DHCS Screening and Enrollment
Templates

Health Education

Compliance Program
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 future.

Compliance Program
CMS Publications
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
Policy Template Exclusion Screenings
Screening Against Government Exclusions Lists Guidance Overview

Health Plan Training Materials
Policies and Procedures
If you need to obtain a copy of a specific policy please contact our Provider Services Department Mon- Fri between 9am and 5pm at (626)943-6100.
Privacy
Security
Breach of Protected Health Information
Transactions and Code Sets
Identifier Standards
References

Resources

Medicare Managed Care Manual
Chapter 21 - Compliance Program Guidelines and Prescription Drug Benefit Manual
Chapter 9 - Compliance Program Guidelines
Medicare Managed Care Manual

The Medicare Learning Network® (MLN) Provider Compliance page contains educational products that inform health care professionals on how to avoid common billing errors and other improper activities when dealing with various CMS Programs.
Medicare Learning Network® (MLN) Provider Compliance

CMS Medicare Parts C & D Fraud, Waste and Abuse Training and General Compliance Training
Provider Compliance
Medicare Parts C and D Fraud, Waste, and Abuse Training and Medicare Parts C and D General Compliance Training

Office of the Inspector General Exclusion Database (OIG)
OIG Exclusions List

System for Award Management (SAM) (fka GSA)
System for Award Management


Tracking Log
Training Materials
Attestation

HEDIS