electronic
Electronic:
To find out more about submitting claims electronically to CenCal Health, please contact the EDI team at CenCal Health.
If you are currently submitting electronically to CenCal Health you can reference the CenCal 5010 Companion Guide, and the Trading Partner Worksheet.
Please email CenCal Health’s EDI Workgroup for further information.
File Transport Security
CenCal Health supports file transfers by FTP, FTPS and SFTP. If sending files using FTP, the files must be secured using PGP. Click here to download CenCal Health's public key.
CenCal Health Provider Portal
CenCal Provider Portal Restricted Site
CenCal Health has implemented electronic billing through our web portal. Submitting a "clean claim" is important in order for your claim to be considered by CenCal Health for payment. These tutorials will teach you how to utilize the main Claims Entry Home Screen Dashboard, enter a CMS-1500 Claim Form, and a UB-04 Claim Form. Visit our Provider Portal to get started.
Click here to access our Provider Portal User Guide for step by step instructions on how to utilize the portal today!
paper
Paper
Still Billing Paper? Listed below are the mailing addresses and the different claim forms accepted by CenCal Health.
Non-Pharmacy Claims:
Electronic Fund Transfer (EFT)
Electronic Fund Transfers (EFT) is a method of bi-monthly payment offered by CenCal Health to our participating contracted providers, this free service provides convenience and savings.
EFT automatically credits payments due for healthcare services performed directly to your savings or checking account. This payment method replaces issuing a paper check for various payment types, including or related to claims processing, i.e. EOPs, Capitation and Incentive payments.
CenCal Health is pleased to announce that beginning on November 1, 2022, we are partnering with Wells Fargo to manage the enrollment and update process for Automated Clearing House (ACH), also known as Electronic Funds Transfer (EFT).
Effective November 1, 2022, all new requests to enroll in or change your EFT information will be processed by Wells Fargo via their Supplier Analysis and Onboarding platform. Providers not currently enrolled in EFT will soon receive an “ACH Outreach” letter from Wells Fargo with instructions on how to enroll. CenCal Health recommends all providers enroll in EFT to ensure that you continue to receive timely payments, increase fraud protection, and simplify reconciliation.
This change will not impact providers who are already enrolled in EFT with CenCal Health unless you are making an update to your EFT information after this date. Claim payment information continues to be available through our Provider Portal.
Please do not hesitate to contact our CenCal Health Provider Services Department with questions at psrgroup@cencalhealth.org or by phone at (805) 562-1676.