Viewing the Printed Provider Directories: To access a copy of the Provider Directories, click on the plan below.
Medi-Cal:
Health Network Provider Directory Volume 1: Primary, Hospitals, and General Health Care Providers
Health Network Provider Directory Volume 2: Specialist Health Care Providers
OneCare:
CalOptima Health doesn’t have a separate Children’s Health Insurance Program (CHIP). Children who qualify for CHIP get care through our Medi-Cal program. All doctors and clinics in this directory accept Medi-Cal members, including children in CHIP, unless they aren’t accepting new patients.
CalOptima Health’s Delegation Model
CalOptima Health works with many subcontractors, including doctors, specialists, pharmacies, hospitals, health networks, medical groups and other health care providers. Subcontractors may be assigned to perform certain tasks on behalf of CalOptima Health. We work together with our subcontractors to determine which functions will be their responsibility and which will remain with CalOptima Health. The tasks could include authorizations, billing, provider credentialing, coordinating medical appointments or other operational functions. CalOptima Health conducts quality assessments of all subcontracted providers to ensure members can see the providers they need for quality care in locations that are easy to access.
Your primary care provider (PCP) will refer you to specialists and services connected with their medical group, health network or with CalOptima Health. If you are going to a specialist already, talk with your PCP or call CalOptima Health Customer Service at 1-888-587-8088 (TTY 711).
Customer Service will help you see that provider if you are eligible for continuity of care. For more information, go to the Continuity of Care section in the member handbook.
Delegation Reporting and Compliance Plan
Subcontractor Network Certification Network Adequacy and Access Assurances Report (NAAAR)
Provider Network Updates: CalOptima Health’s provider network is subject to ongoing change.
Service Availability: Some hospitals and providers may not offer certain services covered under your plan. These excluded services may include:
You should get more information before choosing your health network. Call your doctor, medical group, clinic, health network or CalOptima Health Customer Service at these toll-free numbers:
Cultural Competency Training: All network providers listed in this directory have completed cultural competency training as of the publication date.
Language Interpreter Services (including American Sign Language): There is no cost to members for language interpreter services (under Section 1367.04).
Full and equal access to covered services, including members with disabilities as required under the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973.
Accessing Updated Provider Information: For the most current provider information or to request a printed copy, call the CalOptima Health Member Services number listed on the back of your ID card.
How to Report Provider Directory Data Issue
If you think there is a mistake with the information in the Provider Directory, please let us know in one of the following ways:
By Calling Customer Service:
By Emailing Us: providerdatacorrections@caloptima.org
Subject: Provider Directory Data
By Completing our Form: Report Provider Directory Issue