CalOptima Provider Manual

NOTICE: This Provider Manual provides generalized information relative to the provision of healthcare goods and services to CalOptima Members. For detailed information on requirements, please refer to the applicable CalOptima Policies and Procedures. In the event of a conflict between the contents of this Provider Manual and CalOptima’s Policies and Procedures, the Policies and Procedures shall govern.

Please contact CalOptima’s Provider Resource Line at 1-714-246-8600 for other materials not referenced in this section or forward comments and questions to the following e-mail address,

CalOptima Provider Manual

Use the link below to download and view the CalOptima Provider Manual.

Provider Manual Reference Materials

The CalOptima Provider Manual references various forms and documents related to CalOptima's programs. Use the link below to view or download copies of these materials in the Common Forms section of the CalOptima website. If you do not see a document you are looking for, please contact the Provider Resource Line at 1-714-246-8600.

You Can Report Fraud or Abuse

If you see any activity that you think is fraudulent or wasteful, we strongly encourage you to call our Compliance and Ethics Hotline at 1-877-837-4417 or report the activity using the Suspected Fraud or Abuse Referral Form. You do not have to give your name to report fraud activity.

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