CurrentPHC CaliforniaPolicy N/A

PHC-CA Outbound Enrollment Verification (OEV) Process

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This policy governs how PHC California Member Services verifies a Medi-Cal applicant’s intent to enroll through outbound calls and, when needed, a written notice before the applicant’s enrollment effective date.

Policy Summary

PayerPHC California

PolicyPHC-CA Outbound Enrollment Verification (OEV) Process

Policy CodePolicy N/A

Change TypeNo material change

Effective DateJanuary 1, 2024

Last ReviewDec 5, 2025

Next Review DateN/A

Key ActionComplete the OEV process before the applicant’s enrollment effective date.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

3Maximum call attempts

Form 72.0Call script

Form 71.0Unsuccessful-contact notice

Before effective dateCompletion timing

Monthly

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CurrentPHC CaliforniaPolicy N/A

PHC-CA Outbound Enrollment Verification (OEV) Process

Customize your policy alerts

Sign up for all phccalifornia policy alerts

Know when phccalifornia releases new policies or updates existing guidance.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Policy Summary

PayerPHC California

PolicyPHC-CA Outbound Enrollment Verification (OEV) Process

Policy CodePolicy N/A

Change TypeNo material change

Effective DateJanuary 1, 2024

Last ReviewDec 5, 2025

Next Review DateN/A

Key ActionComplete the OEV process before the applicant’s enrollment effective date.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

3Maximum call attempts

Form 72.0Call script

Form 71.0Unsuccessful-contact notice

Before effective dateCompletion timing

Monthly

Outbound Enrollment Verification Process

Note

Eligibility Review and Verification Initiation

Begin verification after receiving a completed PHC Medi-Cal application from the Sales Enrollment team. Confirm the applicant’s eligibility using the DHCS MEDS system and complete the OEV process before the applicant’s enrollment effective date.

Receive a completed application from the Sales Enrollment team.
Verify applicant eligibility in the DHCS MEDS system before initiating contact.
Complete verification before the enrollment effective date.

Note

Outbound Verification Calls

Conduct outbound enrollment verification to confirm the applicant’s intent to enroll in the PHC California Health Plan. Use the DHCS-approved OEV script, Form 72.0, and make no more than three outbound call attempts.

Use DHCS Form 72.0 for each verification call.
Place up to three outbound call attempts.

Note

Language Assistance

If the applicant’s preferred language is not English, access the Language Line vendor before placing the outbound call.

Use Language Line services to support communication in the applicant’s preferred language.

Note

Applicant Response Handling

Introduce the purpose of the call and confirm the applicant’s availability. If the applicant confirms enrollment, explain the PHC Health Plan and request verbal confirmation to proceed; if the applicant declines, update the required systems and halt further action.

Document verbal enrollment confirmation in HealthSuite and 8x8.
For a decline, update HealthSuite and 8x8 accordingly and stop further enrollment action.

Documentation Required

Unsuccessful Contact Follow-Up

When the applicant cannot be reached after three outbound attempts, complete the DHCS Enrollment Request Verification Notice, Form 71.0, and mail it to the applicant’s address on file.

Complete Form 71.0 after three unsuccessful attempts.
Mail the notice to the address on file.

Documentation Required

Outreach Documentation

Document every outreach attempt and its outcome in HealthSuite and 8x8, including applicant confirmations, declines, and the details of any Form 71.0 mailing.

Record the outcome of each call attempt.
Document verbal confirmations and enrollment declines.
Record Form 71.0 completion and mailing details.

Key Terms and Systems

OEV (Outbound Enrollment Verification)

TermOEV (Outbound Enrollment Verification)

PurposeMandatory process to confirm an applicant’s intent to enroll.

Applies toPHC Health Plan Medi-Cal applicants.

HealthSuite

SystemHealthSuite

OwnerThe Health Plan

PurposeInternal documentation system.