Language Assistance Groups: The practice a doctor works in. These are the resources and the endpoints available with the Alliance Provider Directory API. + Decrease font size. Provider Directory | Community Cares Plan Select PractitionerRoles associated with the specified specialty. Were committed to achieving: Partnering with you to keep your patients living safely and independently in their homes and communities is at the heart of our mission. Inyo The voluntary certification program enables organizations to demonstrate that they have adopted and are adhering to CAQH CORE Operating Rules. Placer Provider Directory for Members - CenCal Health Select roles filled by the specified practitioner. GET [base]/OrganizationAffiliation/[id]/_history/vid, GET [base]/OrganizationAffiliation? Search by Doctor Type Search by Doctor Name Search by Hospital/Facility Doctor type Primary Care Physician Specialty Select Primary Care Type Family Medicine Zip Code Distance Within 15 miles Plan Type Member Handbook Arabic Lake [parameter=value]&_include=HealthcareService:coverage-area, GET [base]/HealthcareService? SHALL: An absolute requirement for all implementations. Select organizations with the specified address (matches any of the string elements of an address). Public Health, * Language: Members who are enrolled in County Employee Plan A, Plan A2, or IHSS Plan A2, must choose providers from the RMC network only. CCA One Care is available in 12 counties in Massachusetts: Barnstable, Berkshire, Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester. Adoption Directory GET [base]/Organization/[id]/_history/vid, GET [base]/Organization? Orange They might also work in different offices or clinics. This is not a guarantee they will be available to accept additional patients at the time you contact them. Medi-Cal members can also go to the Medi-Cal Rx webpage to find Medi-Cal Rx participating pharmacies. On a quarterly basis, CCHP emails a Network Update link for the group to report any changes to the information CCHP has on file. Providers | CAQH Note: For more information about the FHIR RESTful API, please refer to the HL7 FHIR RESTful API topics. [parameter=value]&_include=Location:organization, GET [base]/Location? San Francisco * Translation services available for most languages. Solano CenCal Health is contracted with many primary care providers, specialists, pharmacies and hospitals in your area. Provider Directory - Community Behavioral Health Potential members may contact our Marketing Department at 1-877-661-6230 option 6. [parameter=value]&_revinclude=HealthcareService:organization, GET [base]/Organization? Farsi Select Locations managed by the specified organization. If you have a timely access concern, you can contact CCHP's Utilization Management at 1-877-661-6230 option 4 or file a complaint with the California Department of Managed Health Care by calling the DMHC Toll-free provider complaint line at: 1-877-525-1295. The DaVinci PDEX Plan-Net OrganizationAffiliation profile is based on the core FHIR OrganizationAffiliation resource. Phone Number: The doctors office or hospital phone number. Fresno Please refer to the Kaiser Assignment Criteria document located at cchealth.org/CCHPmaterials or contact Member Services at 1-877-661-6230 (press 2) for more information. To change your primary care provider or get detailed information about your healthcare benefits and prior authorization requirements, call our Member Services team at 866-610-2273(TTY 711). A Decrease font size. An example is a doctor who works only with the heart, cancer, or bones. , California Sierra CalAIM: Enhanced Care Management (ECM) and Community Supports (CS) require prior authorization and are limited to members who meet specific eligibility criteria. The resource may be used to encompass a variety of services covering the entire health care spectrum, including promotion, prevention, diagnostics, hospital and ambulatory care, home care, long-term care and other health-related and community services. Specialty: A provider's specialty is identified when they join the health plan network. Mendocino Destination Guide: Gunzenhausen (Bavaria, Regierungsbezirk ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Members have the choice to refuse professional interpreters and use adult family members or friends. The DaVinci PDEX Plan-Net PractitionerRole profile is based on the core FHIR PractitionerRole resource. Together, we can bring uncommon care to more people with significant needs. Russian Operating rule development for these transactions is currently underway. Hospitals: The network hospitals a doctor can see their patients in. Provider Directory :: Health Plan :: Contra Costa Health Services Frequently Asked Questions, GRIEVANCE FORM Contra Costa Health Plan (CCHP) has been serving the health care needs of Contra Costa County for over 40 years. In an effort to provide CCHP members and providers with useful information to make decisions, CCHP updates provider and facility information within thirty (30) business days after we are notified of a change. This makes sure that Medi-Cal members have access to covered services. Please give us a call, toll-free at 1-877-814-1861, and we can assist in the following ways: 2023 CenCal Health. An Organization refers to a formally or informally recognized grouping of people or organizations formed for the purpose of achieving some form of collective action. If a doctor or hospital makes a change to any of the information below, CCP updates the provider directory within 7 days of learning of the change. Location: The doctors office or hospital address. [parameter=value]&_revinclude=PractitionerRole:service, GET [base]/HealthcareService?[parameter=value]&_revinclude=OrganizationAffiliation:service. Select PractitionerRoles available at the specified location. If the specialty needed is not available within the assigned network, which may be due to, but is not limited to the provider being unable to make an appointment in a timely manner, the provider is located unreasonably far away, or you require a specialty not present in the RMC network, CCHP and the assigned PCP may arrange for whatever referrals, authorizations, and treatments necessary with a specialist that is available in a non-assigned network. Select services associated with the specified specialty. CCA Senior Care Options, CCA Medicare Value, and CCA Medicare Preferred are available in 10 counties in Massachusetts: Bristol, Essex, Franklin, Hampden, Hampshire, Middlesex, Norfolk, Plymouth, Suffolk, and Worcester. Must contain at least 1 character from each of the following four groups: Uppercase letters Lowercase letters Numbers Special Characters May not contain your username May not be any of your last 10 passwords Please contact the Provider Services at (831) 430-5518 with any questions. Lassen Certificate. Nevada To report incorrect provider information, members can contact member services by calling 1-877-661-6230 option 2 or by email: cchp@cchealth.org and Providers or the general public can contact Provider Relations at providerrelations@cchealth.org or by calling 1-877-800-7423 option 6. In addition, on a quarterly basis, CCHP emails a Network Update link to each provider, provider group or facility to report any changes to the information CCHP has on file. CCHA | Find a Provider - Colorado Community Health Alliance Select Organizations with the specified name. Siskiyou The Central California Alliance for Health (the Alliance) has contracted with Beacon Health Options to provide mental health services. A Reset font size. Learn More. Thai Only submit information below that needs to be changed in the directory. It requires CenCal Health to meet both time and distance standards based on county population density. Select health insurance provider networks available in a region described by the specified location. Medi-Cal Dental Program. Colusa CenCal Health is required by the Department of Health Care Services to meet network adequacy standards. CORE Certification Klinikum Altmhlfranken Gunzenhausen reviews | Best Hospitals in The information reported on this Web site is based on the information provided to CCHP from the participating provider and/or verified by licensing and accrediting entities. Mongolian Adults Children/ Adolescents Step 2: Please enter your address to determine the closest providers. This directory gives members, potential members and providers access to our two networks (Regional Medical Center (RMC) and the Community Provider Network (CPN) of physicians, pharmacies, hospitals and ancillary providers. [parameter=value]&_include=HealthcareService:organization, GET [base]/HealthcareService? They will be able to assist you in making the best health plan choice for you. A Increase font size. [parameter=value]&_include=Organization:coverage-area, GET [base]/Organization? As of January 2013, all HIPAA-covered entities must adhere to the federally mandated Phase I and II CAQH CORE Operating Rules, which relate to patient eligibility and claim status. Facility: CCHP updates facility information daily as changes are reported by the facility. Our Fear Free methods and our compassionate staff look forward to making your pet's visit to the vet a positive one! FAQs, Case Studies, Issue Briefs, and more. Benefits of CCAH Provider Portal Online Provider Directory http://www.ccah-alliance.org/providerdirectory.html Click on Provider Directory Search Effective January 2015 CENTRAL CALIFORNIA ALLIANCE FOR HEALTH Provider Directory / Gua de Proveedores / Phau Ntawv Teev Cov Kws Khomob A.2 Primary Care Physicians/ Doctores de Cuidado Primario/ Cov Thawj Kws Khomob Below we describe the information in the fields in the provider directory. Compassionate Care Animal Hospital (CCAH) is a full-service animal hospital located in Ann Arbor, Michigan. CCH will closely monitor activity at the refinery and notify the public if the flaring results in any offsite health impact to the community. Santa Barbara Commonwealth Care Alliance (CCA) is pleased to announce that we are partnering with Cognizant to implement our new claims platform, Facets, effective Q2 2023. Languages Spoken: These abilities are self-reported by the providers in the CPN network when the provider joins the network and at the time of recredentialing. Select Locations with the specified state address. Insurance Plan describes a health insurance offering comprised of a list of covered benefits (for example: the product), costs associated with those benefits (for example: the plan) and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc. Ventura At Commonwealth Care Alliance, we take responsibility for making our relationship with each provider a true partnership. Tuolumne County: GET [base]/PractitionerRole/[id]/_history/vid, GET [base]/PractitionerRole? Select HealthcareServices provided by the specified organization. See our linguistic access and accessibility policy. Select services available in a region described by the specified location. Madera Select HealthcareServices available at the specified location. Enter the appropriate information below to view a list of Dental Providers who may be accepting new Medi-Cal patients. If you are a solo practitioner, enter your name in the box above. [parameter=value]&_revinclude=OrganizationAffiliation:location, GET [base]/Location?[parameter=value]&_revinclude=PractitionerRole:location. Provider Directory - Central California Alliance for Health Accepting New Patients: This provider accepts both new and existing patients. If your zip code and provider type are listed, CenCal Health will assist you in getting an appointment. CCA One Care | CCA Senior Care Options | CCA Medicare Advantage. If your zip code and provider type are listed, CenCal Health will assist you in getting an appointment. [parameter=value]&_include=Location:partof, GET [base]/Location? Includes companies, institutions, corporations, departments, community groups, health care practice groups, payer/insurer, etc. You have the right to call our Member Services department at 1-877-814-1861 to get help finding an appointment to a closer specialist. The Provider Directory API accesses the Alliance FHIR server portion of the Provider and Pharmacy Directories. PDF Monterey and Santa Cruz Medi-Cal Provider Directory Gua de Proveedores Location Name: Name of the doctor's office or hospital address. The DaVinci PDEX Plan-Net InsurancePlan profile is based on the core FHIR InsurancePlan resource. To set your current location, click the green Use Current Location button. Santa Clara Golden Road 365 Detox - Transform Your Health in 21 Days Provider Directory Information Update Form - ccah-alliance.org Medical group: This information is collected from the group at the time they initially join the network. We are dependent on the accuracy and timeliness of changes to the information being reported to CCHP by the providers. Alameda [parameter=value]&_revinclude=HealthcareService:location, GET [base]/Location? A Location is the physical place where health care services are provided, practitioners are employed, organizations are based, etc. We can help you understand and assist you with obtaining referrals to see specialists, explain when referrals are not needed, and help you find a specialist in your area. Please select a language Providers are doctors, physicians or other healthcare professionals that accesses information to help patients or track a refund. 2020 K Street, NW - Suite 660 Washington, D.C. 20006. This specification uses SHALL, SHOULD and MAY as a guideline for required, recommended and optional data FHIR standards. For more information or any questions please call Member Services at 1-866-899-4828 TTY/TDD 1-855-655-5303. The call is free. We collect this information when providers join the network and is reviewed quarterly at the time of the provider network update. Alliance Care IHSS Price Transparency Tool. General Practitioner Select products with the specified identifier. Provider Directory Welcome to Contra Costa Health Plan's Provider Online Search Engine Begin Your Search Here Request Printed Copy of Provider Directory Or call: 1-877-661-6230 (Option 2) Or write: Contra Costa Health Plan Attn: Member Services 595 Center Avenue, Suite 100 Martinez, CA 94553 View/Download Copy of Provider Directory Spanish Select Locations with the specified city address. Mandarin By entering a hospital name, the accreditation status and quality measures are listed. Name: The doctor or hospital that is part of the CCP network. Dental Clinics Serving Medi-Cal Members. [parameter=value]&_include=PractitionerRole:location, GET [base]/PractitionerRole? Using read-only RESTful GET API calls (PUT and POST are not currently supported), you can create an application to access information about our providers and pharmacies. The CAQH CORE Phase III Operating Rules for EFT & ERA have been mandated by HHS and since January 2014 any provider should be asking forthe streamlined electronic transactions that can result due to these operating rules and their affiliated standards. Language interpreter services are available 24 hours a day, 7 days a week at no cost to the member. Effective January 2023, CCA is expanding its product offering in Massachusetts with one new Medicare plan. [parameter=value]&_include=OrganizationAffiliation:location, GET [base]/OrganizationAffiliation? Stanislaus Board Certification: Information on board certification is verified at the time of credentialing and re-verified at least every three years at the time of re-credentialing. If you are a member and would like to choose one of our PCPs, please contact our Member Services department at 1-877-661-6230 option 2. * If your language is not listed, please call the Telephone Service Center at 1-800-322-6384 for free translation services during a dental appointment. Medi-Cal Dental Provider Directory Search. Information regarding quality is obtained by the Joint Commission at the time of survey, as new information becomes available and at resurvey. Languages: The languages a doctor speaks. Our Provider and Pharmacy Directory make it easy to find the care you need. ProcessLogoff - provider.portal.ccah-alliance.org Sometimes, there is not a needed provider close enough. A specific set of Roles/Locations/specialties/services that a practitioner may perform at an organization for a period of time. Authentication is not required to access the Conformance resource. CCA Senior Care Options Directory Documents, CCA Medicare Advantage Directory Documents, Berkshire, Franklin, Hampden, Hampshire-Spanish. San Joaquin Preferred Provider: A doctor that meets strict quality standards. By entering an e-mail in this field I am confirming that the e-mail provided is intended for patient communication and is regularly monitored and maintained in a manner consistent with State and Federal laws. The Boston Globe Names Commonwealth Care Alliance a Top Place to Work for 2022. HL7 FHIR DaVinci PDEX Payer Network (Plan-Net) Implementation Guide Version 1.0.0, HL7 FHIR DaVinci PDEX Plan-Net Profiles, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Endpoint, DaVinci PDEX Plan-Net HealthcareService profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-HealthcareService, http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/HealthcareServiceCategoryCS, DaVinci PDEX Plan-Net InsurancePlan profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan, http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsurancePlanTypeCS, http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Location, http://terminology.hl7.org/CodeSystem/v3-RoleCode, DaVinci PDEX Plan-Net Organization profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Organization, http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/OrgTypeCS, DaVinci PDEX Plan-Net OrganizationAffiliation profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-OrganizationAffiliation, DaVinci PDEX Plan-Net Practitioner profile, http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-Practitioner, DaVinci PDEX Plan-Net PractitionerRole profile. Alliance. Del Norte *In Barnstable and Berkshire Counties: CCA One Care is available; CCA Senior Care Options, CCA Medicare Value, and CCA Medicare Preferred are not yet available. Certified Orthodontist Resources in the Conformance category are used to represent metadata about the datatypes, resources, and CCAH Provider Directory API features of the FHIR specification and can be used to create derived specifications. GET [base]/HealthcareService/[id]/_history/vid, GET [base]/HealthcareService? ASL Interpreter Available: The office can translate into American Sign Language. Hindi It mandated healthcare operating rules for HIPAA claims-related electronic transactions, and CAQH CORE was named by the Secretary of Health and Human Services (HHS) as the authoring entity of these operating rules. Plumas This network contains both primary and specialty care providers to choose from. CAQH CORE is the author of the final set of ACA-mandated operating rules for remaining HIPAA transactions, which include healthcare claims, enrollment and disenrollment in a health plan, premium payments, prior authorization and claims attachments. Alliance Provider Portal [parameter=value]&_revinclude=InsurancePlan:coverage-area, GET [base]/Location? Learn best practices and earn CBI payments for ACE screenings at your practice. The CCA uncommon care model has demonstrated success in reaching and engaging individuals with significant medical, behavioral, and social needsimproving quality of care while keeping patients and members safely at home. Imperial View Urgent Visit Access Offices in Santa Cruz County. If you do not have your Alliance ID number, click on the link for the General Pharmacy Locator. Large healthcare providers may achieve CORE Certification. For further assistance, members can contact Member Services at 1-877-661-6230 option 2 and providers can access interpreter services at 1-877-800-7423 option 4 or directly at 1-866-874-3972. SHOULD: A best practice or recommendation for the implementation. Trinity [parameter=value]&_revinclude=OrganizationAffiliation:primary-organization, GET [base]/Organization? CCAH Office of Licensing and Monitoring Provider Directories It should be noted that this is an all-inclusive resource directory of DHS licensed programs; however, not every provider listed is contracted with DHS to provide services to youth in placement. Kern Tulare The DaVinci PDEX Plan-Net Practitioner profile is based on the core FHIR US Core Practitioner resource. A doctor may work with other doctors. San Diego If you want to check to see if your doctor is board certified go to CertificationMatters.org, DoctorsThatDo.org, or call 1-866-ASK-ABMS (275-2267). Healthcare Provider Directory | Commonwealth Care Alliance MA In those situations, CenCal Health can still get you care. [parameter=value]&_include=PractitionerRole:practitioner, GET [base]/PractitionerRole? Hmong Napa Prosthodontist The RESTful capabilities are discussed in further detail below. Facilities may also notify us at any time regarding changes to their accreditation status. A network is typically owned by a payer. Call 866-610-2273 (TTY 711). The DaVinci PDEX Plan-Net Location profile is based on the core FHIR US Core Location resource. You can also use the filters to search for more specific information. Depending on the plan, benefits may include $0 primary care visits, $0 annual dental and eye exams, $0 transportation, $0 identity theft protection, and $200 or more for over-the-counter health products. San Bernardino We partner with a broad network of providers, dentists, pharmacies, and other healthcare facilities. Electronic Funds Transfer (EFT) Enrollment Form, Behavioral/Mental Health Substance Use Disorder. If CenCal Health cannot find you an appointment with a closer specialist, we will arrange transportation to see the specialist, if needed. Sutter CCHP Medi-Cal members should contact the DHCS Medi-Cal Rx Help Line for any pharmacy questions (1-800-977-2273, TTY 1-800-430-7077). Taiwanese Specialty is verified when the practitioner joins the network and at the time of recredentialing through state licensing and board certification. CCA Provider Homepage | Commonwealth Care Alliance MA Accreditation: This information is collected at the time the facility initially joins the network and then every three years thereafter. Shasta The Index is the authoritative source of information on the healthcare industrys progress toward more automated and efficient business processes. This directory is for informational use only. Dont miss our bimonthly newsletter for community partners. [parameter=value]&_revinclude=InsurancePlan:owned-by, GET [base]/Organization? You can get these documents for free in other formats, such as large print, braille, or audio. San Mateo [parameter=value]&_include=InsurancePlan:owned-by, GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:coverage-area. The Alliance FHIR server SHALL be capable of returning a HealthcareService resource using: The Alliance FHIR server SHOULD be capable of returning a HealthcareService resource using: The Alliance FHIR server SHALL be capable of supporting the following _include parameters: The Alliance FHIR server SHALL be capable of supporting the following _revinclude parameters: The Alliance FHIR server SHALL be capable of returning an InsurancePlan resource using: The Alliance FHIR server SHOULD be capable of returning an InsurancePlan resource using: The Alliance FHIR server SHALL be capable of returning a Location resource using: The Alliance FHIR server SHOULD be capable of returning an Organization resource using: The Alliance FHIR server SHALL be capable of returning an Organization resource using: The Alliance FHIR server SHALL be capable of returning an OrganizationAffiliation resource using: The Alliance FHIR server SHOULD be capable of returning an OrganizationAffiliation resource using: The Alliance FHIR server SHALL be capable of returning a Practitioner resource using: The Alliance FHIR server SHOULD be capable of returning a Practitioner resource using: The Alliance FHIR server SHALL be capable of supporting the following _revinclude parameter: The Alliance FHIR server SHALL be capable of returning a PractitionerRole resource using.
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