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. 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. 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. Select HealthcareServices provided by the specified organization. Shasta Please indicate below any changes to the directory listing for the practice listed above. Search for providers using a specific location or your current location. The online Beacon Provider Directory can be found at the link below. Nurse Advice Line Search by Doctor Type Search by Doctor Name Search by Hospital/Facility Doctor type Primary Care Physician Specialty Select Primary Care Type Family Medicine Zip Code Distance Within 15 miles Plan Type Find-A-Dentist. Insurance Plan describes a health insurance offering comprised of a list of covered benefits (for example: the product), costs associated with those benefits (for example: the plan) and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc. Vietnamese 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. Find Reviews and Contact information on Klinikum Altmhlfranken Gunzenhausen. Certificate. Mono 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. Health and Wellness Rewards Del Norte We partner with a broad network of providers, dentists, pharmacies, and other healthcare facilities. Punjabi Alliance members must use a pharmacy that works with MedImpact. SHALL: An absolute requirement for all implementations. The DaVinci PDEX Plan-Net OrganizationAffiliation profile is based on the core FHIR OrganizationAffiliation resource. Please select the county where you live. Select Locations with the specified address. Provider Directory - Central California Alliance for Health Home > For Providers > Provider Resources > Provider Directory Provider Directory Online Provider Directory Search the Online Provider Directory. Essential Provider: Essential Providers are certain providers that are statewide resources for all Managed Care Plans in all regions. Enrollment for these plans ends December 7. 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. If you are a member or potential member it is important for you to understand how our two networks are organized. Name: The doctor or hospital that is part of the CCP network. PCP's are not required to have hospital privileges. At Commonwealth Care Alliance, we take responsibility for making our relationship with each provider a true partnership. Adults Children/ Adolescents Step 2: Please enter your address to determine the closest providers. Modoc Hospital Affiliation: This information is collected from the provider at the time they initially join the network and verified upon initial and recredentialing, quarterly through the Network Update link, and reviewed on an annual basis. Effective January 2023, CCA is expanding its product offering in Massachusetts with one new Medicare plan. Enter the appropriate information below to view a list of Dental Providers who may be accepting new Medi-Cal patients. Select products that are administered by the specified organization. Medi-Cal Dental Program. CCP checks this information at least every 3 years. Dont miss our bimonthly newsletter for community partners. The FHIR server is recommended to return this data. Then click the magenta Get Location button. [parameter=value]&_include=PractitionerRole:practitioner, GET [base]/PractitionerRole? Santa Barbara GET [base]/Practitioner/[id]/_history/vid, GET [base]/Practitioner?[parameter=value]&_revinclude=PractitionerRole:practitioner. We can help you understand and assist you with obtaining referrals to see specialists, explain when referrals are not needed, and help you find a specialist in your area. Language interpreter services are available 24 hours a day, 7 days a week at no cost to the member. Language Assistance If you want to check to see if your doctor is board certified go to CertificationMatters.org, DoctorsThatDo.org, or call 1-866-ASK-ABMS (275-2267). Board Certifications: A doctor gets a certificate after completing extra training in their specialty. 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. Providers must document this choice in the member's medical record. 2023 - Community Care Plan - Provider Directory - Updated: 03/05/2023. Providers are doctors, physicians or other healthcare professionals that accesses information to help patients or track a refund. CalAIM: Enhanced Care Management (ECM) and Community Supports (CS) require prior authorization and are limited to members who meet specific eligibility criteria. Preferred Provider: A doctor that meets strict quality standards. Humboldt After reviewing the listing for your practice that you received via email or fax, please confirm that all information is correct, or indicate any changes for each provider in your practice (including mid-level practitioners). Select Practitioners with the specified name (matches against any of the elements in the HumanName data type). A Decrease font size. You can also access the Kaiser online directory. GET [base]/HealthcareService/[id]/_history/vid, GET [base]/HealthcareService? 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. CCA now offers three Medicare plans in Massachusetts that combine medical and dental coverage, prescription drugs, and supplemental benefits. You can also call the Medi-Cal Rx Customer Service Center at 800-977-2273 (TTY: Dial 7-1-1). Arabic View Urgent Visit Access Offices in Santa Cruz County. Accreditation: This information is collected at the time the facility initially joins the network and then every three years thereafter. Most hospitals in Contra Costa County and the immediate surrounding area are participants. Found inside - Page 57. There are more protections for immigrants and their families to use public benefits. By entering a hospital name, the accreditation status and quality measures are listed. Please select a language To report incorrect provider information, members can contact member services by calling 1-877-661-6230 option 2 or by email: [email protected] and Providers or the general public can contact Provider Relations at [email protected] or by calling 1-877-800-7423 option 6. Thank you for the opportunity to partner with you. Hours: When the office or hospital is open to see patients. On a quarterly basis, CCHP emails a Network Update link for the group to report any changes to the information CCHP has on file. 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. Sometimes, there is not a needed provider close enough. 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. Find a Provider You can use our online directory to find doctors, specialists and other providers in the network that come with your plan. Alpine Please Note: Be sure to include your full address with City, State, and ZIP. 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. Monterey Tuolumne Endodontist Santa Cruz Showing of This specification uses SHALL, SHOULD and MAY as a guideline for required, recommended and optional data FHIR standards. * Translation services available for most languages. Select Practitioners with the specified family name. Yuba, Specialty: Website: The internet address that the doctor and practice information can be found. It is an in-depth medical detoxification and educational program designed to teach you the how and why behind every step you take. Select HealthcareServices with the specified name. Select PractitionerRoles with the specified role. Who is CenCal Health/What is a Local Health Plan? If your zip code and provider type are listed, CenCal Health will assist you in getting an appointment. The DaVinci PDEX Plan-Net Location profile is based on the core FHIR US Core Location resource. [parameter=value]&_include=InsurancePlan:owned-by, GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:coverage-area. Medi-Cal members can also go to the Medi-Cal Rx webpage to find Medi-Cal Rx participating pharmacies. Select services available in a region described by the specified location. If your zip code and provider type are listed, CenCal Health will assist you in getting an appointment. Select Locations managed by the specified organization. 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. [parameter=value]&_revinclude=PractitionerRole:organization, GET [base]/Organization? It requires CenCal Health to meet both time and distance standards based on county population density. Select OrganizationAffiliations associated with the specified specialty. A network is typically owned by a payer. The doctor or hospital gives CCP this information on their application when they join the health plan. 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. Placer Specialty: The area of medicine the doctor provides care to patients. 6HUYLFHV GHSDUWPHQW DW HPDLO [email protected] 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. A health care provider insurance network is an aggregation of organizations and individuals that deliver a set of services across a geography through health insurance products/plans. The FHIR server may return the data, but there is no requirement to do so. [parameter=value]&_revinclude=OrganizationAffiliation:location, GET [base]/Location?[parameter=value]&_revinclude=PractitionerRole:location. San Mateo Mariposa Korean Taiwanese [parameter=value]&_include=HealthcareService:coverage-area, GET [base]/HealthcareService? + Increase font size. In the CCHP provider online search engine above you can search for providers that participate with CCHP's two networks consisting of over 5,000 primary care providers and specialists. ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. 1 Percent of ICO + SCO members weighted together who have at least one qualifying touch by a care team member within a given month (Rolling three-month average, 7/2021), 2Combined CCA ICO + SCO rate per 1,000 members; hospitalization rates are consistently below the per capita averages during COVID-19 pandemic. Cambodian Oral Surgeon Our directories are printed by county. + Reset font size. Location: The doctors office or hospital address. Were committed to supporting our providers, so that together we deliver the highest-quality, individualized care to your patients. Los Angeles [parameter=value]&_include=Location:partof, GET [base]/Location? The most current board certification status can be verified at The American Board of Medical Specialties website. The DaVinci PDEX Plan-Net PractitionerRole profile is based on the core FHIR PractitionerRole resource. To report any errors, click on the link below. 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. [parameter=value]&_include=PractitionerRole:organization, GET [base]/PractitionerRole? 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 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). Amador They might also work in different offices or clinics. Sonoma 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. For further assistance, members can contact Member Services at 1-877-661-6230 option 2 and providers can access interpreter services at 1-877-800-7423 option 4 or directly at 1-866-874-3972. Call 866-610-2273 (TTY 711). Select Locations with the specified city address. Learn More. In those situations, CenCal Health can still get you care. If you cannot find a dentist in your area who is accepting new patients, please contact the Medi-Cal Telephone Service Center for additional help at 1-800-322-6384. Thai Learn best practices and earn CBI payments for ACE screenings at your practice. Siskiyou Periodontist Interpreter services are available at all CCHP points of contact where members may reasonably need such services. Waiting time in provider office: within 45 minutes or less from the time of the patients appointment until they are taken to the exam room. Select PractitionerRoles associated with the specified specialty. 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. Hospital Quality: The hospitals performance rating. We are dependent on the accuracy and timeliness of changes to the information being reported to CCHP by the providers. 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. Ventura Hindi Accessible with a Wheelchair: The office is handicap accessible. 734-436-0455 CCHP does not verify these skills. Select Locations with the specified state address. The local timezone is named Europe / Berlin with an UTC offset of 2 hours. 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. Step 3a: [parameter=value]&_revinclude=InsurancePlan:administered-by, GET [base]/Organization? 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. If CenCal Health cannot find you an appointment with a closer specialist, we will arrange transportation to see the specialist, if needed. Health and Wellness Rewards Riverside 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. A Reset font size. 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. CCH will closely monitor activity at the refinery and notify the public if the flaring results in any offsite health impact to the community. 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).