For Providers

Learn About the Provider Portal

Your personal connection to us

Female doctor looking at a computer screen

What is the Provider Portal?

The Provider Portal is a secure online website where you have 24-hour access to CalOptima from anywhere with an internet connection. By having a secure username and password, authorized provider users can access:

  • Verify Member Eligibility
  • Check Claims History
  • Check Authorizations Status
  • Submit Referrals

How to get started

Each provider office must complete and sign the Provider Portal Access Agreement and User Roster and return it to CalOptima prior to access being permitted. CalOptima is using a tiered approach for the registration process. To begin your registration process, please contact Provider Relations at 714-246-8600.

For more information on how to make the best use of the Provider Portal, please download and review the reference materials below.

Provider Portal Training

This training provides an overview to familiarize new users with the features of CalOptima’s Provider Portal, such as accessing member data, checking the status of claims and submitting referrals. For more detailed instruction on how to complete specific tasks, please refer to the Provider Portal Reference Guide.


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Provider Directory
  • Find a Provider
    CalOptima Health works with over 3,700 Orange County physicians, making it easy for our members to get the care they need.

    Check here for our extensive list of providers, health networks, medical groups, hospitals and pharmacies.
Claims
Provider Trainings
  • Trainings by Topic
    View the latest model of care and other educational materials designed to help you and your staff provide care for CalOptima Health members.