Initial Onboarding/Annual Training
Welcome! We are pleased to have you as one of our new provider partners. The materials listed below supply you with key information that is useful when providing care to CalOptima Health members.
If you have any questions, please call Provider Relations at 714-246-8600.
Behavioral Health Provider Training
- An orientation for Behavioral Health providers
CalOptima Health Community Network (CHCN) Annual In-Service Training
- A CHCN refresher training
CalOptima Health Community Network (CHCN) Onboarding Provider Training
- An overview of CHCN
CalOptima Health Community Network (CHCN) Provider Training Attestation
- To be completed upon review and completion of the provider training modules
To confirm completion of training modules, sign, date and email this attestation to your Provider Relations representative or providerservicesinbox@caloptima.org
Community-Based Adult Services (CBAS) Provider Training
- Understand how to register, verify eligibility, request prior authorizations and more for members accessing CBAS services
Fraud, Waste and Abuse Web-Based Training Course
- View the Medicare Learning Network’s training on Fraud, Waste and Abuse, and Medicare Parts C and D Compliance
Medi-Cal for Kids & Teens Provider Training
- Training program to increase understanding and awareness of Medi-Cal for Kids & Teens among Medi-Cal managed care plan-enrolled providers
Regional Center of Orange County (RCOC) Provider Training
- An overview of Regional Center of Orange County services
- Learn how to identify members with potential cultural or language needs and when alternative communication methods may be needed. Required for all health care providers and staff who care for members in CalOptima Health Medi-Cal, OneCare and PACE
- Identify and explain the legal requirements related to access for people with disabilities. Required for all health care providers and staff who care for members in CalOptima Health Medi-Cal, OneCare and PACE
Seniors and People With Disabilities
- Resources to assist seniors and people with disabilities (SPD)
Whole-Child Model (WCM) Provider Training
- An overview of CalOptima Health’s Whole-Child Model Program
Other Trainings by Topic
Seniors and People With Disabilities
To help seniors and people with disabilities (SPD).
- Identify member’s disabilities that may physically limit access to health care, communicate effectively or follow directions given by providers.
Americans With Disabilities Act (ADA) Questions and Answers
- Understand requirements of the ADA when providing care to our members.
CalOptima Health Cultural and Linguistics Services Minimum Requirements
- Understand cultural and linguistic requirements when providing care to our members.
Deaf and Disabled Telecommunications Program (DDTP)
- Learn about this phone service to access communication resources for deaf and disabled members.
- Definitions for competency, cultural awareness and sensitivity for SPD training.
- Learn how to communicate and interact respectfully with people who have disabilities.
How to Access Interpreter Services
- Instructions to request and access interpreter services.
Non-Emergency Medical Transportation Authorization Form
- To request an authorization for non-emergency medical transportation.
10 Skills for Empathetic Listening
- Skills needed to become an effective listener.
Disability Awareness
CalOptima Health is committed to ensuring that communications, services and programs are accessible to people with functional limitations, including visual, hearing, cognitive and physical disabilities.
In June 2011, CalOptima Health initiated disability awareness and sensitivity training as required by the California Department of Health Care Services. Disability awareness education continues to be required for all staff and health care providers who care for members in CalOptima Health Medi-Cal, OneCare and PACE.
- Identify and explain the legal requirements related to access for people with disabilities. Required for all health care providers and staff who care for members in CalOptima Health Medi-Cal, OneCare and PACE.
Cultural Competency Training
Learn how to identify members with potential cultural or language needs and when alternative communication methods may be needed.
- Required for all health care providers and staff who care for members in CalOptima Health Medi-Cal, OneCare and PACE.
Fraud, Waste and Abuse
You can report fraud or abuse. If you see any activity that you think is fraudulent or wasteful, we strongly encourage you to call our Compliance and Ethics Hotline at 1-855-507-1805 or report the activity using the Suspected Fraud or Abuse Referral Form. You do not have to give your name to report fraud activity.
Understanding your role in health care fraud
- Understanding your role in identifying health care fraud.
Suspected Fraud or Abuse Referral Form
- Instructions for completing and submitting a suspected fraud or abuse.
Fraud, Waste and Abuse Compliance Training
- CalOptima Health fraud, waste and abuse training module for contracted providers.
Coding
In CalOptima Health’s ongoing efforts to ensure we report accurate coding and proper chart documentation as required by the Centers for Medicare & Medicaid Services, we have created coding tips on various topics to assist the provider community.
- Coding and documentation tips for CKD.
Chronic Obstructive Pulmonary Disease (COPD)
- Coding and documentation tips for COPD and other chronic lung diseases.
- Coding and documentation tips for diabetes mellitus.
- Coding and documentation tips for major depressive disorder.
- Coding and documentation tips for neoplasm.
- Documentation and guidance for progress notes.
- Coding and documentation tips for peripheral vascular disease.
- Substance abuse documentation tips.
Other Trainings by Topic
Assisting Members With Advance Directives: What Providers Need to Know
- Tips for helping members with advance directives.
Authorization Modification/Change Requests From Providers
- Understand the process for modifying prior authorization requests.
California COVID-19 Therapeutics Best Practices Toolkit
- Guidance and recommendations for integrating COVID-19 treatments into routine health services.
Community-Based Adult Services (CBAS) Online Training
- Understand how to register, verify eligibility, request prior authorizations and more for members receiving CBAS services.
Dementia Care Aware Provider Training
- The Dementia Care Aware program offers ways for providers and primary care teams to receive training on the cognitive health assessment and other relevant dementia care topics.
Improving Patient Satisfaction in the Medical Office Training
- Tips to improve the patient experience in your office.
Initial Health Appointment (IHA)
- About the IHA requirement for all new Medi-Cal members.
Screen and Intervene: A Toolkit for Pediatricians to Address Food Insecurity
- Tips for pediatricians to address food insecurity.
HIPAA Training
Learn the Health Insurance Portability and Accountability Act (HIPAA) rules, who must comply with the rules and how the rules are enforced.
- HIPAA basics for providers.
OneCare (HMO D-SNP) Model of Care
OneCare providers and staff are required to complete training on key elements of the OneCare program. The requirement applies to those who directly or indirectly are responsible for providing health care services to our OneCare members or those who administer OneCare health care benefits. The OneCare training module is updated annually to reflect any changes to the program’s regulatory requirements.
OneCare Model of Care Training
- Learn about the members enrolled in OneCare, the model of care components, care coordination and staff roles and responsibilities.
Personal Care Coordinator
Personal Care Coordinator (PCC) training is conducted annually for newly hired PCCs at the health networks and on an as-needed basis for internal CalOptima Health-employed PCCs. Training includes an overview of the model of care processes, roles and responsibilities of the PCC, as well as motivational interviewing, health literacy, member satisfaction and impact on key performance indicators (KPIs).
Leaders from CalOptima Health Case Management, Long-Term Services and Supports, Behavioral Health, Network Management, and Equity and Community Health departments present briefly on how each department relates to the actions and accountabilities of PCCs.
Learn about our “road map” for care management policies, procedures and operational systems for OneCare members.
Medi-Cal Annual Wellness Visits
Medi-Cal Annual Wellness Visits
- Understand the Medi-Cal Annual Wellness Visit Program.
Medi-Cal Annual Wellness Visit Provider Attestation
- Download, complete and obtain information about the Annual Wellness Visit Provider Attestation.
Medi-Cal Annual Wellness Visit Program FAQ
- Find answers to frequently asked questions about the Annual Wellness Visit Program.