Compliance Program
Help Us Help You
Astrana Health 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: astranahealth.ethicspoint.com
Email: Compliance@astranahealth.com
Mail: Attention: Compliance Department
1668 S. Garfield Ave., 2nd Fl.
Alhambra, CA 91801
Additional Compliance Resources
Astrana Health Standards of Conduct Training
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Astrana Health Standards of Conduct
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APL Highlights
DHCS Managed Care All Plan Letters
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DHCS Providers and Partners
Visit Website
Provider Enrollment FAQ 5.31.2018
Excluded Parties
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Policy Template Exclusion Screenings
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Screening Against Government Exclusions Lists Guidance Overview
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Behavioral Health Treatment FAQ
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California Department of Developmental Services
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Health Plan Language Assistance
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Hospice & Palliative Care
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Medicare Managed Care Manual (Refer to Chapter 9 and 21)
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Office of the Inspector General (OIG) Exclusion Database
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Patient Rights and Responsibilities
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Provider Compliance
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Breach of Protected Health Information
Identifier Standards
Privacy
References
Security
Transactions and Code Sets
Sample Employee Training and Screening Tracker
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Health Education
California Children’s Services Conditions
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Interdisciplinary Care Team (ICT) Training
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Preventive Services
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Astrana Health Sterilization and Informed Consent Training
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Astrana Health California Children’s Services (CCS) Training
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Access To Care Flyer – Chinese
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Access To Care Flyer – English
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Access To Care Flyer – Spanish
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Blue Shield Promise Health Education Link
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California Department of Developmental Services Regional Centers
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CHCS Health Literacy Fact Sheets
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Dementia Care Training
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Dietary Guide for Americans
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LA Care Health Education Link
Visit Website
Medi-Cal Early & Periodic Screening Diagnosis & Treatment For Children & Young Adults
Download PDF
Sterilization – Consent Form PM 330 Department of Health Services
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Sterilization – Permanent Birth Control for Men
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Sterilization – Permanent Birth Control for Men (Spanish)
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Sterilization – Permanent Birth Control for Women
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Sterilization – Permanent Birth Control for Women (Spanish)
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WIC Program Guide
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Resources
Quick Resources & Training Material
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Health Home Process
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ePayment Center (ACH) Portal Training Guide
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Zelis Payment Network (ZPN) Portal Training Guide
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HEDIS
2020 HEDIS Measures
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HEDIS 2020 Hybrid Measure Quick Guide
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HEDIS 2020 Administrative Measure Quick Guide with Codes
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HEDIS 2020 Chart Submission Requirements
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HEDIS 2020 Hybrid Measure
PM160 Notification Letter
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Updated PM160 Notification Letter
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QI Interventions Reported by Top Performing IPAs
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Templates
Provider Dispute Resolution Request Form (ADV)
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Provider Dispute Resolution Request Form (AHC)
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Provider Dispute Resolution Request Form (ALPHA)
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Provider Dispute Resolution Request Form (APC)
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Provider Dispute Resolution Request Form (APCMG)
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Provider Dispute Resolution Request Form (BAIPA)
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Provider Dispute Resolution Request Form (CFC)
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Provider Dispute Resolution Request Form (CVIPA)
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Provider Dispute Resolution Request Form (GOM)
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Provider Dispute Resolution Request Form (LSMA)
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Provider Dispute Resolution Request Form (NCPN)
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Waiver of Liability Statement
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ALPHA Authorization Form
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BAIPA Authorization Form
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CFC Authorization Form
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EHIPA Authorization Form
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AHC Authorization Request Form
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APC and Affiliate IPAs Authorization Form
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Provider Training
Astrana Health 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, Astrana Health 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 2024 Annual Provider Training Attestation Form.
Medicare Part C & D – General Compliance Training 2020
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Medicare Part C & D – Fraud Waste and Abuse Training 2020
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Fraud & Abuse MLN Booklet (4649244)
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Astrana Health Fraud Waste and Abuse (FWA) Training 2022
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Astrana Health General Compliance Training 2024
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Cultural Competency Training
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HIPAA Basics for Providers 2022 (MLN Booklet)
Download PDF
Astrana Health HIPAA Training – 2022
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Astrana Health Standard of Conduct
Download PDF
Alignment Provider – MOC Training
Download PDF
Blue Shield Promise – CMC and D-SNP MOC Training
Download PDF
Brand New Day (BHC) – SNP MOC Training
Download PDF
Health Net SNP MOC Training
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L.A. Care – MOC Overview (CMC manual, sec. 4.5.1)
Download PDF
Molina Healthcare MOC Training
Download PDF
SCAN Health Plan SNP MOC Training
Visit Website
Central Health Plan SNP MOC Training
Visit Website
United Healthcare SNP MOC Training
Visit Website
Wellcare – SNP MOC Training
Visit Website
Initial Health Assessment Guidelines
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SCAN IHA Requirements
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Timely Response To Grievance Requests – Alpha Care Medical Group
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Timely Response To Grievance Requests – LaSalle Medical Associate
Download PDF
Astrana Health Contracted SPECIALISTS Responsibilities
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Astrana Health Contracted PCP Responsibilities
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Astrana Health Contracted OB-GYN Providers Responsibilities
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Access to Care Standards
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Balance Billing Training
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Fraud Impersonation Guidelines
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2024 Astrana Health Provider Manual
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