Provider Resources
Compliance Program
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Network Medical Management has published a Compliance Program, which reflects our attention to caring for all of our providers and members' guidance to ensure that our business is conducted in an ethical manner. Your adherence to complying with our Compliance Program is absolutely critical to our mutual success in delivering quality care.
If you have any questions or concerns, please contact our Compliance Department via phone, fax, email, or mail.
Compliance Hotline: 844-975-2651 (Available 24/7)
Website: https://apollomed.ethicspoint.com
Email: Compliance@networkmedicalmanagement.com
Mail: Attention: Compliance Department
1668 S. Garfield Ave., 2nd Fl.
Alhambra, CA 91801
Provider Training
Network Medical Management (NMM) is committed to conducting its business operations with the highest ethical standards and in full compliance with healthcare industry standards and regulations and all applicable Federal and State laws. In keeping with this pledge, NMM has implemented a comprehensive Training Program for network providers inclusive of Compliance items and Utilization Management Protocols and Policies. All network providers are required to review and attest annually to completing the trainings using the 2023 Annual Provider Training Attestation Form.
Fraud, Waste & Abuse (FWA) | General Compliance
Medicare Part C & D - General Compliance Training 2020
Download PDFMedicare Part C & D - Fraud Waste and Abuse Training 2020
Download PDFNMM General Compliance Training 2022
Download PDFNMM Fraud Waste and Abuse (FWA) Training 2022
Download PDFFraud & Abuse MLN Booklet (4649244)
Download PDFCultural Competency
Cultural Competency Training
Download PDFHIPAA Privacy Training
HIPAA Basics for Providers 2022 (MLN Booklet)
Download PDFNMM HIPAA Training - 2022
Download PDFStandard of Conduct
NMM Standard of Conduct 2022
Download PDFModel of Care Training (MOC)
Alignment Provider - MOC Training
Download PDFBlue Shield Promise - CMC and D-SNP MOC Training
Download PDFBrand New Day (BHC) - SNP MOC Training
Download PDFHealth Net SNP MOC Training
Download PDFL.A. Care – MOC Overview (CMC manual, sec. 4.5.1)
Download PDFMolina Healthcare MOC Training
Download PDFSCAN Health Plan SNP MOC Training
Visit WebsiteCentral Health Plan SNP MOC Training
Visit WebsiteUnited Healthcare SNP MOC Training
Visit WebsiteWellcare - SNP MOC Training
Visit WebsiteAdditional Provider Training Resources
Access to Care Standards
Download PDFBalance Billing Training
Download PDFFraud Impersonation Guidelines
Download PDFInitial Health Assessment Guidelines
Download PDFNMM Contracted OB-GYN Providers Responsibilities
Download PDFNMM Contracted PCP Responsibilities
Download PDFNMM Contracted SPECIALISTS Responsibilities
Download PDFSCAN IHA Requirements
Download PDFTimely Response To Grievance Requests - Alpha Care Medical Group
Download PDFTimely Response To Grievance Requests - LaSalle Medical Associate
Download PDF2023 NMM Provider Manual
Download PDFAdditional Compliance Resources
Code of Conduct
NMM Standards of Conduct
Download PDFNMM Standards of Conduct Training
Download PDFDHCS Screening and Enrollment
APL Highlights
DHCS Managed Care All Plan Letters
Visit WebsiteDHCS Providers and Partners
Visit WebsiteProvider Enrollment FAQ 5.31.2018
Excluded Parties
In accordance with the Network Medical Management group policy, all providers, vendors, and contractors are prohibited from contracting with Excluded Parties.
Excluded Parties
Download PDFPolicy Template Exclusion Screenings
Download PDFScreening Against Government Exclusions Lists Guidance Overview
Download PDFMiscellaneous
Behavioral Health Treatment FAQ
Download PDFCalifornia Department of Developmental Services
Download PDFHealth Plan Language Assistance
Download PDFHospice & Palliative Care
Download PDFMedicare Managed Care Manual (Refer to Chapter 9 and 21)
Download PDFOffice of the Inspector General (OIG) Exclusion Database
Visit WebsitePatient Rights and Responsibilities
Download PDFProvider Compliance
Visit WebsitePolicies and Procedures
If you need to obtain a copy of a specific policy, please contact our Provider Services Department from Monday to Friday between 9:00 AM and 5:00 PM PST at (626) 943-6100.