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Frequently Asked Questions (FAQ)


Ask Us A Question         

Care During A Disaster


Question:

When I change my PCP, how do I transfer my medical records, and what should I bring with me on my first appointment?


Answer:
We created a checklist to help you with this kind of change. It’s called the Primary Care Physician Change Checklist, and you’ll find it below. Simply print it out and use it to help you prep for your first visit with your new physician. Because you and your physician are partners in your health, it’s great that you are planning ahead. This will save both of you time and hassle. A top priority? Getting your medical records transferred from your old doctor to the new office. You’ll need to sign a release to allow your previous doctor to send the records to the new physician. If you have an extensive history it may take longer to copy your records. It’s not uncommon (or illegal) for the previous physician to charge a fee for the copying - up to 25 cents per page. 

Primary Care Physician Checklist 

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Question:
What if my current prescription drugs are not on the formulary or have certain restrictions? 

Answer:
Click on Transition Policy Statement

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Question:
What is Advance Health Care Directive?

Answer:
The Advance Healthcare Directive is a legal document that enables you to do either of two things. First, it allows you to accurately communicate your desires in terms of life-sustaining treatment and aggressive interventions. Secondly, you can appoint an agent representative who agrees to accept the responsibility of ensuring your wishes are carried out and who has legal authority to make decisions about your medical care if you become unable to make decisions for yourself. (Sometimes referred to as a Power of Attorney for Healthcare - POA.) Without the POA on file with Inter Valley, we cannot discuss your personal health information with family or friends because we must follow the Health Insurance Portability and Accountability Act (HIPAA). This law was designed to protect your personal information.
Click here for Advanced Directive forms in English or Spanish


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Question:
What do all the numbers on my Inter Valley Membership ID Card mean?

Answer:
Click on How To Read Your ID Card.

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Question:
How do I change my Primary Care Physician (PCP)?

Answer:
You need to contact Member Services to do this. Be sure to call us before making an appointment with a new physician. If you don’t, you and your new PCP may run into some snags. 

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Question:
If I lose or misplace my Membership ID Card, how do I get another card?

Answer:
You can click on new id card to request a new card. Or, you can simply call Member Services at 909-623-6333 or toll-free at 1-800-251-8191. TTY/TDD users may call toll-free at 711. The TTY/TDD number is for the hearing impaired and requires special equipment. (So don’t use this number unless you require the use of a TTY/TDD equipment.)

We’re here to answer your call seven days a week, between the hours of 7:30 a.m. and 8:00 p.m. Your new Membership ID Card will arrive 3 to 5 business days from the date of your request. If you have a scheduled physician appointment before you receive your card, the physician's office can contact our Benefits and Eligibility Department to confirm your enrollment in the Plan.

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Question:
What if I receive a bill?

Answer:
From time to time, you may receive a notice in the mail that looks like a bill for covered services. The truth is, not every notice is a bill. Some are just informational. If what you receive is a bill, just let us know by calling Member Services. We’re happy to assist you seven days a week between 7:30 a.m. and 8:00 p.m. at 909-623-6333 or toll-free at 1-800-251-8191 or for TTY/TDD devices for hearing impaired at 711.
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Question:
How do I know which physicians are part of my Inter Valley Health Plan Service to Seniors Plan?

Answer:
Click here to Find a Doctor or contact Member Services to request a Physician Directory for your area. You can also request directories for all of Inter Valley's Service areas. Each Directory provides a listing of participating physicians, including specialty care physicians, associated hospitals and Urgent Care facilities.
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Question:
How do I Report Suspected Fraud?

Answer:
If you suspect someone is committing fraud or unethical practices, you have a safe place to go with Fraud Alert. Your anonymous report really matters and could be extremely valuable. Fraud Alert is simple to use. You can submit your report by telephone, mail, or website 24-hours-a-day. Rest assured, you do not have to leave your name or otherwise identify yourself. However, it’s helpful that you leave as much specific and detailed information as possible, so the issue can be properly investigated. All reports are submitted to an outside third party who is a fraud investigation expert. Remember that fraudulent activities deprive your community of quality service, supplies, and equipment. So please report any suspected issues promptly.
Click on Fraud Alert for more information

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Question:
How do I get care during a disaster?

Answer:
If the Governor of California or the President of the United States declares a County or State Emergency or disaster within or around our geographic service area, you are still able to get the care you need. During a declared emergency/disaster, Inter Valley Health Plan and its providers are required by Medicare to continue providing you with medical services and access to prescriptions drugs*.  You will be able to receive care via in-network and out-of-network providers during an emergency and the Plan will waive gatekeeper/prior authorizations for referrals, where applicable; and you will be charged only applicable in-network copyaments/co-insurance /cost sharing amounts. 

*PLEASE NOTE:  Inter Valley Health Plan cannot pay for any prescriptions filled by pharmacies outside the United States, even in the event of a medical emergency and/or declared State of Emergency/Disaster. If you have to use an out-of-network pharmacy and you have paid full cost, and not your in-network share of the cost during an emergency, you can send us your receipt(s) and request to be reimbursed the Plan’s share of the cost. 

Please send your request for payment, along with any bills/receipts/documentation of payment you have made to our Claims Dept: 

Attn:  Claims Department – Customer Reimbursement Request (Emergency/Disaster)
Inter Valley Health Plan
P.O. Box 6002, Pomona, CA.  91769-6002


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