This module will walk you through Medi-Cal’s core rules, what qualifies as a billable service, and what to do if a member can benefit from more support than the limit allows.

Now that you’ve learned the CHW Medi-Cal benefit rules, in the next module we’ll go over CHW certification and training requirements.

This module will walk you through what makes a Community Health Worker, CHW, eligible to deliver and bill for services under the Medi-Cal CHW benefit.

We will cover the two eligibility pathways, certification and work experience, along with the training and documentation requirements your organization must meet before billing can begin.

That covers CHW certification and training requirements for your team. In the next module, we’ll go over key platform definitions like Activities, Member Notes, Goals, and Claims, and how they connect to your billing process.

Related Info: Instructions for uploading your certifications into Pear Suite

This module will show you how to add new members into Pear Suite. You’ll also learn which fields are required for billing towards Medi-Cal CHW benefits.

Now that you’ve learned how to add members, in the next module we’ll cover how to complete a screening activity and capture the key social needs that Pear Suite uses to generate goals.

This module walks you through the Needs Assessment activity in Pear Suite, which helps identify a member’s health-related social needs, automatically generate goals, and prepare for follow-up.

Now that you’ve seen how to use the Needs Assessment to identify needs and set goals, in the next module you’ll learn how to end an activity and capture the details needed to create a billable claim.

This module will show you how to properly end an activity in Pear Suite, including entering notes and claim details so your work is documented and eligible for reimbursement.

Now that you know how to finish an activity and generate a claim, in the next module you’ll learn how to manage and track member goals.

This module will show you how to use the Goals feature in Pear Suite to document member needs, track progress, and ensure services are connected to meaningful outcomes.

Now that you know how to create and complete goals, in the next module you’ll learn how to document ongoing support with the Member Follow-Up and Assistance activity.

This module will guide you through the Member Follow-Up and Assistance activity in Pear Suite, the primary way to document and bill for support provided after the initial Needs Assessment.

Now that you’ve learned how to record follow-up services and keep goals updated, in the next module you’ll practice what you’ve learned so far by completing a hands-on assignment in Pear Suite.

This module gives you a chance to put everything you’ve learned into practice. Before beginning, admins should log into Pear Suite and create user accounts for their team. To do this, go to the Users section in the left-hand sidebar and add new users. You can read the article below to know more about adding a user. 

Adding a User

Once your admin has added you, log into your Pear Suite account and follow the steps below to practice what you’ve learned.

You’ll log into Pear Suite, add a test member, complete activities, and practice documenting services just as you would with a real member.

Once you’ve practiced adding a member, completing activities, and entering claim details, you’re ready to continue. In the next module, you’ll learn how to review and manage claims, including how to resolve errors before submitting them.

This module will show you how to manage claims in Pear Suite, including how to review claim details, resolve errors, and track the status of your organization’s billable activities.

You’ve now learned how to correct errors and mark claims as Ready for Screening. The next module will walk you through setting up a payout account so your organization can receive reimbursements directly.

This module will walk you through how to set up a payout account in Pear Suite using Stripe, so your organization can receive reimbursement from health plans once claims are paid.

After your Stripe payout account is connected, Pear Suite will transfer reimbursements directly to your bank account and update claims with a Paid status. In the next module, we’ll wrap up your training with key resources and support information to help you get started.

This final module provides you with the key resources and support information you’ll need as you begin using Pear Suite with real members, including how to reach support, access billing help, and join live office hours.