To select the Kaiser Permanente Medical Group as your PCP for Medi-Cal, you must have been a recent Kaiser member or meet other criteria to qualify. Please select a county Los Angeles Our nationally recognized care model is proven effective in addressing unmet social determinants of health, behavioral health, and medical needs. Oral Pathologist This is not a guarantee they will be available to accept additional patients at the time you contact them. This section describes the FHIR profiles, resources and RESTful capabilities that the Provider Directory API supports. The Boston Globe Names Commonwealth Care Alliance a Top Place to Work for 2022, 8:00 am to 6:00 pm, Monday through Friday, Superior patient experiences and improved clinical outcomes, Optimal access, responsiveness, transparency, and timeliness in all our communications, Operational excellence and strong analytics and reporting that support provider performance. Our Member Services staff can help you find and select a doctor from the Provider Directory for Members. Sometimes, there is not a needed provider close enough. The doctor or hospital gives CCP this information on their application when they join the health plan. An example is a doctor who works only with the heart, cancer, or bones. Thai Our Regional Medical Center Network (RMC) has 10 Health Centers conveniently located throughout the county and the Regional Medical Center Hospital in Martinez. Tagalog 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. Potential members may contact our Marketing Department at 1-877-661-6230 option 6. [parameter=value]&_include=PractitionerRole:organization, GET [base]/PractitionerRole? A Network refers to a health care provider insurance network. [parameter=value]&_revinclude=HealthcareService:location, GET [base]/Location? GET [base]/OrganizationAffiliation/[id]/_history/vid, GET [base]/OrganizationAffiliation? Select roles filled by the specified organization. Madera [parameter=value]&_include=Organization:partof, GET [base]/Organization? PDF Monterey and Santa Cruz Medi-Cal Provider Directory Gua de Proveedores Arabic [parameter=value]&_include=PractitionerRole:practitioner, GET [base]/PractitionerRole? Hmong Tuolumne Santa Barbara To find a pharmacy, use Medi-Cal Rx's online pharmacy directory using the link below: The Central California Alliance for Health (the Alliance) contracts with a company called MedImpact to provide pharmacy services. Pedodontist 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. Orange [parameter=value]&_include=Location:partof, GET [base]/Location? Nevada View Urgent Visit Access Offices in Merced County. Farsi If you are a member and would like to choose one of our PCPs, please contact our Member Services department at 1-877-661-6230 option 2. Search - Provider Directory [parameter=value]&_include=OrganizationAffiliation:primary-organization, GET [base]/OrganizationAffiliation? + Reset font size. 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. If the specialty needed is not available within the assigned network, which may be due to, but is not limited to the provider being unable to make an appointment in a timely manner, the provider is located unreasonably far away, or you require a specialty not present in the RMC network, CCHP and the assigned PCP may arrange for whatever referrals, authorizations, and treatments necessary with a specialist that is available in a non-assigned network. Some doctors might have all the patients they can fit in, while still giving you the best care. Yuba, Specialty: CCHP does not verify these skills. HL7 FHIR DaVinci PDEX Payer Network (Plan-Net) Implementation Guide Version 1.0.0, HL7 FHIR DaVinci PDEX Plan-Net Profiles, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Endpoint, DaVinci PDEX Plan-Net HealthcareService profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-HealthcareService, http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/HealthcareServiceCategoryCS, DaVinci PDEX Plan-Net InsurancePlan profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan, http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsurancePlanTypeCS, http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location, http://terminology.hl7.org/CodeSystem/v3-RoleCode, DaVinci PDEX Plan-Net Organization profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization, http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/OrgTypeCS, DaVinci PDEX Plan-Net OrganizationAffiliation profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-OrganizationAffiliation, DaVinci PDEX Plan-Net Practitioner profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Practitioner, DaVinci PDEX Plan-Net PractitionerRole profile. San Bernardino Provider Directory | Community Cares Plan Members have the choice to refuse professional interpreters and use adult family members or friends. We are dependent on the accuracy and timeliness of changes to the information being reported to CCHP by the providers. Contra Costa Health Plan (CCHP) has been serving the health care needs of Contra Costa County for over 40 years. For more information, please call the doctors office. On a quarterly basis, CCHP emails a Network Update link for the group to report any changes to the information CCHP has on file. Dont miss our bimonthly newsletter for community partners. San Benito Specialty: The area of medicine the doctor provides care to patients. Select roles offered by the specified organization. All of CCHP contracted hospitals utilize hospitalists to admit and provide services to inpatient members. CCA Senior Care Options Directory by County (2023) view: Bristol, Norfolk, Plymouth Essex Franklin, Hampden, Hampshire Middlesex Suffolk Worcester CCA Senior Care Options Directory by County - Spanish (2023) view: Bristol, Norfolk, Plymouth-Spanish Essex-Spanish Franklin, Hampden, Hampshire-Spanish Middlesex-Spanish Suffolk-Spanish Our directories are printed by county. Llame al 866-610-2273 (TTY 711). Cambodian Sometimes CCP does not receive a notice that the information has changed. San Mateo You can get these documents for free in other formats, such as large print, braille, or audio. ProcessLogoff - provider.portal.ccah-alliance.org The Provider Directory API accesses the Alliance FHIR server portion of the Provider and Pharmacy Directories. Select health insurance provider networks available in a region described by the specified location. Learn More. GET [base]/Organization/[id]/_history/vid, GET [base]/Organization? Operating rule development for these transactions is currently underway. Frequently Asked Questions, GRIEVANCE FORM Registered Dental Hygienists in Alternative Practice. Providers in the CCRMC network are certified in languages spoken in addition to English. 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. Provider Directory - Central California Alliance for Health Home > For Providers > Provider Resources > Provider Directory Provider Directory Online Provider Directory Search the Online Provider Directory. The online Beacon Provider Directory can be found at the link below. CCA Provider Homepage | Commonwealth Care Alliance MA Medi-Cal members can also go to the Medi-Cal Rx webpage to find Medi-Cal Rx participating pharmacies. [parameter=value]&_revinclude=InsurancePlan:coverage-area, GET [base]/Location? Essential Provider: Essential Providers are certain providers that are statewide resources for all Managed Care Plans in all regions. If the provider no longer accepts new patients, the provider is required to notify CCHP within five (5) business days. Solano In those situations, CenCal Health can still get you care. Includes companies, institutions, corporations, departments, community groups, health care practice groups, payer/insurer, etc. 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. Operating rule development for these transactions is currently underway. 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). CAQH CORE is the author of the final set of ACA-mandated operating rules for remaining HIPAA transactions, which include healthcare claims, enrollment and disenrollment in a health plan, premium payments, prior authorization and claims attachments. Select Organizations of the specified type. Please select the county where you live. FAQs, Case Studies, Issue Briefs, and more. You are now being transferred to the CCA corporate website. Found inside - Page 57. 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 products with the specified identifier. Groups: The practice a doctor works in. Select organizations with the specified address (matches any of the string elements of an address). Only submit information below that needs to be changed in the directory. 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. A profile is a set of rules which allows a resource to be constrained, or to include extensions, so the resource can add additional attributes. Alliance Provider Portal Please select a specialty Members are entitled to receive full and equal access to covered service including members with disabilities as required under the American with Disabilities Act of 1990 in section 504 of the Rehabilitation Act of 1973. Search by plan name, specialty, location, or provider name. Timely Access to Care: The California Department of Managed Health Care (DMHC) has regulations set forth in Title 28, Section 1300.67.2.2 for health plans to provide timely access to care for our members. Nurse Advice Line Mandarin Select services associated with the specified specialty. Alliance members and Primary Care Providers (PCPs) may access Beacon Health Options 24 hours a day, 365 days a year via a toll-free line. Our Fear Free methods and our compassionate staff look forward to making your pet's visit to the vet a positive one! If you are a member or potential member it is important for you to understand how our two networks are organized. . Endodontist Golden Road 365 Detox - Transform Your Health in 21 Days [parameter=value]&_include=OrganizationAffiliation:location, GET [base]/OrganizationAffiliation? Select PractitionerRoles with the specified role. [parameter=value]&_include=PractitionerRole:service, GET [base]/PractitionerRole? Cultural Competency Training: The office staff is trained to meet the needs of people of all different cultures. Telephone wait time for practice/plan to answer: within 10 minutes, Telephone call back wait time practice/provider office: by the end of the next business day, Telephone call back wait time triage: within 30 minutes. + Decrease font size. Search - Provider Directory What care are you looking for? Medi-Cal Dental Dental Portal Medi-Cal Provider Directory Enter the appropriate information below to view a list of Dental Providers who may be accepting new Medi-Cal patients. Alliance Care IHSS Price Transparency Tool. Online Provider Directory http://www.ccah-alliance.org/providerdirectory.html Click on Provider Directory Search Effective January 2015 CENTRAL CALIFORNIA ALLIANCE FOR HEALTH Provider Directory / Gua de Proveedores / Phau Ntawv Teev Cov Kws Khomob A.2 Primary Care Physicians/ Doctores de Cuidado Primario/ Cov Thawj Kws Khomob Modoc [parameter=value]&_include=InsurancePlan:owned-by, GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:coverage-area. Fresno Imperial Learn best practices and earn CBI payments for ACE screenings at your practice. By entering a hospital name, the accreditation status and quality measures are listed. Select Locations that are part of the specified location. Provider Directory :: Health Plan :: Contra Costa Health Services To find a pharmacy, use MedImpact's online Pharmacy Directory using the link below. Member Handbook [parameter=value]&_include=OrganizationAffiliation:service, GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:network. Accessible with a Wheelchair: The office is handicap accessible. View Urgent Visit Access Offices in Monterey County. To report incorrect provider information, members can contact member services by calling 1-877-661-6230 option 2 or by email: cchp@cchealth.org and Providers or the general public can contact Provider Relations at providerrelations@cchealth.org or by calling 1-877-800-7423 option 6. 2020 K Street, NW - Suite 660 Washington, D.C. 20006. CORE is bringing the healthcare industry together to accelerate interoperability, increase automation and align administrative and clinical activities. Select HealthcareServices provided by the specified organization. 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 are now being transferred to the CCA corporate website.