We are dependent on the accuracy and timeliness of changes to the information being reported to CCHP by the providers. Cultural Competency Training: The office staff is trained to meet the needs of people of all different cultures. Select roles where the organization is a member of the specified health insurance provider network. Our Community Provider Network (CPN) is a network of community based private providers of primary and specialty care. 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. 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 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. The Index is the authoritative source of information on the healthcare industrys progress toward more automated and efficient business processes. You are now being transferred to the CCA corporate website. ASL Interpreter Available: The office can translate into American Sign Language. 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. This information is subject to change without notice. Humboldt Inyo 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. The DaVinci PDEX Plan-Net HealthcareService profile is based on the core FHIR HealthcareService resource. Kern [parameter=value]&_include=OrganizationAffiliation:primary-organization, GET [base]/OrganizationAffiliation? 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. Medi-Cal members can also go to the Medi-Cal Rx webpage to find Medi-Cal Rx participating pharmacies. Showing of CCP checks this information at least every 3 years. 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. Lake 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. Members have the choice to refuse professional interpreters and use adult family members or friends. The DaVinci PDEX Plan-Net InsurancePlan profile is based on the core FHIR InsurancePlan resource. 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. This network contains both primary and specialty care providers to choose from. Select HealthcareServices provided by the specified organization. Members who are enrolled in County Employee Plan A, Plan A2, or IHSS Plan A2, must choose providers from the RMC network only. GET [base]/InsurancePlan/[id]/_history/vid, GET [base]/InsurancePlan? * Translation services available for most languages. Vietnamese Learn More. 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. CCA now offers three Medicare plans in Massachusetts that combine medical and dental coverage, prescription drugs, and supplemental benefits. Select Locations managed by the specified organization. Preferred Provider: A doctor that meets strict quality standards. Hours: When the office or hospital is open to see patients. Alliance Care IHSS Price Transparency Tool. 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). 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). Hospital Quality: The hospitals performance rating. Dont miss our bimonthly newsletter for community partners. 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 Medi-Cal Dental Provider Directory Search. Please fill out this form to request a printed Provider and Pharmacy Directory and well mail you a directory for your county. 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. Sutter Accepting new patients: The doctor is taking new patients. Phone Number: The doctors office or hospital phone number. [parameter=value]&_include=Location:organization, GET [base]/Location? Find-A-Dentist. Select services associated with the specified specialty. Select products with the specified identifier. Together, we can bring uncommon care to more people with significant needs. 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. Placer Note: For more information about the FHIR RESTful API, please refer to the HL7 FHIR RESTful API topics. Current time in Gunzenhausen is now 07:51 PM (Saturday). Accreditation: This information is collected at the time the facility initially joins the network and then every three years thereafter. Select OrganizationAffiliations available at the specified location. A Decrease font size. [parameter=value]&_revinclude=PractitionerRole:service, GET [base]/HealthcareService?[parameter=value]&_revinclude=OrganizationAffiliation:service. The most current board certification status can be verified at The American Board of Medical Specialties website. You have the right to call our Member Services department at 1-877-814-1861 to get help finding an appointment to a closer . All Rights Reserved. CAQH CORE Operating Rules are helping streamline administrative transactions for health plans, healthcare providers and vendors. Were committed to supporting our providers, so that together we deliver the highest-quality, individualized care to your patients. Our nationally recognized care model is proven effective in addressing unmet social determinants of health, behavioral health, and medical needs. 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? Select organizations with the specified address (matches any of the string elements of an address). A Practitioner is a person who is directly or indirectly involved in the provisioning of health care. Select PractitionerRoles associated with the specified specialty. 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). Please indicate the name of your practice in the box above. CORE Certification GET [base]/OrganizationAffiliation/[id]/_history/vid, GET [base]/OrganizationAffiliation? 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. Mono County: Cantonese. 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. , California 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. Select roles filled by the specified practitioner. We can assist you with your selection for primary care provider. Providers must document this choice in the member's medical record. Please select a specialty GET [base]/HealthcareService/[id]/_history/vid, GET [base]/HealthcareService? San Bernardino A Reset font size. 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. **In Dukes and Nantucket Counties: CCA health plans are not yet available. Tagalog Locations can range in scope from a room in a building to a geographic region/area. Llame al 866-610-2273 (TTY 711). Select health insurance provider networks available in a region described by the specified location. To set a specific location, enter an address, city, ZIP code, and/or point of interest in the Location Search box. Essential Provider: Essential Providers are certain providers that are statewide resources for all Managed Care Plans in all regions. For more information or any questions please call Member Services at 1-866-899-4828 TTY/TDD 1-855-655-5303. The doctor or hospital gives CCP this information on their application when they join the health plan. Our Member Services staff can help you find and select a doctor from the Provider Directory for Members. 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. Members who are enrolled in our Medi-Cal plan or County Employee Plan B can choose providers from the CPN or RMC network. Contra Costa Operating rule development for these transactions is currently underway. Results are as of 12/1/2020 unless otherwise noted. Select PractitionerRoles providing the specified service. Imperial 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. 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. Laotian 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. A network is typically owned by a payer. These are the resources and the endpoints available with the Alliance Provider Directory API. Alliance members must use a pharmacy that works with MedImpact. MAY: An optional inclusion for the implementation; not a requirement. A Reset font size. Monterey Tulare SHOULD: A best practice or recommendation for the implementation. 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. 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. Select HealthcareServices providing the specified category of services. Select OrganizationAffiliations with the specified role. 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. It is an in-depth medical detoxification and educational program designed to teach you the how and why behind every step you take. 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. 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. New for 2023: CCA Medicare Premier will be available in Middlesex, Suffolk, Norfolk, and Worcester Counties. Spanish [parameter=value]&_include=OrganizationAffiliation:participating-organization, GET [base]/OrganizationAffiliation? 2023 - Community Care Plan - Provider Directory - Updated: 03/05/2023. Plumas [parameter=value]&_include=PractitionerRole:location, GET [base]/PractitionerRole? The Healthcare Service resource typically describes services offered by an organization/practitioner at a location. Learn best practices and earn CBI payments for ACE screenings at your practice. The ACA has taken operating rules to a new level. 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. Stanislaus Operating rule development for these transactions is currently underway. Languages: The languages a doctor speaks. Select HealthcareServices with the specified name. Lassen You can get these documents for free in other formats, such as large print, braille, or audio. Select products that are owned by the specified organization. Select Locations with the specified state address. Skilled Nursing Facility/Intermediate Care Facilities: within 5 business days of request. An example is a doctor who works only with the heart, cancer, or bones. 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. 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. 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. Select roles offered by the specified organization. Member Handbook 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. Includes companies, institutions, corporations, departments, community groups, health care practice groups, payer/insurer, etc. San Luis Obispo CenCal Health is required by the Department of Health Care Services to meet network adequacy standards. San Francisco If you are a member or potential member it is important for you to understand how our two networks are organized. To find a pharmacy, use MedImpact's online Pharmacy Directory using the link below. PCP's are not required to have hospital privileges. Registered Dental Hygienists in Alternative Practice. 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. This is not a guarantee they will be available to accept additional patients at the time you contact them. Who is CenCal Health/What is a Local Health Plan? Public Health, * Language: To set your current location, click the green Use Current Location button. Certified Orthodontist Please select a language The call is free. If your zip code and provider type are listed, CenCal Health will assist you in getting an appointment. 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. Use the Provider Directory Information Update Form to alert us to any changes to your provider information. Implements RESTful behaviors according to the FHIR specification. CCA now offers three Medicare plans in Massachusetts that combine medical and dental coverage, prescription drugs, and supplemental benefits. Medi-Cal Dental Program. Merced 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. 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. Location Name: Name of the doctor's office or hospital address. The number to call in each county is. They might also work in different offices or clinics. 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. Search - Provider Directory What care are you looking for? The FHIR server may return the data, but there is no requirement to do so. Nurse Advice Line Then click the magenta Get Location button. ccah provider directory 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. Please select a county Specialty: A provider's specialty is identified when they join the health plan network. You are now being transferred to the CCA corporate website. Only submit information below that needs to be changed in the directory. 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. Oral Pathologist SHALL: An absolute requirement for all implementations. Benefits of CCAH Provider Portal Select PractitionerRoles with the specified role. Accepting New Patients: This provider accepts both new and existing patients. Calaveras A Increase font size. + Decrease font size. To report any errors, click on the link below. The DaVinci PDEX Plan-Net Location profile is based on the core FHIR US Core Location resource.