Home
Contact Us
Site Map
CalOptima Direct Fee Schedule
CalOptima Direct Forms
Provider Orientation Training Dates
How to Access Interpreter Services
Pediatric Preventive Services Periodicity Schedule
Provider Dispute Resolution
Formulary Information
Authorization Referral Form
Language Identification Tool
CalOptima Resource Contact Sheet
Claims Administration
Member Eligibility
Refer to
Member Services
section.
Provider Eligibility
Refer to
Provider Enrollment and Registration
section.
Claim Forms
CMS1500 (Professional/Ancillary Services)
UB04 (Facility Services)
PM160 (CHDP Services)
Refer to
Pediatric Preventive Services Provider Manual
section.
25-1 (LTC Services)
Refer to
LTC Resources
section.
How To Submit Claims
EDI/Hardcopy
Address
Billing Tips
Provider Online Tool
and
Claim Inquiry (Claims Resolution Unit)
Information available on WEB and refer to
Provider Online Tool
section.
Address
Contact number, times available and services offered
Reject Notification
Common Denials and How to Avoid
Provider Dispute Resolution (PDR) (Claim Resubmission)
General Information for Physicians section.
