Frequently Asked Questions

What is a MRF?

A MRF (Medical Request Form) is the authorization form in which the prescribing physician will complete if a medication is non-formulary or requires a Prior Authorization as listed on the CenCal formulary. MRF Form

What is a PAF?

A PAF (Pharmacy Authorization Form) is the form in which the prescribing physician will complete if the member has exceeded their 7 prescriptions per month. CenCal Health allows a member to receive 7 prescriptions per month, not including antibiotics, medications related to family planning, cancer, diabetes, transplant members, members in nursing facilities and a newborn using the Mother’s Identification Number. PAF Form

Who do I contact to check the status of an authorization?

To check the status of an authorization the phone number to call is (800) 788-2949.

Where can I find the CenCal Health formulary?

What is the difference between Medi-Cal and CenCal Health?

CenCal Health is a managed Medi-Cal plan in Santa Barbara and San Luis Obispo County. The Department of Health Care Services oversees the Medi-Cal program in the state of California.

How do I process Pharmacy Claims for CenCal Health?

CenCal Health is contracted with MedImpact who is the Pharmacy Benefits Manager (PBM). To process a pharmacy claim you may contact MedImpact at 1(800) 788-2949.  All CenCal Health programs utilize the same BIN, Carrier/PCN and Group.

cencal card

Who is the Specialty Provider for CenCal Health?

All Specialty medications are processed through Diplomat Specialty. Specialty Medications

How do I find a pharmacy in the CenCal Health network?

The majority of retail pharmacies are contracted with MedImpact. CenCal Health's Pharmacy network is vast and spans both Santa Barbara and San Luis Obispo Counties. To locate a pharmacy within the CenCal network visit the Physician Directory.