Provider Resources
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
Code of Conduct
Astrana Health Standards of Conduct Training
Download PDFAstrana Health Standards of Conduct
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.
Breach of Protected Health Information
Identifier Standards
Privacy
References
Security
Transactions and Code Sets
Tracking Log
Sample Employee Training and Screening Tracker
Download PDFHealth Education
Utilization Management
California Children’s Services Conditions
Download PDFInterdisciplinary Care Team (ICT) Training
Download PDFPreventive Services
Download PDFAstrana Health Sterilization and Informed Consent Training
Download PDFAstrana Health California Children’s Services (CCS) Training
Download PDFGeneral Education Materials
Access To Care Flyer – Chinese
Download PDFAccess To Care Flyer - English
Download PDFAccess To Care Flyer - Spanish
Download PDFBlue Shield Promise Health Education Link
Visit WebsiteCalifornia Department of Developmental Services Regional Centers
Download PDFCHCS Health Literacy Fact Sheets
Download PDFDementia Care Training
Download PDFDietary Guide for Americans
Visit WebsiteLA Care Health Education Link
Visit WebsiteMedi-Cal Early & Periodic Screening Diagnosis & Treatment For Children & Young Adults
Download PDFSterilization - Consent Form PM 330 Department of Health Services
Download PDFSterilization - Permanent Birth Control for Men
Download PDFSterilization - Permanent Birth Control for Men (Spanish)
Download PDFSterilization - Permanent Birth Control for Women
Download PDFSterilization - Permanent Birth Control for Women (Spanish)
Download PDFWIC Program Guide
Download PDFResources
Training Material
Quick Resources & Training Material
Download PDFHealth Home Process
Download PDFZelis Training Material
ePayment Center (ACH) Portal Training Guide
Download PDFZelis Payment Network (ZPN) Portal Training Guide
Download PDFHEDIS
LA Care HEDIS Resources
2020 HEDIS Measures
Download PDFHEDIS 2020 Hybrid Measure Quick Guide
Download PDFHEDIS 2020 Administrative Measure Quick Guide with Codes
Download PDFHEDIS 2020 Chart Submission Requirements
Download PDFHEDIS 2020 Hybrid Measure
PM160 Notification Letter
Download PDFUpdated PM160 Notification Letter
Download PDFQI Interventions Reported by Top Performing IPAs
Download PDFTemplates
Claims
Provider Dispute Resolution Request Form (ADV)
Download PDFProvider Dispute Resolution Request Form (AHC)
Download PDFProvider Dispute Resolution Request Form (ALPHA)
Download PDFProvider Dispute Resolution Request Form (APC)
Download PDFProvider Dispute Resolution Request Form (APCMG)
Download PDFProvider Dispute Resolution Request Form (BAIPA)
Download PDFProvider Dispute Resolution Request Form (CFC)
Download PDFProvider Dispute Resolution Request Form (CVIPA)
Download PDFProvider Dispute Resolution Request Form (GOM)
Download PDFProvider Dispute Resolution Request Form (LSMA)
Download PDFProvider Dispute Resolution Request Form (NCPN)
Download PDFWaiver of Liability Statement
Download PDFUtilization Management
ALPHA Authorization Form
Download PDFBAIPA Authorization Form
Download PDFCFC Authorization Form
Download PDFEHIPA Authorization Form
Download PDFAHC Authorization Request Form
Download PDFAPC and Affiliate IPAs Authorization Form
Download PDFProvider 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.