Independent physician associations

Santé Physicians

Phone, published email, fax, addresses and the next step for your office.

6 contact routesNo directory research calls placed

provider services

HMO customer service — providers and members

Official page read
Phone559-228-5410Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage
California

Mailing address

Not researched for this route

Current Reference & Support PDF, page 4, visually reviewed. This guide directs eligibility information to the health plan. No historic Medi-Cal phone or benefit determination is inferred. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

claims

Commercial and Medicare Advantage HMO claims

Official page read
Phone855-608-9019Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage
California

Mailing address
Santé Physicians (HMO name), P.O. Box 1507, Fresno, CA 93716-1507

HMO paper claims; include the actual HMO name. Some POS claims apply only when the member uses the HMO component.

Current linked Operations PDF, pages 18–19. Page 19 was visually reviewed. The same document retains older specialty-drug policies, which are not imported as current benefit rules. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

appeals grievances

Commercial and Medicare Advantage provider disputes

Official page read
Phone

No phone listed for this route

Fax

559-224-2672

Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage
California

Mailing address
Santé Customer Service/Appeals, P.O. Box 792, Fresno, CA 93712

Provider dispute resolution requests for commercial and Medicare Advantage claims; not original claims.

Operations pages 23–24 distinguish provider disputes from original claims. Page 24 fax/address visually reviewed. The current document also offers the QuickCap PDR module. Filing deadlines must be checked against the applicable notice. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

prior authorization

HMO utilization-management authorization inquiries

Official page read
Phone559-228-2905Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage
California

Mailing address

Not researched for this route

Reference & Support PDF page 4 was visually reviewed. This is the explicitly labeled authorization inquiry route; older specialty-policy UM numbers are not substituted. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

portal

QuickCap login, access and electronic-claims setup support

Official page read
Phone559-233-2273Published email

PortalSupport@santehealth.net

QuickCap account/login access and electronic-claims setup support, not claim adjudication or clinical-document email.

Published hours

Not published in this record

Product, plan and location

Confirm the exact product or service
California

Mailing address

Not researched for this route

Operations page 1 and the current homepage corroborate portal support. The portal supports claims, authorizations and PDR; no account was entered. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

provider enrollment credentialing

Credentialing department

Official page read
Phone559-228-5432Fax

559-224-2046

Published hours

Not published in this record

Product, plan and location

Confirm the exact product or service
California

Mailing address

Not researched for this route

Resources-at-a-Glance, page 13, visually reviewed. The fax/phone are published for Credentialing and also appear under Quality Management; request the credentialing team. The linked manual is current on the site but does not establish a fresh publication date. Physician-owned California IPA administered by Santé Health System. The current site describes its network in Fresno, Madera and Kings counties. HMO delegation and individual plan/physician participation require confirmation; Santé is not the insurance carrier.

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

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