Manuals And Resources

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Questions




If you have questions or need assistance, call our Provider Relations Department at:

1-714-246-8600

Monday through Friday from 8 a.m. to 4 p.m. Pacific Time

Provider Manuals

The provider manual in this section give CalOptima providers the most current information about our Medi-Cal, OneCare (HMO SNP) and PACE programs. As a Medi-Cal managed care plan, the information in these resources is subject to change due to regulation or legislation.

This manual references provider enrollment and registration responsibilities, claims submission information, member eligibility verification, and guidelines for submitting and processing medical authorizations.

The Long Term Care Information section of this Website has additional resources specifically for long term care and hospice providers.

CalOptima Policies and Procedures

In addition to the provider manuals above, you may also access CalOptima's online policy and procedure database, hosted by Compliance 360.

Provider Search and Directories

CalOptima is proud to work with over 3,700 physicians, more than 450 pharmacies and a majority of the hospitals and long-term care facilities in Orange County. The provider directories represent a comprehensive list of our provider partners for our Medi-Cal and OneCare (HMO SNP) programs.

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