Please login through our QuickCap ProCare Web Portal.
Compatibility: Google Chrome
For Provider Portal login requests, please email email@example.com
Provider Required Training
Welcome to the Physician Training Module. Below are our provider training modules that you can access to assist you in providing care to our members.
Please click on the link for your necessary training:
Health Plan Training:
All Staff/Physician Trainings:
- Cultural Linguistics Training (CL)
- Fraud, Waste, and Abuse (FWA)
- HIPAA Privacy, Breach Notification and Compliance
- Compliance Program
Our Utilization Management Guidelines
ProCare utilizes clinical practice guidelines as standards of healthcare that are applicable to members and providers. Our Quality Management Committee performs regular reviews of nationally and locally developed guidelines and then gives final approval on the adoption of all considered guidelines.
All clinical practice guidelines are adopted based on scientific evidence, review of the medical literature or appropriately established authority, as cited. All recommendations are based on published consensus guidelines, and not on any particular treatment or service based solely on cost consideration.
These guidelines are suggested recommendations and to be used as a guide for the purpose of making Medical Necessity* clinical decisions. Clinicians and their patients should work together to develop individual treatment plans that are personalized to the specific needs and circumstances of each patient. Clinicians and members have the right to request a copy of a guideline that ProCare has used to make a treatment authorization decision.
ProCare utilizes an assortment of sources in developing our Utilization Management Guidelines, which include (but are not limited to):
- Medicare and Med-Cal’s Coverage Policy Statements
- National Guideline Clearinghouse
- Evidence in the peer-reviewed published medical literature
- Technology assessments and structured evidence reviews
- Evidence-based consensus statements
- Expert opinions of healthcare providers
- Evidence-based guidelines from nationally recognized professional healthcare organizations and public health agencies, Apollo Guidelines or Inter-Qual
*Medical Necessity includes all healthcare services necessary for the diagnosis and/or treatment of a medical condition causing significant pain, negative impact on the health status of the member, potential disability or that is potentially life threatening.