Provider Manual

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.

View our current CenCal Health Provider Manual or access individual sections through the links below.

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 Programs and Community Supports 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 Complaints and Grievances

Section P:  Health Education and Information

Section Q: Fraud Waste and Abuse (FWA) & Protected Health Information (PHI)

Section R: Forms Library