Join Our Network

join3 Join us in our effort to provide quality healthcare to those in need. CenCal Health has a provider inclusive policy and we work with interested and eligible providers in the area.

We are contracted with 94% of the providers who reside in Santa Barbara County and over 75% of the providers who reside in San Luis Obispo County. This represents over 1600 physicians.

We believe in making processes as easy as possible so that you can focus on providing quality healthcare.

Effective January 1, 2018, CenCal Health is required by federal law to ensure all new contracted providers are enrolled in the claim status calloutDepartment of Health Care Services (DHCS) Medi-Cal ProgramProviders who enroll through DHCS are eligible to provide services to Medi-Cal Fee for Service (FFS) beneficiaries as well as CenCal Health Medi-Cal beneficiaries. Providers who ONLY provide services to CenCal Health Medi-Cal beneficiaries may elect to enroll directly through CenCal Health. Please click on the Medi-Cal Enrollment tab below for more information. 

If you are not enrolled, please contact our Provider Services Representatives at (805) 562-1676 or via email at psrgroup@cencalhealth.org and our team will assist you with the enrollment process.

Thank you for your interest in joining CenCal Health; your local health plan.

Contracting

To be reimbursed for non-emergent services for an eligible member of a health program administered by CenCal Health, providers must have an executed Agreement with CenCal Health. To provide emergent care to any Medi-Cal member, providers need only be enrolled in the State Medi-Cal program.

Primary Care Physicians (PCPs) and Specialists may contract with CenCal Health either individually, in groups, or as outpatient clinic providers. Primary Care and Specialty physician groups may choose to contract as a single contracting entity. Facilities and ancillary providers complete the provider panel as determined by each program’s specific needs. In addition, we contract with out-of-area providers as needed to assure the availability of specialized services to members of our programs.

Our Provider Services Representative is available to answer questions and guide prospective providers through the credentialing and contracting process. Please reference our Onboarding Applications and Forms below for prerequisite requirements for participation as it may vary by provider type, and submit a Provider Information Form, in addition to a W-9 Taxpayer Information Form.  

Claims are payable for services rendered on or after the date the contract is fully executed. Claims for services rendered prior to execution of your provider agreement may not be reimbursed.

As your relationship and experience with us grows, your Provider Services Representative are available to answer questions during this process.

Medi-Cal Enrollment

For more instructions about Medi-Cal Enrollment requirements and process, click here.

To verify enrollment with State Medi-Cal, you may search the Department of Health Care Services' (DHCS) database via the link below (click "Preview" and enter your National Provider Identifier (NPI) in the search field on the Data Table).

  • Physicians and most other provider types, please click here 

The State's PAVE portal is a web-based application designed to simplify and accelerate the State Medi-Cal enrollment process. Providers must utilize the portal to complete and submit applications, report changes to existing enrollments, and respond to requests for continued enrollment or re-validation.  Please be sure to maintain current and accurate information about yourself and/or your group, as data submitted through PAVE comprises the database DHCS uses to understand the network of Medi-Cal providers in California. This is important even if you only see CenCal Health members and never submit claims for Fee-For-Service members.

New Provider Onboarding Application

CenCal Health has a quality of care program designed to improve the health plan and the delivery of health care to our members. As part of this program, we credential providers practicing as individuals or belonging to groups contracted with CenCal Health.  Concurrent with our contracting process, most providers will also be required to complete an Onboarding packet below.  CenCal Health is now credentialing mental health providers offering services to CenCal Health members at a Federally Qualified Healthcare Center (FQHC). Please note that the packet requirements vary by provider type.

Please do not provide services to members until you receive written notice that your application has been approved. Claims for services rendered prior to this approval and executed contract may not be reimbursed.

Our Provider Services Representatives are available to answer questions and guide prospective providers through this onboarding process and will notify you of your effective date with CenCal Health. Please contact us at (805) 562-1676 or psrgroup@cencalhealth.org to get started! 

Physician Provider  

  • Allopathic Physicians (MD)
  • Chiropractor
  • Osteopathic Physicians (DO)
  • Podiatrist (DPM)
  • Psychiatrist
Non-Physician Medical Practitioner
  • Certified Nurse Midwife (CNM)
  • Certified Registered Nurse Anesthetist (CRNA)
  • Nurse Practitioner (NP)
  • Physician Assistant (PA)
Allied Provider
  • Acupuncturist
  • Audiologist
  • Behavioral Health Nurse - RN, LPN, NA
  • Board Certified Behavioral Analyst (BCBA) or Board Certified Associate Behavior Analyst (BCaBA)
  • Certified Diabetes Educator
  • Clinical Social Worker
  • Hearing Aid Dispenser
  • International Board-Certified Lactation Consultant
  • Licensed Clinical Social Worker (LCSW)
  • Marriage and Family Therapist (LMFT)
  • Occupational Therapist
  • Optometrist
  • Physical Therapist
  • Physical Therapist Assistant
  • Psychologist
  • Registered Dietician/Nutritionist
  • Speech Language Pathologist

Organizational Provider

  • Ambulatory Surgical Center (freestanding only)
  • Acute Rehabilitation Facility
  • Birth Center (freestanding & licensed only)
  • CBAS (ADHC)
  • Extended Care Facility
  • Home Health Agency
  • Hospice
  • Hospitals – All Types
  • Intermediate Care Facility
  • Kidney Dialysis Centers
  • Laboratories
  • Long Term Care Facility
  • Skilled Nursing Facility
  • Sleep Centers
  • Sub-Acute Facility
  • Transportation Providers

Durable Medical Equipment Provider

Locum Tenens

Please fill out the Locum Tenens Notification Form. Locum tenens are providers who temporarily take the place of, or cover, for another provider. All Locum Tenens who render services to CenCal Health members must be disclosed to the our Provider Services staff before providing care to CenCal Health members. Please fill out the Locum Tenens Notification form for all Locum Tenens prior to their starting at your practice.

Notice of Practice Changes

Be sure to have the following information available and notify CenCal Health of changes to your practice, if any of the following changes occur.

  • NPI Changes
  • Practice re-location or new locations added
  • Change in ownership or name
  • New providers join (or providers leave) your practice

enroll in other programs

Do you need to enroll in other county and state programs? Contact these programs below for more information.

Child Health and Disability Prevention Program (CHDP)
Vaccines for Children (VFC)

California Children’s Services (CCS)

CenCal Health partners with The Holman Group for mental health services. For enrollment information, please contact The Holman Group.

CenCal Health does not manage the Medi-Cal Dental Program. For enrollment information, please contact Denti-Cal.