CAQH CORE Operating Rules are helping streamline administrative transactions for health plans, healthcare providers and vendors. PDF Monterey and Santa Cruz Medi-Cal Provider Directory Gua de Proveedores Select PractitionerRoles available at the specified location. Provider Directory Welcome to Contra Costa Health Plan's Provider Online Search Engine Begin Your Search Here Request Printed Copy of Provider Directory Or call: 1-877-661-6230 (Option 2) Or write: Contra Costa Health Plan Attn: Member Services 595 Center Avenue, Suite 100 Martinez, CA 94553 View/Download Copy of Provider Directory **In Dukes and Nantucket Counties: CCA health plans are not yet available. This program arms you with the information to reduce your toxic exposure, increase your liver's biotransformation of toxins, and to enhance your elimination of these transformed toxins from your body. Shasta [parameter=value]&_revinclude=InsurancePlan:administered-by, GET [base]/Organization? Authentication is not required to access the Conformance resource. CORE is bringing the healthcare industry together to accelerate interoperability, increase automation and align administrative and clinical activities. [parameter=value]&_include=Organization:coverage-area, GET [base]/Organization? Who is CenCal Health/What is a Local Health Plan? [parameter=value]&_include=HealthcareService:organization, GET [base]/HealthcareService? Select Locations that are part of the specified location. Marin 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. The CCAH provider portal gives you the information, tools and resources you need to support the day-to-day needs of your patients and office. Merced Search - Provider Directory What care are you looking for? 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). The doctor or hospital gives CCP this information on their application when they join the health plan. Certified Orthodontist Enhanced Care Management and Community Supports, Utilization Management: Authorization and Referrals, Request Printed Copy of Provider Directory, The American Board of Medical Specialties website, linguistic access and accessibility policy, Urgent care appointments not requiring prior authorization: within 48 hours of request, Urgent care appointments requiring prior authorization: within 96 hours of request, Non-urgent appointments for primary care: within 10 business days of request, Non-urgent appointments with specialists: within 15 business days of request, Non-urgent appointments for ancillary services for the diagnosis or treatment of injury, illness or other health conditions: within 15 business days of request, First Prenatal Visit: within 14 calendar days of request, Mental Health Routine Non-Urgent: within 10 business days of request, Mental Health Routine Non-Urgent Follow-Up: within 10 business days of request, Mental Health Urgent: within 48 hours of request. If you have a timely access concern, you can contact CCHP's Utilization Management at 1-877-661-6230 option 4 or file a complaint with the California Department of Managed Health Care by calling the DMHC Toll-free provider complaint line at: 1-877-525-1295. Contra Costa [parameter=value]&_include=PractitionerRole:service, GET [base]/PractitionerRole? 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. Most hospitals in Contra Costa County and the immediate surrounding area are participants. [parameter=value]&_revinclude=HealthcareService:organization, GET [base]/Organization? In those situations, CenCal Health can still get you care. 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. CCHP discourages the use of family members, friends or minors to interpret or translate materials. Dental Clinics Serving Medi-Cal Members. You can get these documents for free in other formats, such as large print, braille, or audio. Select Locations managed by the specified organization. Sierra [parameter=value]&_revinclude=OrganizationAffiliation:location, GET [base]/Location?[parameter=value]&_revinclude=PractitionerRole:location. Nurse Advice Line Hospital Quality: The hospitals performance rating. Taiwanese 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. 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. Glenn They might also work in different offices or clinics. Select PractitionerRoles associated with the specified specialty. [parameter=value]&_revinclude=PractitionerRole:organization, GET [base]/Organization? The Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors. Health (Just Now) The Central California Alliance for Health (the Alliance) has contracted with Beacon Health Options to provide some outpatient mental health services. Sutter MAY: An optional inclusion for the implementation; not a requirement. Spanish 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. Provider Directory | Community Cares Plan The RESTful capabilities are discussed in further detail below. There are more protections for immigrants and their families to use public benefits. Showing of 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. This makes sure that Medi-Cal members have access to covered services. Alliance Provider Directory - provider.portal.ccah-alliance.org Russian Skilled Nursing Facility/Intermediate Care Facilities: within 5 business days of request. Fresno 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. Golden Road 365 Detox - Transform Your Health in 21 Days 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. Farsi [parameter=value]&_revinclude=HealthcareService:location, GET [base]/Location? On a quarterly basis, CCHP emails a Network Update link for the group to report any changes to the information CCHP has on file. Effective January 2023, CCA is expanding its product offering in Massachusetts with one new Medicare plan. [parameter=value]&_revinclude=InsurancePlan:coverage-area, GET [base]/Location? Select Practitioners with the specified given name. Modoc Accreditation: This information is collected at the time the facility initially joins the network and then every three years thereafter. Yolo Llame al 866-610-2273 (TTY 711). For more information or any questions please call Member Services at 1-866-899-4828 TTY/TDD 1-855-655-5303. 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. Facility: CCHP updates facility information daily as changes are reported by the facility. Select health insurance provider networks available in a region described by the specified location. Hindi Search for providers using a specific location or your current location. Resources in the Conformance category are used to represent metadata about the datatypes, resources, and CCAH Provider Directory API features of the FHIR specification and can be used to create derived specifications. 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. The Healthcare Service resource typically describes services offered by an organization/practitioner at a location. Enrollment for these plans ends December 7. 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. Health and Wellness Rewards + Decrease font size. Medi-Cal members can also go to the Medi-Cal Rx webpage to find Medi-Cal Rx participating pharmacies. The DaVinci PDEX Plan-Net OrganizationAffiliation profile is based on the core FHIR OrganizationAffiliation resource. Kern Mendocino Preferred Provider: A doctor that meets strict quality standards. Please select the county where you live. As of 01/01/2022, Medi-Cal Rx is the administrator of Medi-Cal Pharmacy Benefits. We collect this information when providers join the network and is reviewed quarterly at the time of the provider network update. Santa Cruz The resource may be used to encompass a variety of services covering the entire health care spectrum, including promotion, prevention, diagnostics, hospital and ambulatory care, home care, long-term care and other health-related and community services. A Reset font size. Updates will be posted at cchealth.org. Santa Barbara County Providers In this listing, you will find a complete list of contracted CenCal Health providers in Santa Barbara County. Phone Number: The doctors office or hospital phone number. Pharmacy: CCHP Commercial members can refer to the online search engine for pharmacies but also can access all Walgreens and Rite Aid locations. The information in your search results reflects our records at the time of our last update to the search website, which is updated nightly. Prosthodontist Oral Pathologist Destination Guide: Gunzenhausen (Bavaria, Regierungsbezirk Hmong Sacramento In those situations, CenCal Health can still get you care. For more information, please call the doctors office. Ventura Learn More. CCA Provider Homepage | Commonwealth Care Alliance MA 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. A Practitioner is a person who is directly or indirectly involved in the provisioning of health care. FAQs, Case Studies, Issue Briefs, and more. 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. 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. Armenian PDF Medi-Cal Merced Provider Directory - ccah-alliance.org Select PractitionerRoles providing the specified service. [parameter=value]&_include=OrganizationAffiliation:location, GET [base]/OrganizationAffiliation? 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. The Central California Alliance for Health (the Alliance) has contracted with Beacon Health Options to provide mental health services. Select roles where the practitioner is a member of the specified health insurance provider network. Trinity New for 2023: CCA Medicare Premier will be available in Middlesex, Suffolk, Norfolk, and Worcester Counties. Documents will be mailed within five (5) business days of receiving request. This specification uses SHALL, SHOULD and MAY as a guideline for required, recommended and optional data FHIR standards. Imperial Japanese Select roles filled by the specified organization. [parameter=value]&_include=Location:partof, GET [base]/Location? Accepting new patients: The doctor is taking new patients. 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. [parameter=value]&_include=InsurancePlan:administered-by, GET [base]/InsurancePlan? Specialty: A provider's specialty is identified when they join the health plan 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. The DaVinci PDEX Plan-Net PractitionerRole profile is based on the core FHIR PractitionerRole resource. Tulare Select products that are offered in the specified location. Our Fear Free methods and our compassionate staff look forward to making your pet's visit to the vet a positive one! 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). Alameda Stanislaus Search - Provider Directory Commonwealth Care Alliance (CCA) is pleased to announce that we are partnering with Cognizant to implement our new claims platform, Facets, effective Q2 2023. General Practitioner The Provider Directory API accesses the Alliance FHIR server portion of the Provider and Pharmacy Directories. [parameter=value]&_include=PractitionerRole:location, GET [base]/PractitionerRole? Thai [parameter=value]&_include=OrganizationAffiliation:service, GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:network. 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. It requires CenCal Health to meet both time and distance standards based on county population density. San Diego Current time in Gunzenhausen is now 07:51 PM (Saturday). A doctor may work with other doctors. 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. San Benito You can also access the Kaiser online directory. Plumas The doctor provides an excellent patient experience. Provider Directory :: Health Plan :: Contra Costa Health Services Essential Provider: Essential Providers are certain providers that are statewide resources for all Managed Care Plans in all regions. The FHIR server may return the data, but there is no requirement to do so. [parameter=value]&_include=PractitionerRole:practitioner, GET [base]/PractitionerRole? + Reset font size. Select Locations with the specified state address. Location: The doctors office or hospital address. Gunzenhausen in Regierungsbezirk Mittelfranken (Bavaria) with it's 16,477 habitants is a city located in Germany about 262 mi (or 422 km) south-west of Berlin, the country's capital town. Mariposa Provider Directory - Central California Alliance for Health Home > For Providers > Provider Resources > Provider Directory Provider Directory Online Provider Directory Search the Online Provider Directory. Operating rule development for these transactions is currently underway. + Increase font size. CCP checks this information at least every 3 years. Found inside - Page 57. CCAH Provider Portal - provider.portal.ccah-alliance.org CCA now offers three Medicare plans in Massachusetts that combine medical and dental coverage, prescription drugs, and supplemental benefits. A Location is the physical place where health care services are provided, practitioners are employed, organizations are based, etc. Select products that are administered by the specified organization. Central California Alliance for Health | ccah-alliance.org You are now being transferred to the CCA corporate website. Full Print Version of the CBH Provider Directory (Updated 1/3/2023) Step 1: Are you looking for a provider that services adults or children/adolescents? San Francisco Provider Directory - Central California Alliance for Health To report any errors, click on the link below. Click here to see the detailed categorization and full set of resources that fall into this category in the HL7 FHIR Standard. All of CCHP contracted hospitals utilize hospitalists to admit and provide services to inpatient members. The FHIR server must return this data. Tagalog [parameter=value]&_include=OrganizationAffiliation:participating-organization, GET [base]/OrganizationAffiliation? GET [base]/PractitionerRole/[id]/_history/vid, GET [base]/PractitionerRole? Implements RESTful behaviors according to the FHIR specification. Providers must document this choice in the member's medical record. Select roles offered by the specified organization. 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 PractitionerRoles with the specified role. 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. Alliance members must use a pharmacy that works with MedImpact. Placer Below we describe the information in the fields in the provider directory. Compassionate Care Animal Hospital (CCAH) is a full-service animal hospital located in Ann Arbor, Michigan. This is not a guarantee they will be available to accept additional patients at the time you contact them.
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