An example is a doctor who works only with the heart, cancer, or bones. Mandarin The information in your search results reflects our records at the time of our last update to the search website, which is updated nightly. FAQs, Case Studies, Issue Briefs, and more. Tehama Then click the magenta Get Location button. The FHIR server is recommended to return this data. Imperial 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. To set a specific location, enter an address, city, ZIP code, and/or point of interest in the Location Search box. Pedodontist Select HealthcareServices with the specified name. Vietnamese SHOULD: A best practice or recommendation for the implementation. Select PractitionerRoles with the specified role. Select roles where the organization is a member of the specified health insurance provider network. Select services available in a region described by the specified location. [parameter=value]&_revinclude=OrganizationAffiliation:location, GET [base]/Location?[parameter=value]&_revinclude=PractitionerRole:location. Alliance Care IHSS Price Transparency Tool. A Decrease font size. 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. You have the right to call our Member Services department at 1-877-814-1861 to get help finding an appointment to a closer . GET [base]/Location? San Benito Providers are doctors, physicians or other healthcare professionals that accesses information to help patients or track a refund. Who is CenCal Health/What is a Local Health Plan? Our Regional Medical Center Network (RMC) has 10 Health Centers conveniently located throughout the county and the Regional Medical Center Hospital in Martinez. Below we describe the information in the fields in the provider directory. Location: The doctors office or hospital address. GET [base]/OrganizationAffiliation/[id]/_history/vid, GET [base]/OrganizationAffiliation? A Location is the physical place where health care services are provided, practitioners are employed, organizations are based, etc. Please select the county where you live. El Dorado [parameter=value]&_include=HealthcareService:coverage-area, GET [base]/HealthcareService? 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. County: 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. Accreditation: This information is collected at the time the facility initially joins the network and then every three years thereafter. Facility: CCHP updates facility information daily as changes are reported by the facility. 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. CCA Senior Care Options Directory Documents, CCA Medicare Advantage Directory Documents, Berkshire, Franklin, Hampden, Hampshire-Spanish. Laotian Frequently Asked Questions, GRIEVANCE FORM Amador Please indicate the name of your practice in the box above. Sometimes, there is not a needed provider close enough. Providers in the CCRMC network are certified in languages spoken in addition to English. Interpreter services are available at all CCHP points of contact where members may reasonably need such services. Specialty: A provider's specialty is identified when they join the health plan network. You can search for a specific doctor, or for types of doctors like specialists, by using ourFind a Doctorsearch. Los Angeles Cambodian Select Organizations that are part of the specified organization. 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. Endodontist Select Locations with the specified postal code address. [parameter=value]&_revinclude=PractitionerRole:service, GET [base]/HealthcareService?[parameter=value]&_revinclude=OrganizationAffiliation:service. 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. Potential members may contact our Marketing Department at 1-877-661-6230 option 6. [parameter=value]&_include=HealthcareService:location, GET [base]/HealthcareService? 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. , California This directory is for informational use only. 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 ACA has taken operating rules to a new level. GET [base]/Practitioner/[id]/_history/vid, GET [base]/Practitioner?[parameter=value]&_revinclude=PractitionerRole:practitioner. 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. Sierra 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. Select OrganizationAffiliations available at the specified location. Medi-Cal Dental Provider Directory Search. Dont miss our bimonthly newsletter for community partners. Preferred Provider: A doctor that meets strict quality standards. CAQH CORE Operating Rules are helping streamline administrative transactions for health plans, healthcare providers and vendors. Adults Children/ Adolescents Step 2: Please enter your address to determine the closest providers. [parameter=value]&_revinclude=PractitionerRole:network, GET [base]/Organization?[parameter=value]&_revinclude=OrganizationAffiliation:participating-organization. Provider Directory - Central California Alliance for Health Home > For Providers > Provider Resources > Provider Directory Provider Directory Online Provider Directory Search the Online Provider Directory. 2020 K Street, NW - Suite 660 Washington, D.C. 20006. Electronic Funds Transfer (EFT) Enrollment Form, Behavioral/Mental Health Substance Use Disorder. Public Health, * Language: 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. Dental Clinics Serving Medi-Cal Members. Board Certifications: A doctor gets a certificate after completing extra training in their specialty. 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. Board certifications for most Doctors of Osteopathic Medicine (D.O.) A Reset font size. 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. PCP's are not required to have hospital privileges. Trinity Hospital Quality: The hospitals performance rating. 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). 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. 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. Adoption Directory ASL Interpreter Available: The office can translate into American Sign Language. 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. Punjabi Authentication is not required to access the Conformance resource. 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. Colusa 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. CORE Certification This specification uses SHALL, SHOULD and MAY as a guideline for required, recommended and optional data FHIR standards. 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. 2023 - Community Care Plan - Provider Directory - Updated: 03/05/2023. Siskiyou Learn More. Select PractitionerRoles available at the specified location. For more information, please call the doctors office. Contra Costa Health Plan (CCHP) has been serving the health care needs of Contra Costa County for over 40 years. Hospitals: The network hospitals a doctor can see their patients in. The DaVinci PDEX Plan-Net PractitionerRole profile is based on the core FHIR PractitionerRole resource. Cantonese. This is not a guarantee they will be available to accept additional patients at the time you contact them. [parameter=value]&_include=PractitionerRole:practitioner, GET [base]/PractitionerRole? 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). Kings Groups: The practice a doctor works in. Effective January 2023, CCA is expanding its product offering in Massachusetts with one new Medicare plan. Who are Providers? Operating rule development for these transactions is currently underway. We are dependent on the accuracy and timeliness of changes to the information being reported to CCHP by the providers. SHALL: An absolute requirement for all implementations. Russian On a quarterly basis, CCHP emails a Network Update link for the group to report any changes to the information CCHP has on file. Together, we can bring uncommon care to more people with significant needs. Hours: When the office or hospital is open to see patients. Alliance. These are the resources and the endpoints available with the Alliance Provider Directory API. Lake 734-436-0455 Locations can range in scope from a room in a building to a geographic region/area. 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? Location Name: Name of the doctor's office or hospital address. View rating by specialty and compare nearby hospitals. [parameter=value]&_revinclude=OrganizationAffiliation:primary-organization, GET [base]/Organization? New for 2023: CCA Medicare Premier will be available in Middlesex, Suffolk, Norfolk, and Worcester Counties. CCA Senior Care Options, CCA Medicare Value, and CCA Medicare Preferred are available in 10 counties in Massachusetts: Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester. 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? Please select a county This is not a guarantee they will be available to accept additional patients at the time you contact them. If CenCal Health cannot find you an appointment with a closer specialist, we will arrange transportation to see the specialist, if needed. There are more protections for immigrants and their families to use public benefits. 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. Languages: The languages a doctor speaks. The Provider Directory API accesses the Alliance FHIR server portion of the Provider and Pharmacy Directories. Information regarding quality is obtained by the Joint Commission at the time of survey, as new information becomes available and at resurvey. **In Dukes and Nantucket Counties: CCA health plans are not yet available. It requires CenCal Health to meet both time and distance standards based on county population density. CCHP discourages the use of family members, friends or minors to interpret or translate materials. 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 [parameter=value]&_include=OrganizationAffiliation:primary-organization, GET [base]/OrganizationAffiliation? Most hospitals in Contra Costa County and the immediate surrounding area are participants. Tulare CCH will closely monitor activity at the refinery and notify the public if the flaring results in any offsite health impact to the community. Benefits of CCAH Provider Portal 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. We partner with a broad network of providers, dentists, pharmacies, and other healthcare facilities. Periodontist Select Practitioners with the specified family name. By entering a hospital name, the accreditation status and quality measures are listed. Alpine A network is typically owned by a payer. The Provider Directory API supports the following FHIR approved implementation guide, and supports the following profiles: The base URL for each endpoint: [The Provider Directory platform is being retooled and this link will be available soon], [The Provider Directory platform is being retooled and this link will be available soon]. CCA will not contact you unless we have questions about your request. 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. Were committed to supporting our providers, so that together we deliver the highest-quality, individualized care to your patients. Plumas 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. [parameter=value]&_revinclude=HealthcareService:location, GET [base]/Location? You can get these documents for free in other formats, such as large print, braille, or audio. We share our providers dedication to assuring the highest levels of care and service for people with complex health needs. [parameter=value]&_include=Organization:coverage-area, GET [base]/Organization? Select products with the specified identifier. 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. Select services associated with the specified specialty. The FHIR server may return the data, but there is no requirement to do so. Members who are enrolled in County Employee Plan A, Plan A2, or IHSS Plan A2, must choose providers from the RMC network only. Commonwealth Care Alliance (CCA) is pleased to announce that we are partnering with Cognizant to implement our new claims platform, Facets, effective Q2 2023. 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. Found inside - Page 57. General Practitioner [parameter=value]&_include=HealthcareService:organization, GET [base]/HealthcareService? Lassen Connecting, solving and transforming healthcare business challenges. Our nationally recognized care model is proven effective in addressing unmet social determinants of health, behavioral health, and medical needs. The Central California Alliance for Health (the Alliance) has contracted with Beacon Health Options to provide mental health services. GET [base]/PractitionerRole/[id]/_history/vid, GET [base]/PractitionerRole? 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. Select Organizations with the specified name. View Urgent Visit Access Offices in Santa Cruz County. CCA One Care is available in 12 counties in Massachusetts: Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester. Select insurance plans of the specified type. Select products that are administered by the specified organization. Marin MAY: An optional inclusion for the implementation; not a requirement. The hospital reports the safety and quality of its care. 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. Select OrganizationAffiliations with the specified role. 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. Large healthcare providers may achieve CORE Certification. The FHIR server must return this data. Please select a language Calaveras ProcessLogoff - provider.portal.ccah-alliance.org Health and Wellness Rewards [parameter=value]&_include=OrganizationAffiliation:location, GET [base]/OrganizationAffiliation? Dont miss our bimonthly newsletter for community partners. Our Community Provider Network (CPN) is a network of community based private providers of primary and specialty care. Frequently Asked Questions, GRIEVANCE FORM Select roles filled by the specified organization. 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). + Reset font size. Specialty is verified when the practitioner joins the network and at the time of recredentialing through state licensing and board certification. 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. Orange Some doctors might have all the patients they can fit in, while still giving you the best care. Modoc If you are a member or potential member it is important for you to understand how our two networks are organized. GET [base]/HealthcareService/[id]/_history/vid, GET [base]/HealthcareService? 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. CenCal Health is contracted with many primary care providers, specialists, pharmacies and hospitals in your area. Mongolian A Practitioner is a person who is directly or indirectly involved in the provisioning of health care. Spanish Nurse Advice Line Shasta Enrollment for these plans ends December 7. 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. CalAIM: Enhanced Care Management (ECM) and Community Supports (CS) require prior authorization and are limited to members who meet specific eligibility criteria. This network contains both primary and specialty care providers to choose from. The DaVinci PDEX Plan-Net Practitioner profile is based on the core FHIR US Core Practitioner resource. Medical group: This information is collected from the group at the time they initially join the network. 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. Search - Provider Directory What care are you looking for? . The hospital gets reviewed by national organizations to see if they meet these standards. Sutter GET [base]/InsurancePlan/[id]/_history/vid, GET [base]/InsurancePlan? CCA One Care | CCA Senior Care Options | CCA Medicare Advantage. The RESTful capabilities are discussed in further detail below. San Luis Obispo 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).
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