Mailing addressGrievance and Appeals Resolution Services, 505 City Parkway West, Orange, CA 92868
Completed provider claim-payment dispute form and supporting documentation.
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.
Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.
appeals grievances
Provider service authorization disputes — clinical GARS fax and mail
Official page read
Phone
No phone listed for this route
Fax
714-954-2321
Published hours
Not published in this record
Product, plan and location
medicaid · medicare advantage California
Mailing addressCalOptima Health, Provider Clinical Disputes/GARS, 505 City Parkway West, Orange, CA 92868
Provider service authorization dispute form and supporting clinical documentation.
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.
Mailing addressCalOptima Health OneCare Complete, Pharmacy Management Appeals, 505 City Parkway West, Orange, CA 92868
Prescription drug denial redetermination form and supporting information.
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.
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.
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Call preparation · editorial guide
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Find appeal teams, faxes and mailing addresses. Use the denial notice to confirm the appeal level, filing deadline and recipient.
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Denial notice, remittance and reason codes
Previous appeal confirmation and decision
Supporting evidence and any required authorization to represent the member
Questions to resolve
Is this a claim correction, provider dispute or member appeal?
What deadline and submission channel apply to this case?
How can the office confirm receipt and track the decision?
This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.
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