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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 section in the member handbook.