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Provider Quick Reference Guide Contact List Provider Quick Reference Guide Contact List CalOptima Health — Departments CalOptima Health — Other Agencies CalOptima Health – Delegated Health Networks CalOptima Health, A Public Agency
Answers to frequently asked questions for providers The preferred drug list is available on CalOptima’s website Medications not on the Approved Drug List, must be approved The provider completes the Prior Authorization form and sends to the approved pharmacy to submit to CalOptima for approval
For CalOptima Health Providers As the largest health insurer in Orange County, CalOptima Health is proud that our members have access to a comprehensive network of providers that includes nearly 8,400 primary care providers and specialists, 600 pharmacies, 40 hospitals and 200 long-term care facilities
Provider Claims Dispute Request Form Please return this completed form and any supporting documentation to CalOptima Health by mailing them to: Grievance and Appeals Resolution Services 505 City Parkway West Orange, CA 92868
PROVIDER MANUAL - CHOC Health Alliance CalOptima may receive an inquiry for CBAS from a variety of sources, including: CBAS center, a member or member’s authorized representative, a member’s primary care provider (PCP) or specialist, a member’s case manager or personal care coordinator
CLAIMS RESUBMISSION FORM CalOptima will review all claim resubmission requests submitted in compliance with these guidelines within forty-five (45) days of receipt of a resubmission request The resubmission package should be addressed as follows: CalOptima Attn: Claims Resubmission P O Box 11037 Orange CA 92856
Provider Common Forms - caloptima. org If you do not see a form you are looking for, or you have any questions, please call our Provider Relations department at 714-246-8600 Materials available on this website in PDF format may require the free Adobe Reader to view Download Adobe Reader for free from the Adobe website