CalOptima’s success is a reflection of our partnerships with local health care providers. Together, we share the goal of delivering quality care to our members.

As the second largest health insurer in Orange County, CalOptima is proud our members have access to a comprehensive network of providers that includes 6,100 doctors, 484 pharmacies, 30 community health centers and a majority of the hospitals and long-term care facilities in the area.

Every one of our partnerships with local health care providers is essential to us. Our goal is to make it easier for providers to do the best possible job of serving our members.

Providers and other health care professionals who have questions regarding Medi-Cal or OneCare (HMO SNP) programs can call our Provider Relations Department at 1-714-246-8600.

Network Expansion

As our community’s need for cost-effective quality health care services expands, so does the need to enhance our delivery system by increasing the number and type of providers available to members. See the links below for more information.
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Links and Resources

Quick Links
Provider FAQs
Provider Trainings

Updates and Events

CalOptima is ready to accept ICD-10 codes for claims with D/O/S on or after 10/1/15. For more information, view our ICD-10 FAQs.
As of January 1, 2015, some members of Covered California health plans have transitioned to Medi-Cal. If you have questions about how this transition may affect members served by your organization, call CalOptima Provider Relations at 1-714-246-8600, Monday through Friday, from 8 a.m. to 4 p.m.
Events and Workshops
Provider Communications
Important Updates
Prior Auth Information
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Report Fraud or Abuse

You Can Report Fraud or Abuse. If you see any activity that you think is fraudulent or wasteful, we strongly encourage you to call our Compliance and Ethics Hotline at 1-877-837-4417 or report the activity using the Suspected Fraud or Abuse Referral Form. You do not have to give your name to report fraud activity.
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