The CAQH CORE Phase III Operating Rules for EFT & ERA have been mandated by HHS and since January 2014 any provider should be asking forthe streamlined electronic transactions that can result due to these operating rules and their affiliated standards. You can also access the Kaiser online directory. Santa Barbara County Providers In this listing, you will find a complete list of contracted CenCal Health providers in Santa Barbara County. El Dorado As of January 2013, all HIPAA-covered entities must adhere to the federally mandated Phase I and II CAQH CORE Operating Rules, which relate to patient eligibility and claim status. Accepting New Patients: This provider accepts both new and existing patients. . Amador Tuolumne Our Provider and Pharmacy Directory make it easy to find the care you need. ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Must contain at least 1 character from each of the following four groups: Uppercase letters Lowercase letters Numbers Special Characters May not contain your username May not be any of your last 10 passwords Please contact the Provider Services at (831) 430-5518 with any questions. Santa Clara The Provider Directory API accesses the Alliance FHIR server portion of the Provider and Pharmacy Directories. CalAIM: Enhanced Care Management (ECM) and Community Supports (CS) require prior authorization and are limited to members who meet specific eligibility criteria. They will be able to assist you in making the best health plan choice for you. CAQH technology-enabled solutions, operating rules and research help nearly 1,000 health plans, 2 million providers, government entities and vendors connect, exchange information and operate more efficiently. Click to see Board of Directors Meeting Schedule/Upcoming Agenda. Del Norte To report any errors, click on the link below. SHOULD: A best practice or recommendation for the implementation. The Organization Affiliation resource describes relationships between two or more organizations, including the services one organization provides another, the location(s) where they provide services, the availability of those services, electronic endpoints and other relevant information. By entering an e-mail in this field I am confirming that the e-mail provided is intended for patient communication and is regularly monitored and maintained in a manner consistent with State and Federal laws. Select Practitioners with the specified given name. The Central California Alliance for Health (the Alliance) has contracted with Beacon Health Options to provide mental health services. Our Regional Medical Center Network (RMC) has 10 Health Centers conveniently located throughout the county and the Regional Medical Center Hospital in Martinez. View Urgent Visit Access Offices in Merced County. San Diego As of 01/01/2022, Medi-Cal Rx is the administrator of Medi-Cal Pharmacy Benefits. Riverside Enrollment for these plans ends December 7. The Central California Alliance for Health (the Alliance) has contracted with Beacon Health Options to provide some outpatient mental health services. The ACA has taken operating rules to a new level. Modoc As of Feb. 24, Medi-Cal Rx PA requirements reinstated for 46 Standard Therapeutic Classes, COVID-19 Therapeutics Warmline and treatment webinars, Thursday training for Adverse Childhood Experiences (ACEs) screening. Some doctors might have all the patients they can fit in, while still giving you the best care. * Translation services available for most languages. [parameter=value]&_include=Location:organization, GET [base]/Location? Only submit information below that needs to be changed in the directory. Japanese Select Locations managed by the specified organization. Select PractitionerRoles available at the specified organization. Select Locations that are part of the specified location. Office of Licensing and Monitoring Provider Directories It should be noted that this is an all-inclusive resource directory of DHS licensed programs; however, not every provider listed is contracted with DHS to provide services to youth in placement. Select PractitionerRoles with the specified role. Specialty: The area of medicine the doctor provides care to patients. A Increase font size. If a doctor or hospital makes a change to any of the information below, CCP updates the provider directory within 7 days of learning of the change. Fresno More than 130 participating organizations representing healthcare providers, health plans, government agencies and the organizations setting the standards for healthcare and data exchange are part of the CAQH CORE multi-stakeholder collaboration. Who are Providers? Note: For more information about the FHIR RESTful API, please refer to the HL7 FHIR RESTful API topics. The voluntary certification program enables organizations to demonstrate that they have adopted and are adhering to CAQH CORE Operating Rules. Shasta In an effort to provide CCHP members and providers with useful information to make decisions, CCHP updates provider and facility information within thirty (30) business days after we are notified of a change. Were committed to achieving: Partnering with you to keep your patients living safely and independently in their homes and communities is at the heart of our mission. Whether or not a member is assigned to the RMC or the CPN network, if specialty care is not available in their assigned network, CCHP and the assigned primary care provider (PCP) may arrange for whatever referrals, authorizations, and treatments necessary to see a specialist in a non-assigned network. * If your language is not listed, please call the Telephone Service Center at 1-800-322-6384 for free translation services during a dental appointment. SHALL: An absolute requirement for all implementations. We help you extend your reach into your patients homes and communities through care coordination, behavioral health, and long-term services. Board Certification: Information on board certification is verified at the time of credentialing and re-verified at least every three years at the time of re-credentialing. Arabic We are dedicated to providing the highest quality of care for your furry family members. San Francisco Website: The internet address that the doctor and practice information can be found. To change your primary care provider or get detailed information about your healthcare benefits and prior authorization requirements, call our Member Services team at 866-610-2273(TTY 711). [parameter=value]&_include=InsurancePlan:administered-by, GET [base]/InsurancePlan? Thai Alliance. The call is free. GET [base]/PractitionerRole/[id]/_history/vid, GET [base]/PractitionerRole? Medical group: This information is collected from the group at the time they initially join the network. A Decrease font size. If you do not have your Alliance ID number, click on the link for the General Pharmacy Locator. Phone Number: The doctors office or hospital phone number. The DaVinci PDEX Plan-Net Practitioner profile is based on the core FHIR US Core Practitioner resource. This directory gives members, potential members and providers access to our two networks (Regional Medical Center (RMC) and the Community Provider Network (CPN) of physicians, pharmacies, hospitals and ancillary providers. If CenCal Health cannot find you an appointment with a closer specialist, we will arrange transportation to see the specialist, if needed. Please refer to the Kaiser Assignment Criteria document located at cchealth.org/CCHPmaterials or contact Member Services at 1-877-661-6230 (press 2) for more information. Depending on the plan, benefits may include $0 primary care visits, $0 annual dental and eye exams, $0 transportation, $0 identity theft protection, and $200 or more for over-the-counter health products. Sutter Our Member Services staff can help you find and select a doctor from the Provider Directory for Members. Verification is obtained either by contacting the accrediting agency directly or by obtaining a copy of the approval letter or report provided by the facility. To find a pharmacy, use MedImpact's online Pharmacy Directory using the link below. The Provider Directory API accesses the Alliance FHIR server portion of the Provider and Pharmacy Directories. Cultural Competency Training: The office staff is trained to meet the needs of people of all different cultures. In addition, on a quarterly basis, CCHP emails a Network Update link to each provider, provider group or facility to report any changes to the information CCHP has on file. Imperial Select PractitionerRoles associated with the specified specialty. *In Barnstable and Berkshire Counties: CCA One Care is available; CCA Senior Care Options, CCA Medicare Value, and CCA Medicare Preferred are not yet available. Provider Directory Information Update Form, Merced County Medi-Cal Provider Directory, Monterey and Santa Cruz Medi-Cal Provider Directory, Alliance Care IHSS Health Plan Provider Directory. Using read-only RESTful GET API calls (PUT and POST are not currently supported), you can create an application to access information about our providers and pharmacies. The Alliance FHIR server SHALL be capable of returning a HealthcareService resource using: The Alliance FHIR server SHOULD be capable of returning a HealthcareService resource using: The Alliance FHIR server SHALL be capable of supporting the following _include parameters: The Alliance FHIR server SHALL be capable of supporting the following _revinclude parameters: The Alliance FHIR server SHALL be capable of returning an InsurancePlan resource using: The Alliance FHIR server SHOULD be capable of returning an InsurancePlan resource using: The Alliance FHIR server SHALL be capable of returning a Location resource using: The Alliance FHIR server SHOULD be capable of returning an Organization resource using: The Alliance FHIR server SHALL be capable of returning an Organization resource using: The Alliance FHIR server SHALL be capable of returning an OrganizationAffiliation resource using: The Alliance FHIR server SHOULD be capable of returning an OrganizationAffiliation resource using: The Alliance FHIR server SHALL be capable of returning a Practitioner resource using: The Alliance FHIR server SHOULD be capable of returning a Practitioner resource using: The Alliance FHIR server SHALL be capable of supporting the following _revinclude parameter: The Alliance FHIR server SHALL be capable of returning a PractitionerRole resource using. Gender: A doctors sex, either Male or Female. The number to call in each county is. [parameter=value]&_include=PractitionerRole:network, Nurse Advice Line Nurse Advice Line Implements RESTful behaviors according to the FHIR specification. Together, we can bring uncommon care to more people with significant needs. CORE Certification CenCal Health is contracted with many primary care providers, specialists, pharmacies and hospitals in your area. Compassionate Care Animal Hospital (CCAH) is a full-service animal hospital located in Ann Arbor, Michigan. Who is CenCal Health/What is a Local Health Plan? GET [base]/OrganizationAffiliation/[id]/_history/vid, GET [base]/OrganizationAffiliation? CCH will closely monitor activity at the refinery and notify the public if the flaring results in any offsite health impact to the community. ASL Interpreter Available: The office can translate into American Sign Language. Inpatient mental health services and services for the treatment of severe mental health conditions continue to be covered through county mental health departments, not the Alliance. Sierra GET [base]/HealthcareService/[id]/_history/vid, GET [base]/HealthcareService? It requires CenCal Health to meet both time and distance standards based on county population density. Commonwealth Care Alliance (CCA) is pleased to announce that we are partnering with Cognizant to implement our new claims platform, Facets, effective Q2 2023. Contra Costa Health (CCH) has been notified by the Martinez Refining Company of planned maintenance work at its facility that will cause flaring visible from Interstate 680 and Marina Vista Ave from Friday through Monday, March 6th. In addition, on a quarterly basis, CCHP emails a Network Update link to each facility to report any changes to the information CCHP has on file. Mariposa Quality Data: Hospital quality data is available through the Joint Commission website, through the link to Quality Check. Select Locations with the specified address. Facility: CCHP updates facility information daily as changes are reported by the facility. Contra Costa Health Plan (CCHP) has been serving the health care needs of Contra Costa County for over 40 years. A Decrease font size. Kings In those situations, CenCal Health can still get you care. Provider Directory Information Update Form Provider Directory Information Update Form Senate Bill 137 requires the Alliance to solicit updated information from providers on a regular basis to ensure that the most accurate data for your practice is included in our Provider Directories. [parameter=value]&_include=OrganizationAffiliation:primary-organization, GET [base]/OrganizationAffiliation? CCHP does not verify these skills. [parameter=value]&_revinclude=PractitionerRole:service, GET [base]/HealthcareService?[parameter=value]&_revinclude=OrganizationAffiliation:service. It mandated healthcare operating rules for HIPAA claims-related electronic transactions, and CAQH CORE was named by the Secretary of Health and Human Services (HHS) as the authoring entity of these operating rules. Health (Just Now) The Central California Alliance for Health (the Alliance) has contracted with Beacon Health Options to provide some outpatient mental health services. 6HUYLFHV GHSDUWPHQW DW HPDLO directory@ccah-alliance.org RU VHQG D UHTXHVW E\ PDLO WR Central California Alliance for Health Attn: Member Services 1600 Green Hills Road Suite 101 Scotts Valley, CA 95066 If you are a provider or member of the public and would like a printed copy of the provider directory, please call (877) 778-3915. [parameter=value]&_include=OrganizationAffiliation:location, GET [base]/OrganizationAffiliation? You are now being transferred to the CCA corporate website. Sonoma You can also use the filters to search for more specific information. Periodontist A doctor may work with other doctors. Effective January 2023, CCA is expanding its product offering in Massachusetts with one new Medicare plan. Downloadable PDF Directories A Reset font size. The CCA uncommon care model has demonstrated success in reaching and engaging individuals with significant medical, behavioral, and social needsimproving quality of care while keeping patients and members safely at home. Select OrganizationAffiliations with the specified role. Accepting new patients: The doctor is taking new patients. FAQs, Case Studies, Issue Briefs, and more. The information reported on this Web site is based on the information provided to CCHP from the participating provider and/or verified by licensing and accrediting entities. Find Reviews and Contact information on Klinikum Altmhlfranken Gunzenhausen. Select insurance plans of the specified type. Dental Clinics Serving Medi-Cal Members. The DaVinci PDEX Plan-Net Network profile is based on the core FHIR Organization resource, and the DaVinci PDEX Plan-Net Organization profile is based on the core FHIR US Core Organization resource. Preferred Provider: A doctor that meets strict quality standards. CCHP Medi-Cal members should contact the DHCS Medi-Cal Rx Help Line for any pharmacy questions (1-800-977-2273, TTY 1-800-430-7077). Name: The doctor or hospital that is part of the CCP network. Chinese The online Beacon Provider Directory can be found at the link below. You have the right to call our Member Services department at 1-877-814-1861 to get help finding an appointment to a closer . Benefits of CCAH Provider Portal Please select a county CCA now offers three Medicare plans in Massachusetts that combine medical and dental coverage, prescription drugs, and supplemental benefits. Mendocino Medi-Cal members can also go to the Medi-Cal Rx webpage to find Medi-Cal Rx participating pharmacies. Language Assistance Mongolian Exceptions may apply to the timely access standards if the DMHC has found exceptions to be permissible. Please select the county where you live. The DaVinci PDEX Plan-Net PractitionerRole profile is based on the core FHIR PractitionerRole resource. You are now being transferred to the CCA corporate website. The doctor provides an excellent patient experience. At Commonwealth Care Alliance, we take responsibility for making our relationship with each provider a true partnership. We share our providers dedication to assuring the highest levels of care and service for people with complex health needs. Yolo Find a Provider You can use our online directory to find doctors, specialists and other providers in the network that come with your plan. Pharmacy: CCHP Commercial members can refer to the online search engine for pharmacies but also can access all Walgreens and Rite Aid locations. Provider Directory - Central California Alliance for Health Home > For Providers > Provider Resources > Provider Directory Provider Directory Online Provider Directory Search the Online Provider Directory. Members who are enrolled in our Medi-Cal plan or County Employee Plan B can choose providers from the CPN or RMC network. Russian County: A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time. [parameter=value]&_include=PractitionerRole:service, GET [base]/PractitionerRole? Llame al 866-610-2273 (TTY 711). [parameter=value]&_include=Organization:partof, GET [base]/Organization? can be viewed free at osteopathic.org. Select roles filled by the specified practitioner. Using read-only RESTful GET API calls (PUT and POST are not currently supported), you can create an application to access information about our providers and pharmacies. CCP checks this information at least every 3 years. Connecting, solving and transforming healthcare business challenges. Select HealthcareServices providing the specified category of services. Operating rule development for these transactions is currently underway. Select Practitioners with the specified name (matches against any of the elements in the HumanName data type). Select products that are offered in the specified location. Frequently Asked Questions, GRIEVANCE FORM Select roles filled by the specified organization. Select roles where the organization is a member of the specified health insurance provider network. A Location is the physical place where health care services are provided, practitioners are employed, organizations are based, etc. Hmong Registered Dental Hygienists in Alternative Practice. Contra Costa View rating by specialty and compare nearby hospitals. On a quarterly basis, CCHP emails a Network Update link for the group to report any changes to the information CCHP has on file. Availability of Hard Copy Directories: Members may request printed directories or have web pages printed and mailed to them by clicking on the link below. Operating rule development for these transactions is currently underway. Thank you for the opportunity to partner with you. , California See our linguistic access and accessibility policy. Korean Continuity of Care Policy, 2023 Central California Alliance for Health | Website Feedback, Enhanced Care Management and Community Supports, Member Services Advisory Group Application, Whole Child Model Family Advisory Committee (WCMFAC), Provider Credentialing Applications and Policies, Complex Case Management and Care Coordination, Pain Management and Substance Use Resources, Interpreter Services Provider Quick Reference Guide, Interpreter Services Quality Assurance Form, Promoting Cultural and Linguistic Competency, Breastfeeding Support and Breast Pump Benefit, Prior Authorization Information Request for Injectable Drugs, Medical Nutrition Therapy Benefit Quick Reference Guide, Antidepressant Medication Management Tip Sheet, Immunizations: Adult Exploratory Measure Tip Sheet, Programmatic Measure Benchmarks & Performance Improvement, 90-Day Referral Completion Exploratory Tip Sheet, Application of Fluoride Varnish Tip Sheet, Immunizations: Children (Combo 10) Tip Sheet, Chlamydia Screening in Women Exploratory Measure Tip Sheet, Child and Adolescent Well-Care Visits Tip Sheet, Child and Adolescents BMI Assessment Tip Sheet, Well-Child Visits in the First 15 Months of Life Tip Sheet, Unhealthy Alcohol Use in Adolescents and Adults Tip Sheet, Tuberculosis (TB) Risk Assessment Exploratory Tip Sheet, Maximizing Your Value-Based Payments using CPT Category II Coding Tip Sheet, Lead Screening in Children Exploratory Measure Tip Sheet, Diabetic HbA1c Poor Control >9% Tip Sheet, Developmental Screening in the First 3 Years Tip Sheet, Controlling High Blood Pressure Exploratory Measure Tip Sheet, Best Practices for Reducing Patient No-Shows Tip Sheet, Ambulatory Care Sensitive Admissions Tip Sheet, USPSTF Recommendations for Primary Care Practice, Preventable Emergency Care Visit Diagnosis Tip Sheet, California Management Guidelines: Childhood Lead Poisoning, Standard of Care Guidelines: Childhood Lead Poisoning, Adverse Childhood Experiences (ACEs) Screening in Children and Adolescents Tip Sheet, Screening for Depression and Follow-Up Plan Tip Sheet, Initial Health Assessment Billing Code List, Chronic and Persistent Conditions Health Measures, DHCS Facility Site Review (FSR) Checklist, FSR Critical Elements: Interim Monitoring Form, DHCS Medical Record Review (MRR) Checklist, Screening for Adverse Childhood Experiences (ACEs). Select Organizations of the specified type. Oral Pathologist Use the Provider Directory Information Update Form to alert us to any changes to your provider information. Plumas Lake You have the right to call our Member Services department at 1-877-814-1861 to get help finding an appointment to a closer specialist. [parameter=value]&_include=InsurancePlan:owned-by, GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:coverage-area. We can explain what hospitals are near you. If your zip code and provider type are listed, CenCal Health will assist you in getting an appointment. Select products that are administered by the specified organization. We are dependent on the accuracy and timeliness of changes to the information being reported to CCHP by the providers.
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