Monday, February 19, 2024 is Presidents’ Day, our offices will be closed. Have a safe holiday.

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Policies & Procedures

CenCal Health has established Polices and Procedures under which the agency operates. Such policies are established to insure that departments within CenCal Health work effectively together in day to day processes.

CenCal Health Policies and Procedures include those most important for contracted providers to have available for review. These Policies and Procedures may be updated from time to time, and when they are so updated, the new Policy and Procedure will be made available to you to replace those currently contained in this Provider Manual. Most changes to these Polices and Procedures are considered non material and reflect changes in CenCal Health’s day to day processes or regulatory required changes.

Access to Care

Individual Health Education Behavioral Assessment: the Staying Healthy Assessment

Member Grievance System

Provider Credentialing and Peer Review Policy

Provider Grievance System

Provider Grievance Form

Notification of Utilization Review Determinations

CenCal Health Compliance Plan (Reference pgs. 16 – 18 for Provider Code of Conduct)