The Provider Manual includes information such as Provider enrollment, Responsibilities, Claims information, Member eligibility, Guidelines for medical authorizations. If you have any questions about this publication please contact the Provider Services Department at (805) 562-1676 or by sending an email to Provider Services.
Click here to view our current CenCal Health Provider Manual or click the links below to access individual sections.
Table of Contents
Section A: Introduction
Section B: Provider Resources
Section C: Contracting and Credentialing
Section D: Provider Responsibilities
Section E: Covered Benefits and Services
Section F: Services Covered by Other Agencies
Section G: Eligibility Verification and Enrollment
Section H: Referrals and Authorizations
Section I: Care Management Services
Section J: Disease Management Programs
Section K: Claims and Billing Guidelines
Section L: Quality Management
Section M: Member Services
Section N: Language Assistance Program
Section O: Provider/Member Complaints and Grievances Grievances
Section P: Health Education and Information
Section Q: Fraud Waste and Abuse (FWA) & Protected Health Information (PHI)
Section R: Pharmacy
Section S: Forms Library