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for Providers

Select Program:

Medi-Cal (Available in DEL NORTE, HUMBOLDT, LAKE, LASSEN, MARIN, MENDOCINO, MODOC, NAPA, SHASTA, SISKIYOU, SOLANO, SONOMA, TRINITY, AND YOLO) - PHC is a managed care organization that contracts with the State of California to ensure that Medi-Cal recipients its service area have access to quality medical care. PHC ensures access by contracting with medical providers and then assigning our members to a primary care physician. The primary care physician is then responsible for providing medical care to those members assigned to him/her. The PCP is also responsible for referring his/her patients to a specialist when there is a medical need.

Healthy Families (Available in NAPA, SOLANO, AND YOLO) - The Healthy Families Program is being transitioned into Medi-Cal, with the last phase of transition set to occur on September 1, 2013.

Healthy Kids (Available in MARIN, SOLANO, SONOMA AND YOLO) - The Healthy Kids Health Plan is a locally developed and funded comprehensive health care coverage program for eligible children residing in Napa, Solano, Sonoma and Yolo Counties. Partnership HealthPlan of California is the health plan for Healthy Kids. Families pay low monthly premiums, which are based on family size and income. Benefits include medical, dental, vision and mental health services.

The Healthy Kids Health Plan covers children if they are ineligible for full-scope, no share of cost Medi-Cal or the Healthy Families program.

Senior Advantage Plan (Available in SOLANO, NAPA, and YOLO) - PartnershipAdvantage is a Medicare Advantage program offered by PHC. This program combines PHC Medi-Cal, Medicare Parts A and B and Medicare Prescription Drug Coverage ("Part D"). PartnershipAdvantage (HMO SNP) coordinates your Medicare and PHC Medi-Cal benefits, creating a seamless health plan where all of a beneficiary's covered health benefits are in one plan.

The PartnershipAdvantage (HMO SNP) program is offered through a contract between Partnership HealthPlan of California (PHC) and the Centers for Medicare and Medicaid Services (CMS).

*A full description of the PartnershipAdvantage (HMO SNP) prescription drug benefit is listed in the Member PartnershipAdvantage (HMO SNP) section under "Our Part D Benefit".

Attention Contracted PartnershipAdvantage (HMO SNP) Providers

CMS requires that all contracted providers conduct Fraud, Waste, and Abuse training for their staff. Annually: Attestation of trainings is due before December 31of each calendar year. Below are free materials to assist providers:

Medicare Requirements Letter by PHC's Compliance Officer, Medicare Policy, Free Training Materials Meeting CMS Requirements, and Attestation Form

Fraud, Waste, and Abuse Brochures

If you have any questions about the training materials, please contact the PHC Compliance Officer or Provider Relations Department at 707-863-4100.

PHC Primary Care Blog

PHC has an Internet blog that was created to improve communication and information exchange with the primary care clinicians in our network. It is a source of useful information on clinical topics and other issues of interest to clinicians taking care of our patients. The articles are brief and added weekly. You can add your own feedback and comments on any of the articles published.

The blog is at www.phcprimarycare.org. Bookmark the site when you first visit and also sign up to receive email notifications when new articles are posted to the blog.