Site Map

• For Providers
• Getting Started
• About CalOptima Link
• Electronic Data Interchange (EDI)
• Eligibility/Benefit Inquiry and Response (270/271)
• When do providers use claim status inquiry and response?
• Provider Claim Registration Forms
• How to Verify Eligibility
• Prior Authorizations
• Health Networks
• Resources
• Provider FAQs
• Provider FAQs
• You Can Report Fraud or Abuse
• Provider Search and Directories
• Manuals, Policies and Guides
• Pediatric Prevention Services Provider Resources
• CalOptima TechAssist Program (COTAP)
• Clinical Practice Guidelines (CPG)
• Common Forms
• Adverse Childhood Experiences
• Health Education
• Staying Healthy Assessment Forms
• Multi-Language Health Education Materials
• Behavioral Health Getting Started
• AMSC Resources
• Autism Resources
• Behavioral Health Resources
• Behavioral Health Incentive Program
• Autism Resources
• FAQs and Guides
• Getting Started
• Announcements
• Newsletters
• Events
• Important Updates
• Long-Term Care
• Community-Based Adult Services
• CBAS FAQ
• Long-Term Services and Supports Facilities
• Long-Term Services and Supports Forms
• Pharmacy Information
• Pharmacy Residency
• Medi-Cal and CalOptima Direct
• OneCare (HMO SNP) (Medicare Part D) Resources
• Pharmacy Resources
• Pharmacy and Therapeutics Changes
• CalOptima Plan Profile Sheets
• Medication Use/Treatment Guidelines
• Pharmacy Updates
• Provider Trainings
• Fraud, Waste and Abuse
• Coding
• Coding
• Cultural Competency Training
• Disability Awareness
• HEDIS Hybrid Medical Record Review
• HIPAA Training
• Provider Initial Onboarding / Annual Training
• OneCare Connect
• OneCare (HMO SNP) Model of Care
• Other Trainings by Topic
• Personal Care Coordinator Training
• Seniors and Persons with Disabilities
• How to Contract with CalOptima
• Credentialing
• About CalOptima
• History
• Isabel Becerra
• Jackie Brodsky, RN
• Clayton Chau, M.D., Ph.D.
• Clayton M. Corwin
• Andrew Do
• Mary Giammona, M.D., MPH
• Victor Jordan
• J. Scott Schoeffel
• Michelle Steel
• Trieu Tran, M.D.
• Doug Chaffee
• Nancy Huang
• Richard Sanchez, REHS, MPH
• Board and Advisory Committees
• Member Advisory Committee
• OneCare Connect Member Advisory Committee
• Whole-Child Model Family Advisory Committee
• Provider Advisory Committee
• Finance and Audit Committee
• Quality Assurance Committee
• Investment Advisory Committee
• Fast Facts
• Community Relations
• Community Grants
• Request a Speaker
• Satellite Office
• Upcoming Events and Meetings
• Community Outreach
• Forums and Meetings
• Community Alliances
• CalOptima Community Alliances Partners
• Informational Series
• CalOptima’s Commitment to Compliance
• Health Care Fraud
• First Tier, Downstream and Related Entities
• Compliance Resource Links
• Doing Business With CalOptima
• Upcoming Meetings and Materials
• Board Meeting Live Stream
• Committee Live Stream
• Past Meeting Materials
• Board Meeting Archive
• FY 2018-2019
• FY 2018-2019
• FY 2017-2018
• FY 2016-2017
• Member Advisory Committee Archive
• Fiscal Year 2019-2020
• Fiscal Year 2018-2019
• Provider Advisory Committee Archive
• Fiscal Year 2019-2020
• Fiscal Year 2018-2019
• OneCare Connect Member Advisory Committee Archive
• Fiscal Year 2019-2020
• Fiscal Year 2018-2019
• Quality Assurance Committee Archive
• Fiscal Year 2018-2019
• Fiscal Year 2017-2018
• Fiscal Year 2016-2017
• Finance and Audit Committee Archive
• Fiscal Year 2018-2019
• Fiscal Year 2017-2018
• Investment Advisory Committee Archive
• Fiscal Year 2018-2019
• Fiscal Year 2017-2018
• Whole-Child Model Family Advisory Committee Archive
• Fiscal Year 2019-2020
• Fiscal Year 2018-2019
• A Great Place to Work
• Search Open Positions
• Rewards and Benefits
• Employee Appreciation
• Health and Well-Being
• Opportunities for Growth
• Retirement Benefits
• Work/Life Balance
• Awards and Recognition
• Press Releases
• CalOptima Publications
• Press and Media Contacts
• CalOptima Celebrates 25 Years in Orange County
• CalOptima Celebra 25 Años En El Condado De Orange
• CalOptima Kỷ Niệm 25 Năm Tại Quận Cam
• "Don't Wait — Vaccinate" Campaign Launches
• CalOptima Welcomes New Board
• CalOptima Board Transition Begins
• New Program to Protect Nursing Home Residents
• CalOptima Welcomes Interim CEO
• CalOptima Announces National Recruitment for CEO
• Program for Seniors Earns Top Satisfaction Rating
• CalOptima Program for Seniors Leading the Way in Growth and Access
• Be Well OC Breaks Ground on First Mental Health and Wellness Campus in Orange County
• CalOptima Employees Award Scholarships to Members Pursuing an Education in Health Care
• CalOptima Tackling Homeless Health With New Programs
• CalOptima Tackling Homeless Health With New Programs
• CalOptima Chăm Sóc Sức Khỏe Cho Người Vô Gia Cư Với Những Chương Trình Mới
• CalOptima Implementa Nuevos Programas Para Abordar La Salud De Las Personas Sin Vivienda
• David Ramirez Joins CalOptima
• CalOptima Rated Top Medi-Cal Plan in California
• CalOptima El Obtuvo El Primer Lugar De Los Planes De Salud De Medi-Cal en California
• CalOptima Là Chương Trình Medi-Cal Được Xếp Hạng Cao Nhất Trong Tiểu Bang California
• 2018 Member Scholarship Recipient
• CalOptima Programs for Seniors to Expand
• Most Extensive Member health Needs Assesment
• CalOptima is Top Medi-Cal Plan in California
• 2018 Member Scholarship Recipient
• CalOptima Honored for Latino Outreach
• Certification to Strengthen Electronic Transactions
• CalOptima Honored for Latino Outreach
• Features
• Health and Wellness
• Advance Directive Resource
• Interactive Self-Management Tools
• Asthma Management
• Cancer
• Depression
• Diabetes Management
• Fitness
• High Blood Pressure
• Immunizations
• Injury Prevention
• Medication
• Mental Health
• Nutrition
• Pregnancy/Postpartum
• Tobacco Cessation
• Wellness
• Wellness Programs
• Member Health Rewards Programs
• Features
• Give Them the Best Shot
• Generalized anxiety disorder
• Bright Steps
• Sun Safety Tips to Help Prevent Skin Cancer
• Coronavirus Disease 2019 (COVID-19)
• Telehealth Visits During COVID-19
• Tips for Social Distancing
• Tips to Prevent COVID-19
• Community Communication COVID-19
• Provider Communication COVID-19
• COVID-19 Telehealth Information
• COVID-19 Provider Alerts (Fax Blasts)
• COVID-19 Regulatory Highlights
• Don’t Wait—Vaccinate
• Website Privacy Policy
• Resources Home
• Community and Other Resources
• Government Agencies and Programs
• Health Network Resources
• Members
• Medi-Cal
• New Members Start Here
• Benefits
• Other Programs
• MSSP
• Member Liaisons
• Interpreter Services
• Supplemental Security Income (SSI)
• Services Provided by a Different Agency
• Prior Authorization
• Need to Get Health Advice?
• Find a Provider
• Find a PCP or Specialist
• Find a Hospital, Facility or Ancillary Provider
• Find Urgent Care
• Find a Behavioral Health Provider
• Find a Pharmacy
• Find a Vision Provider
• Frequently Asked Questions
• Common Forms
• Other Important Documents
• Pharmacy Program
• Approved Drug List Changes
• Recalls and Withdrawals
• Drug Prior Authorization Request
• Rights and Responsibilities
• Reporting and Solving Problems
• Grievance and Appeal Form
• You Can Report Fraud or Abuse
• Whole-Child Model
• Health Homes Program (HHP)
• OneCare Connect
• Benefits
• Need to Get Health Advice?
• Over-the-Counter (OTC) Items
• Frequently Asked Questions
• Find a Provider
• Find a PCP or Specialist
• Find Urgent Care
• Find a Hospital, Facility or Ancillary Provider
• Find a Behavioral Health Provider
• Find a Pharmacy
• Find a Vision Provider
• How to Enroll
• New Member Orientation Schedule
• New Members Start Here
• Pharmacy
• Medication Therapy Management
• Member Documents
• Common Forms
• Other Important Documents
• Your Rights
• Right and Responsibilities
• You Can Report Fraud or Abuse
• How to File an Appeal or Grievance
• Online Member Request, Appeal or Complaint Form
• Disclaimers
• OneCare (HMO SNP)
• Benefits
• Frequently Asked Questions
• Find a Provider
• Find a PCP or Specialist
• Find a Hospital, Facility or Ancillary Provider
• Find Urgent Care
• Find a Behavioral Health Provider
• Find a Pharmacy
• Find a Vision Provider
• How to Enroll
• New Member Orientation Schedule
• New Members Start Here
• Pharmacy
• Medication Therapy Management
• Member Documents
• Common Forms
• Other Important Documents
• Your Rights
• Rights and Responsibilities
• You Can Report Fraud or Abuse
• How to File an Appeal or Grievance
• Online Member Request, Appeal or Complaint Form
• Disclaimers
• PACE
• The PACE Center
• How To Enroll
• Benefits
• Frequently Asked Questions
• What Is An Interdisciplinary Team (IDT)?
• Member Documents
• Member Documents
• Common Forms
• Your Rights
• Report Fraud or Abuse
• Your Rights and Responsibilities
• Grievance Process
• Learn About the Member Portal
• Contact Us Home
• How to Get Here

• الإبلاغ عن الاحتيال وإساءة الاستخدام
• Immunizations
• MentalHealth
• Pregnancy
• نصائح وقائية خاصة بالتعرض للشمس للمساعدة على منع سرطان الجلد
• مرض فيروس كورونا 2019 (COVID-19)
• الرعاية البُعادية (عن بُعد) خلال COVID-19
• نصائح للتباعد الاجتماعي
• نصائح لمنع COVID-19
• لا تنتظر – احصل على التطعيمات
• الأعضاء
• Medi-Cal
• الأعضاء الجدد يبدأون هنا
• المزايا
• برامج أخرى
• MSSP
• التواصل مع الأعضاء
• خدمات الترجمة الفورية
• دخل الضمان التكميلي (SSI)
• الخدمات المقدمة من قبل وكالات أخرى
• التصريح المسبق
• هل أنت بحاجة للحصول على مشورة صحية؟
• اعثر على مزود
• العثور على طبيب رعاية أولية أو أخصائي
• ابحث عن مستشفى أو مرفق أو مزود إضافي
• البحث عن رعاية عاجلة
• العثور على مزود صحة سلوكية
• ابحث عن صيدلية
• ابحث عن مزود عيون
• الأسئلة المتكررة
• النماذج الشائعة
• وثائق مهمة أخرى
• برنامج الصيدلة
• التغييرات على قائمة الأدوية المعتمدة
• سحب الأدوية واسترجاعها
• الحقوق والمسؤوليات
• الإبلاغ عن وحل المشاكل
• نموذج التظلمات والاستئنافات
• الإبلاغ عن الاحتيال وإساءة الاستخدام
• نموذج الطفل الشامل (WCM)
• برنامج بيت الصحة (Health Homes، HHP)
• OneCare Connect
• المزايا
• هل أنت بحاجة للحصول على مشورة صحية؟
• Over-the-Counter (OTC) Items
• الأسئلة المتكررة
• اعثر على مزود
• العثور على طبيب رعاية أولية أو أخصائي
• البحث عن رعاية عاجلة
• ابحث عن مستشفى أو مرفق أو مزود إضافي
• العثور على مزود صحة سلوكية
• ابحث عن صيدلية
• ابحث عن مزود عيون
• كيفية التسجيل
• جدول توجيه الأعضاء الجدد
• الأعضاء الجدد يبدأون هنا
• برنامج الصيدلة
• إدارة العلاج الدوائي
• وثائق الأعضاء
• النماذج الشائعة
• وثائق مهمة أخرى
• حقوقك
• الحقوق والمسؤوليات
• يمكنك الإبلاغ عن الاحتيال أو سوء الاستخدام
• كيفية تقديم استئناف أو تظلم
• نموذج إلكتروني لتقديم طلبات أو استئنافات الأعضاء أو شكاويهم
• إخلاء المسؤولية
• اتصل بنا

• 您可以舉報欺詐或濫用
• Immunizations
• MentalHealth
• Pregnancy
• 預防皮膚癌的陽光防曬提示
• 2019新型冠狀病毒 (COVID-19)
• COVID-19期間的虛擬護理
• 社交距離技巧
• 預防 COVID-19技巧
• 不要等待 — 接種疫苗。
• 會員
• Medi-Cal
• 新會員從這裡開始
• 福利
• 其他計劃
• 多功能耆老服務 (MSSP)
• 會員聯絡員
• 口譯服務
• 生活保障補助金 (SSI)
• 其牠機構提供的服務
• 預先授權
• 需要獲取健康建議
• 尋找家庭醫生或專科醫生
• 尋找家庭醫生或專科醫生
• 尋找家庭醫生或專科醫生
• 尋找醫院, 設施或 輔助醫療服務者
• 查找緊急護理
• 尋找一位行為健康醫療服務者
• 尋找藥房
• 查尋視力醫療服務者
• 常見問題
• 常用表格
• 其它重要文件
• 已批准的藥物目錄變更
• 召回與撤銷
• 權利與義務
• 報告和解決問題
• 申訴與上訴表格
• 您可以舉報欺詐或濫用
• 兒童全面保健模式
• Health Homes Program (HHP)
• OneCare Connect
• 福利
• 需要獲取健康建議
• Over-the-Counter (OTC) Items
• 常見問題
• 尋找家庭醫生或專科醫生
• 查找緊急護理
• 尋找醫院, 設施或 輔助醫療服務者
• 尋找一位行為健康醫療服務者
• 尋找藥房
• 查尋視力醫療服務者
• 如何加入
• 新會員說明會日程表
• 新會員從這裡開始
• 藥房
• 藥物治療管理
• 會員資料
• 常用表格
• 其它重要資料
• 您的權利
• 權利與義務
• 您可以舉報欺詐或濫用
• 如何提出上訴或申訴
• 線上會員請求、上訴或投訴表
• 免責聲明
• 聯絡我們