Providers | Blue Shield of California Promise Health Plan

Quality Improvement Incentive Program (Q.I.I.P)

120 Day Initial Health Assessments*

We reimburse you $50 for health assessments completed within 120 days of each new Blue Shield of California Promise Health Plan member's effective date with you. This is in addition to the current fee-for-service reimbursement you receive as a Blue Shield of California Promise Health Plan directly contracted PCP.

* Use ICD-9 Code V70.0 to indicate initial Health Assessment Physical Examination, on the HCFA 1500-Section 21.)

Medi-Cal Child Health & Disability Program (CHDP) Services

In addition to your capitation, Blue Shield of California Promise Health Plan reimburses for CHDP Services.

Note: CHDP services will be paid at CHDP rates when submitted accurately on a PM-160 Form within 30 days from the date of service. (Claims may be paid up to a year from date of service). Rendering physicians, must submit the appropriate information to Blue Shield of California Promise Health Plan to participate in the QIIP programs. Please contact your Blue Shield of California Promise Health Plan Provider Services Representative at (800) 468-9935 for more information about these programs.

Immunizations

Get reimbursed $5.00 for each of the following adult immunizations given.
  • (90471) Immunization administration, single or combination vaccine/toxoid
  • (90472) Immunization administration; two or more single or combination vaccines/toxoids

Postpartum Care Incentive Program

The Postpartum Care Incentive Program is created to educate our new mothers on the importance of their postpartum care visit. The postpartum visit should be scheduled between 21 to 56 days after their delivery. To encourage our members/new mothers to come in for their check up, we give a $40.00 gift card once the mother has come in for their postpartum visit. As a new mom it is important to make sure that the mom/mother is well from labor. For taking care of our members, we give the providers a $50.00 incentive.

Provider Appreciation

We are pleased to introduce our Provider Appreciation program. We are finalizing the details and look forward to sharing with you more information soon.

Here is the Part 1 Webinar collateral created by IHA giving an introduction of their Value Based Pay for Performance (VBP4P) Program:

If you would like additional information on IHA’s VBP4P program, please visit the IHA’s VBP4P website to get more information

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