The provider manuals in this section give CalOptima providers the most current information about our Medi-Cal, OneCare (HMO SNP) and Healthy Families programs. As a Medi-Cal managed care plan, the information in these resources is subject to change due to regulation or legislation.

These manuals reference provider enrollment and registration responsibilities, claims submission information, member eligibility verification, and guidelines for submitting and processing medical authorizations.

In addition to the provider manuals above, you may also access CalOptima's online policy and procedure database, hosted by Compliance 360.

CalOptima is proud to work with over 3,700 physicians, more than 450 pharmacies and a majority of the hospitals and long-term care facilities in Orange County. The provider directories represent a comprehensive list of our provider partners for our Medi-Cal, OneCare (HMO SNP) and Healthy Families programs.

Health networks and medical groups often require different information than smaller practices, and we have developed resources to meet their unique needs.

CalOptima is dedicated to keeping our members healthy. To do this, we developed a variety of informative health education materials and programs ranging from guides about how to deal with asthma to programs designed to help members stop smoking. These programs and materials are available in several languages.

For more information about our health education programs and services, e-mail our Health Education Department at healthpromotions@caloptima.org, or call our Customer Service Department at 1-888-857-8088 or 1-714-246-8500.