About CalOptima Link

Support and resources

Important Update

CalOptima is required to protect the privacy and security of our member’s protected health information by implementing the following changes to the CalOptima Link Provider Portal:

CalOptima Link no longer displays the member’s street address, telephone number or clinical summaries. Claims inquiries are now a stand-alone function of the Provider Portal which requires a new registration to access.
To register for claims function, click on the “Register for CalOptima Link” arrow below and create a new log in, using your same NPI and TIN (Note: There may be time-delay due to volume of registrations.)

For any questions and to check claim status, please call the Claims department at 714-246-8885.

CalOptima Link has resources and tools so you can submit referrals online, view authorization status, view clinical alerts at a glance, create reports, view referral information, and more.

Download the CalOptima Link user guide .

After we receive your registration request, we will contact you by phone. To adhere to security standards for access to CalOptima Link, our customer support staff will request confirmation of employment or affiliation on company letterhead. This will ensure access only to the appropriate staff in your office.

For registration questions or technical support, please call 800-864-8160.

Providers and other health care professionals with questions regarding Medi-Cal, OneCare Connect, OneCare or PACE can call the Provider Relations department at 714-246-8600 or email: providerservices@caloptima.org

Electronic Data Interchange (EDI)

Eligibility/Benefit Inquiry and Response (270/271)
When to use eligibility and benefit inquiry and response
Claim Status Inquiry and Response (276/277)
When to use claim status inquiry and response

Provider Disputes

Dispute Process
Review the payment dispute process for Medi-Cal and OneCare contracted providers

Prior Authorizations

Authorization required procedure codes
The authorization required procedure codes list for medical and outpatient services should be used for services rendered.

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