2021 VHP Provider Manual

Page 20

Back to Chapter 3 Table of Contents

CH 3:

Enrollment & Elligibility This Chapter Includes: Alert Alert draws attention to critical information that has changed this year.

1. VHP’s Four Commercial, HMO Products 2. Employer Group 3. Covered California and Individual & Family Plan 4. Eligibility Grace Period for Covered California Members and Individual & Family Plan Members

Contact Contact information on who to contact for assistance. Book Table of Contents Click the purple VHP circle logo, located at the bottom left corner, to return to the main TOC.

5. Subsidized Members 6. Non-Subsidized Members 7. Verifying Eligibility and Benefits 8. Online Verification of VHP Member Eligibility 9. VHP Member ID Cards 10. Member Cost Share

11. Sample ID Cards for Employer Group, Covered California & Indivivuals & Family Plans 12. EDI: Enrollment and Eligibility (834) and Response (999 & TA1) 13. Eligibility and Capitation Reports 14. Provider Entities Delegated for Administrative and/or Clinical Services

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CH 3: Enrollment & Elligibility

2021 / Provider Manual


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Ch 22: Delegated Entities

3min
pages 201-203

Ch 21: Regulatory & Compliance Requirements

14min
pages 192-200

Ch 20: Quality Management

12min
pages 183-191

Ch 19: Behavioral Health Services

19min
pages 171-182

Ch 17: Utilization Management

30min
pages 144-166

Ch 18: Case Management

4min
pages 167-170

Ch 16: Pharmacy Services

18min
pages 131-143

Ch 15: Provider Disputes & Member Grievances

8min
pages 124-130

Ch 13: Claims & Billing Submission

29min
pages 102-121

Ch 14: Encounter Data

2min
pages 122-123

Ch 10: Primary Care Providers & Other Providers

14min
pages 84-92

Ch 12: Timely Access Requirements

5min
pages 96-101

Ch 9: Credentialing & Recredentialing

26min
pages 65-83

Ch 11: Locum Tenens

4min
pages 93-95

Ch 6: Cultural, Linguistics, & Disability Access Requirements & Services

8min
pages 49-54

Ch 2: Resources for Providers

10min
pages 12-19

Ch 4: Member Benefits, Exclusion, & Limitations

12min
pages 33-44

Ch 5: Member Rights & Responsibilities

5min
pages 45-48

Ch 3: Enrollment & Elligibility

14min
pages 20-32

R Record Review

9min
pages 59-64

CH 1: Introduction

6min
pages 6-11

Ch 7: Health Education Program

4min
pages 55-58
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