launch a new Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) on Thursday, January 1, 2026. For more information regarding this update, please click here.

The California Department of Healthcare Services (DHCS) recently enacted the targeted rate increase (TRI) fee schedule through State Plan Amendment (SPA) 23-0035. For more information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We have an important reminder regarding our DME and supplies vendor. For more information regarding this update, please click here.

QMetrics on behalf of the Alliance will administer the Provider Appointment Availability Survey (PAAS) on an annual basis. All health plans in California are required to survey providers to assess the availability of routine and urgent appointments. For more information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We are sharing this information to invite our contracted Internal Medicine or Family Practice Physicians or psychiatrists to join our Peer Review and Credentialing Committee (PRCC). To learn more about this important committee for our community, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. Welcome to a new HEDIS measurement year 2024! As we plan for another successful year, we want to share a brief reminder on the measures we track and recommendations for focused timing. For more information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We have an important reminder that we would like to share with you. To help ensure the safety of our members and compliance with the California Department of Health Care Services (DHCS) California Advancing and Innovating Medi-Cal (CalAIM) Population Health Management Policy Guide, all members must receive transitional care services when moving from one setting or level of care to another. For more information regarding this update, please click here.

Our provider partner satisfaction is a top priority. We are working to improve our Utilization Management and Claims processes to help ensure proper claim payment to our provider partners, and alignment of authorized services. To accomplish this goal, we are reviewing each benefit and we will be sending you updates, as the information is ready to share. This communication provides an update on Utilization Management (UM) Medications (physician-administered medications) codes that require prior authorization, effective Monday, June 3, 2024.

For more information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our provider partner community and appreciates all your hard work to protect the health and well-being of our members. We have an important update that we would like to share with you. Starting Monday, July 1, 2024, Alliance Medi-Cal members who require Continuous Glucose Monitoring (CGM) devices and supplies will need a prior authorization (PA) from Medi-Cal Rx.

For more information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We are sharing urgent information regarding a potential network interruption for Change Healthcare claims submissions. On Wednesday, February 21, 2024, the Alliance received notification that our vendor, Change Healthcare experienced a cyber security attack. We took immediate action to disconnect data exchange systems to prevent further impact. We continue to monitor the situation. For information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We are sharing an important update for our provider partners requesting authorization for Home Health services and Home Health agencies.
The Alliance aims to process authorizations for medically necessary Home Health services routine and urgent requests following our regulatory prior authorization processing time.

For more information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our provider network. We are dedicated to working with our providers, members, and the community to improve our services and programs.
Alliance members have the right to authorize (give) a friend, family member, or another person they identify to assist them with the coordination of their care.

For more information regarding this update, please click here.

Our provider partner satisfaction is a top priority. We are working to improve our Utilization Management and Claims processes to help ensure proper claim payment to our provider partners, and alignment of authorized services. This communication provides an update on Hospice procedure or revenue codes that require prior authorization. For more information regarding this update, please click here.

At Alameda Alliance for Health (Alliance), we value our dedicated provider partner community and appreciate all the hard work you do to protect health and wellbeing. We are sharing this notice to inform you about an important update regarding the Alliance vendor Change Healthcare / Optum. For more information regarding this notice, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We are sharing urgent information regarding a potential network interruption for Change Healthcare claims submissions. For more information regarding this update, please click here.

Our provider partner satisfaction is a top priority. We are working to improve our Utilization Management and Claims processes to help ensure proper claim payment to our provider partners, and alignment of authorized services. This communication provides an update on infusion codes that require prior authorization. For information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community, and we are here for you. We are sharing the Alliance Initial Health Appointment Provider Guide to share an overview of the requirements and best practices. To access this guide, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We are sending information to invite our contracted Internal Medicine or Family Practice Physicians or psychiatrists to participate on our Pharmacy and Therapeutics (P&T) Committee. For more information regarding this update, please click here.

Alameda Alliance for Health (Alliance) values our dedicated provider partner community. We are sharing important reminders as they relate to claims and billing processes. For more information regarding this update, please click here.

The Alliance is honored to provide asthma and diabetes disease management programs to our members as a part of our Medi-Cal and Group Care benefits. For more information regarding this update, please click here.

The Alliance currently receives admission notifications (face sheets) via fax when a member is admitted to a hospital. We also receive Admission Discharge Transfer (ADT) feeds, a hospital data feed that provides similar information. For more information regarding this update, please click here.