CalOptima Health

Current FAQ publishes this general provider mailbox. Contracting and training use the separate Provider Services Inbox route.

TTY 711. Current Medi-Cal page gives narrower Monday–Friday 8 a.m.–5:30 p.m. hours for orientation and certain program assistance; those purpose-specific hours are separate.

TTY 711. Published CalOptima Health behavioral-health support route.

Current Contact Us page labels this number for Claims and Provider Resource Line. Check the member’s assigned health network before submitting a claim.

Current EDI page specifically lists this number for provider claim-status verification. The general Contact Us page lists 714-246-8600 for Claims; both are retained with their published purposes, without a supersession claim.

Current Claims and Eligibility page directs contracted providers and prospective contracting inquiries to this mailbox. Separate from non-contracted registration and the general providerservices mailbox.

Training questions use Provider Relations; signed completion attestations may be emailed to this inbox or the assigned representative.

Use the currently linked non-contracted registration form with its required W-9 and supporting materials. Form title is December 2022; fax/email are also confirmed in current September 2026 manual L2. This is registration for claims review, not acceptance into the contracted network.

Mailbox for errors in the published provider directory. Do not use as claims, contracting or member clinical intake.

Obtain a tracking number first; the nurse case manager supplies the fax destination for clinical information. This route is specifically for inpatient post-stabilization authorization.

Published after-hours inpatient post-stabilization route. Obtain the tracking number and case-specific clinical fax from the UM team.

Current linked ARF has an older revision; current September 2026 manual F1 page 100 independently confirms routine and retrospective fax routing. Use the urgent route only when its criteria apply.

Current linked ARF and September 2026 manual F1 page 100 agree on this urgent fax. Urgent requests must meet the source’s clinical urgency criteria.

Current linked OneCare ARF and September 2026 manual F1 page 103 confirm this fax for routine, retrospective and urgent medical authorization requests. Delegated health-network responsibilities still apply.

Medical-benefit physician-administered drugs only. September 2026 manual section I2 directs the completed authorization form here; this is separate from retail Medi-Cal Rx and OneCare Part D intake.

Current linked form is for claim reimbursement or processing disputes. Clinical authorization disputes use a different form and route. Follow the applicable member/network and plan instructions.

Current linked service authorization dispute form. Clinical authorization denials, reductions, suspensions or terminations; not claim-payment or billing disputes. Required supporting clinical information must accompany the form.

Current provider Pharmacy page’s general CalOptima Health Pharmacy Program information contact. Specific drug authorization and appeal destinations are listed separately.

Current provider Pharmacy page links this form; use the OneCare Part D row. Phone is corroborated in current manual section I5. Appeals use the separately listed appeal fax.

For pharmacy personnel only. The currently linked OneCare support sheet is revised January 2025; current September 2026 manual I5 independently confirms the pharmacy PA telephone. Older conflicting B1 table numbers are not used.

Form currently linked from the 2026 OneCare Pharmacy page; form code H5433_25IRPD039_C. TTY 711. Member, prescriber or authorized representative may use the form; representation requirements remain on the source.

Form currently linked from the 2026 OneCare Pharmacy page; code H5433_25IRPD041_C. Published phone supports expedited requests and representative questions. The form’s four-hours footer typo is not used for hours.

Corporate office visitor location. This address is not automatically a claims, referral or appeal mailing destination.

In-person Customer Service address; use the program-specific member telephone for phone help.

TTY 711. For authorized services, call at least two business days before the appointment; call as soon as possible for urgent appointments. Have the member ID card ready. This notice is not a determination of individual ride eligibility.

TTY 711. Verified on the explicit 2026 OneCare page. Generic OneCare pages may already present 2027 benefits.

TTY 711. Current 2026 page says to request rides for authorized services at least two business days before the appointment; urgent appointments as soon as possible. Have the member ID card ready.

Prospective 2027 benefit-year product, not active 2026 coverage. Official July 21, 2026 announcement says open enrollment starts November 1, 2026. TTY 711.

PACE center and customer service. TTY 714-468-1063. Program enrollment and eligibility require the PACE team’s review.

1-844-999-PACE. PACE intake team determines whether program requirements and service area apply. TTY 714-468-1063.

Published PACE TTY contact; not a voice claims desk.

Current PACE page links the December 2025 referral form. The form requires the individual’s authorization to forward their contact details and request PACE intake contact.

Public business intake contact printed on the December 2025 PACE referral form currently linked from the PACE page. Individual staff availability and hours are not stated.

Public business intake contact printed on the December 2025 PACE referral form currently linked from the PACE page. Individual staff availability and hours are not stated.

Public business intake contact printed on the December 2025 PACE referral form currently linked from the PACE page. Individual staff availability and hours are not stated.

Public business intake contact printed on the December 2025 PACE referral form currently linked from the PACE page. Individual staff availability and hours are not stated.

Current PACE Your Rights page directs participant concerns to PACE staff or the general PACE line. It also gives 844-999-7223 as a toll-free alternative. No older grievance mailbox is inferred.

Adult and child/youth submission sections of the currently linked ECM form specify this email/fax. Form revision is September 20, 2024. The form’s conflicting 800-587-8088 help number is withheld; the current CalAIM webpage gives 888-587-8088 for member assistance.

Current dedicated CalAIM page links the 13-page December 2025 Community Supports form. This newer form is used instead of the May 2024 form still linked from the general Medi-Cal page. Phone is member assistance; fax and mail are referral submission.

TTY 711. Purpose-specific hours on the current CalAIM page; participation and changes remain subject to the program’s process.

TTY 711. Customer Service login assistance described in the current virtual behavioral-health visit instructions; appointment scheduling uses the separately identified provider.

September 2026 manual J1: direct referrals for CalOptima Health Direct and Community Network members. Members assigned to an HMO, PHC or shared-risk network use their assigned health network. No older triage phone is inferred.

September 2026 manual J4: new members with hemophilia in CalOptima Health Direct or Community Network. For a member in another health network, the source first directs the provider to that network.

September 2026 manual M5 specifically publishes this mailbox and Provider Resource Line for HEDIS questions. It is not a general medical-records submission destination.

September 2026 manual M7 specifies these reporting channels for potential quality-of-care issues.

September 2026 manual N6 publishes this email for seminar registration. It is not presented as the live interpreter scheduling line.

September 2026 manual O1 publishes these contact methods for health and wellness information. No older B1 health-education fax is added.

September 2026 manual P1 publishes the hotline and form-submission email/fax. Current provider HTML independently confirms the hotline. This is compliance reporting, not claims-status or billing support.

September 2026 manual P2: provider breach-reporting contact; ask for the Privacy Officer. This is not a medical-records request or general member inbox.