Cultural Competency Compliance Training Attestation

All fields are required unless noted.

Are you on any VSP Medicaid Network or the Advantage Network in Santa Clara County, CA or do you provide services to VSP Medicaid patients?

Yes No

Have you recently joined the network (or are going through required on boarding?)

Yes No

California Medicaid/Medi-Cal, Santa Clara County Advantage Network doctors, and doctors providing services to VSP Medicaid patients must complete the following training modules as required by California state regulations. Doctor owners must attest that they and their staff, including employee doctors, have completed the training. Employee doctors need only attest for themselves.

Cultural Competency and Patient Engagement
Better Communication, Better Care: Provider Tools to Care for Diverse Populations
Seniors and Persons with Disabilities
Patient’s Rights and Responsibilities and Languages
Special Needs Plans Model of Care (SNP-MOC)
Critical Incident Training
HICE General Compliance (Medicare Parts C & D)
HICE FWA (Medicare Fraud Waste and Abuse)

I am a/an

doctor owner employee doctor

Cultural Competency Training

Meeting the needs of patients from diverse backgrounds is an important part of providing quality eye care. The following Cultural Competency training modules contain resources and guidelines on how to communicate clearly with patients of different cultures and ages. Once you have reviewed the below training modules, submit your attestation to have your Cultural Competency training completion date added to your VSP Find a Doctor directory listing.

If you have already taken Cultural Competency training from another source, you can submit the online attestation for Cultural Competency training to have your Cultural Competency training date added to your VSP Find a Doctor directory listing.

VSP Provided Cultural Competency Courses

Cultural Competency and Patient Engagement
Better Communication, Better Care: Provider Tools to Care for Diverse Populations
Seniors and Persons with Disabilities
Patient’s Rights and Responsibilities and Languages
Special Needs Plans Model of Care (SNP-MOC)

What cultural competency training have you completed?

VSP Other

What organization did you obtain the training from/through?

School Professional Association Health Plan Continuing Education Other

What’s the name of the organization?

What date did you complete the training?

Doctor First Name

Doctor Last Name

Doctor NPI

Select your Degree

Email

Phone

Attestation

I attest that I and my staff, including employee doctors, have completed the training modules indicated above, as required by my state to participate on VSP's Medicaid Network (Medi-Cal). Checking this box acts as my electronic signature.

Attestation

I attest that I have completed the training modules indicated above, as required by my state to participate on VSP's Medicaid Network (Medi-Cal). Checking this box acts as my electronic signature.

Attestation

I attest that I have completed the indicated Cultural Competency training. Checking this box acts as your electronic signature.

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