Employee Health Systems – Multicultural Medical Group
Due to direction from the California Department of Managed Health Care, Health Net is moving members who receive care from Employee Health Systems Medical Group (EHS) and Multicultural Medical Group to new participating medical groups and (in some cases) to new primary care physicians. The reason for the move is to ensure uninterrupted access to care.
Health Net is committed to helping ensure a smooth transition. Please see below for answers to commonly asked questions that may apply to you if you currently receive care from an EHS or Multicultural physician.
In most cases, EHS and Multicultural physicians are available to Health Net members through other contracted participating provider groups (PPGs), clinics and Health Net’s Direct Network.
In some cases, EHS and Multicultural members will be moved to new primary care physicians (PCPs) so they have uninterrupted access to care.
The notification letter you received from Health Net in early January explains whether you will be able to continue seeing your current PCP. (If you have Medi-Cal coverage and live in either Riverside or San Bernardino counties, your notification letter came from Molina Healthcare.)
If you would like to select a PCP other than the one we moved you to, please call us at 1-844-442-5047.
If you have Medi-Cal coverage and live in either Riverside or San Bernardino counties, you may call Molina Healthcare at 1-888-665-4621 to select a new PCP.
Many specialists contract with more than one PPG – or they may have a Direct Network relationship with Health Net – so there is a good chance the specialist you now see is contracted with Health Net.
However, if the specialists you currently see are not contracted with the new PPG you were assigned to, they may be contracted with other PPGs. That may mean you would have to change PCPs so that you can continue to see your specialists.
For help in determining whether a particular specialist is contracted with your new PPG, please call our dedicated phone representatives at 1-844-442-5047.
The hospital you use will depend on what hospitals your new PPG and your PCP use.
Yes, for certain services that meet our “transition of care” guidelines. The notification letter you received from Health Net had a Transition of Care form in it. You may fill it out and return it to us, or you may call us at:
CalViva Health: 1-888-893-1569
Please contact the PCP we assigned you to for direction on which laboratories and radiology services to use.
Yes. If you are assigned to a new doctor, you can request your previous doctor send him or her your medical records. You may contact your previous PCP for more information.
No, your benefits are not changing.
There will be no change in your medication coverage. If you use a self-injectable medication, you should contact your PCP to see if there is any change in how this medication is provided to you. If you have any prescriptions that need to be renewed after January, you will need to contact your new PCP and ask him or her to order the medications.
EHS and Multicultural are responsible for services and claims up to January 31, 2018.
You may call our dedicated phone representatives at 1-844-442-5047.