Modoc Together, we can bring uncommon care to more people with significant needs. There are more protections for immigrants and their families to use public benefits. Alliance Care IHSS Price Transparency Tool. 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). Found inside - Page 57. There are more protections for immigrants and their families to use public benefits. Information regarding quality is obtained by the Joint Commission at the time of survey, as new information becomes available and at resurvey. Commonwealth Care Alliance (CCA) is pleased to announce that we are partnering with Cognizant to implement our new claims platform, Facets, effective Q2 2023. The local timezone is named Europe / Berlin with an UTC offset of 2 hours. Members have the choice to refuse professional interpreters and use adult family members or friends. The Healthcare Service resource typically describes services offered by an organization/practitioner at a location. Select products with the specified identifier. CORE Certification San Joaquin 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. The Provider Directory API accesses the Alliance FHIR server portion of the Provider and Pharmacy Directories. 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. We are dependent on the accuracy and timeliness of changes to the information being reported to CCHP by the providers. CCA One Care is available in 12 counties in Massachusetts: Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester. Nurse Advice Line View Urgent Visit Access Offices in Merced County. 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. The ACA has taken operating rules to a new level. Select products that are owned by the specified organization. Benefits of CCAH Provider Portal Nevada Our Community Provider Network (CPN) is a network of community based private providers of primary and specialty care. A doctor may work with other doctors. Compassionate Care Animal Hospital (CCAH) is a full-service animal hospital located in Ann Arbor, Michigan. GET [base]/InsurancePlan/[id]/_history/vid, GET [base]/InsurancePlan? Frequently Asked Questions, GRIEVANCE FORM Mariposa A Increase font size. Russian Languages Spoken: These abilities are self-reported by the providers in the CPN network when the provider joins the network and at the time of recredentialing. Placer 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). Certified Orthodontist Los Angeles They will be able to assist you in making the best health plan choice for you. Thai For more information, please call the doctors office. Solano [parameter=value]&_include=PractitionerRole:location, GET [base]/PractitionerRole? Our Provider and Pharmacy Directory make it easy to find the care you need. Del Norte Providers in the CCRMC network are certified in languages spoken in addition to English. Most hospitals in Contra Costa County and the immediate surrounding area are participants. If CenCal Health cannot find you an appointment with a closer specialist, we will arrange transportation to see the specialist, if needed. Endodontist Ventura Select Locations with the specified city address. Plumas Periodontist View Urgent Visit Access Offices in Santa Cruz County. Electronic Funds Transfer (EFT) Enrollment Form, Behavioral/Mental Health Substance Use Disorder. If you are a member or potential member it is important for you to understand how our two networks are organized. On a quarterly basis, CCHP emails a Network Update link for the group to report any changes to the information CCHP has on file. Adults Children/ Adolescents Step 2: Please enter your address to determine the closest providers. Select products that are administered by the specified organization. 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. CCP must include these essential providers in its network, even if the provider is located outside of the region served by CCP. 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. Website: The internet address that the doctor and practice information can be found. Sometimes, there is not a needed provider close enough. Please Note: Be sure to include your full address with City, State, and ZIP. San Mateo [parameter=value]&_revinclude=InsurancePlan:coverage-area, GET [base]/Location? Butte The DaVinci PDEX Plan-Net Practitioner profile is based on the core FHIR US Core Practitioner resource. Vietnamese 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. Dental Clinics Serving Medi-Cal Members. Results are as of 12/1/2020 unless otherwise noted. [parameter=value]&_include=Location:organization, GET [base]/Location? Authentication is not required to access the Conformance resource. This directory is for informational use only. Specialty: A provider's specialty is identified when they join the health plan network. Please select the county where you live. Select HealthcareServices available at the specified location. Language Assistance 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. A Practitioner is a person who is directly or indirectly involved in the provisioning of health care. Select roles filled by the specified practitioner. 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. Armenian El Dorado 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. Accessibility 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. Hmong Pedodontist 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 You have the right to call our Member Services department at 1-877-814-1861 to get help finding an appointment to a closer . CAQH CORE Operating Rules are helping streamline administrative transactions for health plans, healthcare providers and vendors. SHOULD: A best practice or recommendation for the implementation. Inyo Search - Provider Directory What care are you looking for? The DaVinci PDEX Plan-Net Location profile is based on the core FHIR US Core Location resource. Imperial San Benito Select health insurance provider networks available in a region described by the specified location. The DaVinci PDEX Plan-Net HealthcareService profile is based on the core FHIR HealthcareService resource. San Luis Obispo Select roles where the organization is a member of the specified health insurance provider network. Essential Provider: Essential Providers are certain providers that are statewide resources for all Managed Care Plans in all regions. Tagalog See our linguistic access and accessibility policy. Effective January 2023, CCA is expanding its product offering in Massachusetts with one new Medicare plan. Select Organizations of the specified type. To report any errors, click on the link below. The hospital reports the safety and quality of its care. Preferred Provider: A doctor that meets strict quality standards. CCA One Care | CCA Senior Care Options | CCA Medicare Advantage. Trinity InsureKidsNow Search. Orange Accreditation: This information is collected at the time the facility initially joins the network and then every three years thereafter. 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. Facility: CCHP updates facility information daily as changes are reported by the facility. Select HealthcareServices provided by the specified organization. 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. You can also access the Kaiser online directory. SHALL: An absolute requirement for all implementations. **In Dukes and Nantucket Counties: CCA health plans are not yet available. Santa Clara Sonoma Accepting New Patients: This provider accepts both new and existing patients. Groups: The practice a doctor works in. [parameter=value]&_revinclude=InsurancePlan:administered-by, GET [base]/Organization? Tuolumne CenCal Health is required by the Department of Health Care Services to meet network adequacy standards. 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). [parameter=value]&_revinclude=PractitionerRole:network, GET [base]/Organization?[parameter=value]&_revinclude=OrganizationAffiliation:participating-organization. Taiwanese Glenn Facilities may also notify us at any time regarding changes to their accreditation status. The DaVinci PDEX Plan-Net InsurancePlan profile is based on the core FHIR InsurancePlan resource. Specialty: The area of medicine the doctor provides care to patients. Providers are doctors, physicians or other healthcare professionals that accesses information to help patients or track a refund. You can get these documents for free in other formats, such as large print, braille, or audio. 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. Health (Just Now) The Central California Alliance for Health (the Alliance) has contracted with Beacon Health Options to provide some outpatient mental health services. Select roles where the practitioner is a member of the specified health insurance provider network. CCH will closely monitor activity at the refinery and notify the public if the flaring results in any offsite health impact to the community. New for 2023: CCA Medicare Premier will be available in Middlesex, Suffolk, Norfolk, and Worcester Counties. 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. 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 directoryupdates@cchealth.org or by calling 1-877-800-7423 option 6. 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. Member Handbook Interpreter services are available at all CCHP points of contact where members may reasonably need such services. Search from our 29,112 In-network providers, 5,058 primary care providers State (Required) * Location (Required) * Provider Name Optional Search Criteria Plan Name Specialty For Dentist, select "General Dentistry" in specialty drop down box above Need more specialty options? Lake 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. Alliance members must use a pharmacy that works with MedImpact. Please indicate below any changes to the directory listing for the practice listed above. Please give us a call, toll-free at 1-877-814-1861, and we can assist in the following ways: 2023 CenCal Health. Use the Provider Directory Information Update Form to alert us to any changes to your provider information. Yolo Frequently Asked Questions, GRIEVANCE FORM Spanish Specialty is verified when the practitioner joins the network and at the time of recredentialing through state licensing and board certification. The online Beacon Provider Directory can be found at the link below. The Boston Globe Names Commonwealth Care Alliance a Top Place to Work for 2022. Operating rule development for these transactions is currently underway. Please select a specialty View Urgent Visit Access Offices in Monterey County. 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. Select HealthcareServices of the specified type. Cultural Competency Training: The office staff is trained to meet the needs of people of all different cultures. Select OrganizationAffiliations with the specified role. Hospitals: The network hospitals a doctor can see their patients in. Please select a language Name: The doctor or hospital that is part of the CCP network. Language Assistance The Central California Alliance for Health (the Alliance) has contracted with Beacon Health Options to provide mental health services. . To verify the current status of a hospital visit jointcommission.org. Select Locations that are part of the specified location. We help you extend your reach into your patients homes and communities through care coordination, behavioral health, and long-term services. This information is subject to change without notice. Large healthcare providers may achieve CORE Certification. GET [base]/Organization/[id]/_history/vid, GET [base]/Organization? The FHIR server is recommended to return this data. Health and Wellness Rewards 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. Find a Provider You can use our online directory to find doctors, specialists and other providers in the network that come with your plan. Adoption Directory [parameter=value]&_include=OrganizationAffiliation:location, GET [base]/OrganizationAffiliation? [parameter=value]&_include=OrganizationAffiliation:service, GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:network. Locations can range in scope from a room in a building to a geographic region/area. A Decrease font size. Napa Yuba, Specialty: By entering a hospital name, the accreditation status and quality measures are listed. San Diego The doctor or hospital gives CCP this information on their application when they join the health plan. 2023 - Community Care Plan - Provider Directory - Updated: 03/05/2023. Select Organizations with the specified name. 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 Farsi It requires CenCal Health to meet both time and distance standards based on county population density. Sutter 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. Accepting new patients: The doctor is taking new patients. ProcessLogoff - provider.portal.ccah-alliance.org [parameter=value]&_include=Organization:coverage-area, GET [base]/Organization? The call is free. Oral Surgeon Select Practitioners with the specified name (matches against any of the elements in the HumanName data type). 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. If your zip code and provider type are listed, CenCal Health will assist you in getting an appointment. 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. Sacramento Please select a county [parameter=value]&_revinclude=OrganizationAffiliation:location, GET [base]/Location?[parameter=value]&_revinclude=PractitionerRole:location. Learn best practices and earn CBI payments for ACE screenings at your practice. Arabic We can explain what hospitals are near you. This certificate expires, so CCP checks it at least every 3 years. [parameter=value]&_include=InsurancePlan:administered-by, GET [base]/InsurancePlan? An Organization refers to a formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. 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). Find-A-Dentist. 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? The DaVinci PDEX Plan-Net PractitionerRole profile is based on the core FHIR PractitionerRole resource. 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. Prosthodontist [parameter=value]&_include=Organization:partof, GET [base]/Organization? 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). 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. Our directories are printed by county. Updates will be posted at cchealth.org. 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. A Increase font size. Select PractitionerRoles with the specified role. Board Certifications: A doctor gets a certificate after completing extra training in their specialty. 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. Showing of , California 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. This specification uses SHALL, SHOULD and MAY as a guideline for required, recommended and optional data FHIR standards. Our nationally recognized care model is proven effective in addressing unmet social determinants of health, behavioral health, and medical needs. Learn More. Select HealthcareServices with the specified name. This section describes the FHIR profiles, resources and RESTful capabilities that the Provider Directory API supports. A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time. All of CCHP contracted hospitals utilize hospitalists to admit and provide services to inpatient members. Enrollment for these plans ends December 7. Sometimes CCP does not receive a notice that the information has changed. Languages: The languages a doctor speaks. Certificate. 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. Santa Cruz 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. An example is a doctor who works only with the heart, cancer, or bones. Sierra You are now being transferred to the CCA corporate website. Providers must document this choice in the member's medical record. In addition, on a quarterly basis, CCHP emails a Network Update link to each provider to report any changes to the information CCHP has on file. Hospital information is verified by viewing the information listed on their website. Dont miss our bimonthly newsletter for community partners. Contra Costa Health Plan (CCHP) has been serving the health care needs of Contra Costa County for over 40 years. Mongolian Public Health, * Language: Tehama We partner with a broad network of providers, dentists, pharmacies, and other healthcare facilities. Sometimes, there is not a needed provider close enough. [parameter=value]&_revinclude=PractitionerRole:service, GET [base]/HealthcareService?[parameter=value]&_revinclude=OrganizationAffiliation:service. Alameda Select PractitionerRoles available at the specified organization. Were committed to supporting our providers, so that together we deliver the highest-quality, individualized care to your patients. 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 Alliance Care IHSS Price Transparency Tool. 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. The number to call in each county is. 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.