The CenCal Health Pharmacy Provider Manual includes information for our Providers regarding the Pharmacy benefit. This manual will assist our providers as a reference guide for the pharmacy benefit such as our prior authorization process, eligibility, other coverage and other important information. If you have any questions about this publication please contact the Pharmacy Services Department at (805) 562-1080.
Click here to view our current CenCal Health Pharmacy Provider Manual or click the links below to access individual sections.
Table of Contents
Section A: Introduction
Section B: Member Eligibility
Section C: Covered Services
Section D: Prescription Limitations
Section E: Formulary Overview
Section F: Medical Request Forms (MRFs) Process
Section G: Claims Submission
Section H: Coordination of Benefits
Section I: Provider Grievance System
Section J: Pharmacy Audits