Welcome! We are pleased to have you as one of our new provider partners. The materials listed below supply you with key information that is useful when providing care to CalOptima Health members.
If you have any questions, please call Provider Relations at 714-246-8600.
Behavioral Health Provider Training
CalOptima Health Community Network (CHCN) Annual In-Service Training
CalOptima Health Community Network (CHCN) Onboarding Provider Training
CalOptima Health Community Network (CHCN) Provider Training Attestation
To confirm completion of training modules, sign, date and email this attestation to your Provider Relations representative or providerservicesinbox@caloptima.org
Community-Based Adult Services (CBAS) Provider Training
Fraud, Waste and Abuse Web-Based Training Course
Medi-Cal for Kids & Teens Provider Training
Regional Center of Orange County (RCOC) Provider Training
Seniors and People With Disabilities
Whole-Child Model (WCM) Provider Training
To help seniors and people with disabilities (SPD).
Americans With Disabilities Act (ADA) Questions and Answers
CalOptima Health Cultural and Linguistics Services Minimum Requirements
How to Access Interpreter Services
Non-Emergency Medical Transportation Authorization Form
10 Skills for Empathetic Listening
CalOptima Health is committed to ensuring that communications, services and programs are accessible to people with functional limitations, including visual, hearing, cognitive and physical disabilities.
In June 2011, CalOptima Health initiated disability awareness and sensitivity training as required by the California Department of Health Care Services. Disability awareness education continues to be required for all staff and health care providers who care for members in CalOptima Health Medi-Cal, OneCare and PACE.
Learn how to identify members with potential cultural or language needs and when alternative communication methods may be needed.
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 1-855-507-1805 or report the activity using the Suspected Fraud or Abuse Referral Form. You do not have to give your name to report fraud activity.
Understanding your role in health care fraud
Suspected Fraud or Abuse Referral Form
Fraud, Waste and Abuse Compliance Training
In CalOptima Health’s ongoing efforts to ensure we report accurate coding and proper chart documentation as required by the Centers for Medicare & Medicaid Services, we have created coding tips on various topics to assist the provider community.
Chronic Obstructive Pulmonary Disease (COPD)
Assisting Members With Advance Directives: What Providers Need to Know
Authorization Modification/Change Requests From Providers
California COVID-19 Therapeutics Best Practices Toolkit
Community-Based Adult Services (CBAS) Online Training
Dementia Care Aware Provider Training
Improving Patient Satisfaction in the Medical Office Training
Initial Health Appointment (IHA)
Screen and Intervene: A Toolkit for Pediatricians to Address Food Insecurity
CalOptima Health Behavior Health Treatment (BHT) Provider Training
ECDS - Depression Screening Measures
HEDIS Documentation Requirements for Providers
Learn the Health Insurance Portability and Accountability Act (HIPAA) rules, who must comply with the rules and how the rules are enforced.
OneCare providers and staff are required to complete training on key elements of the OneCare program. The requirement applies to those who directly or indirectly are responsible for providing health care services to our OneCare members or those who administer OneCare health care benefits. The OneCare training module is updated annually to reflect any changes to the program’s regulatory requirements.
OneCare Model of Care Training
Personal Care Coordinator (PCC) training is conducted annually for newly hired PCCs at the health networks and on an as-needed basis for internal CalOptima Health-employed PCCs. Training includes an overview of the model of care processes, roles and responsibilities of the PCC, as well as motivational interviewing, health literacy, member satisfaction and impact on key performance indicators (KPIs).
Leaders from CalOptima Health Case Management, Long-Term Services and Supports, Behavioral Health, Network Management, and Equity and Community Health departments present briefly on how each department relates to the actions and accountabilities of PCCs.
Learn about our “road map” for care management policies, procedures and operational systems for OneCare members.
Medi-Cal Annual Wellness Visits
Medi-Cal Annual Wellness Visit Provider Attestation Instructions
Medi-Cal Annual Wellness Visit Program FAQ
OneCare Annual Wellness Visits