Annual Directory Validation
CalOptima Health requires that all participating providers with CHOC Health Alliance verify their demographic information on an annual basis. Failure to validate and attest to the accuracy of the directory information may result in panel closure, suppression from the Provider Directory, and/or delay of payment. Attestation Form.
Annual Provider Training
CHOC Health Alliance is required to provide annual refresher training to our contracted practices. To review our training document, click on the link here – Provider Training
In addition, please review the below CalOptima Health Trainings:
- CHOC Health Alliance Provider Training – CHA New Provider Training
- Disability Awareness Training – Disability Awareness (caloptima.org)
- Cultural Competency Training – Cultural Competency Training (caloptima.org)
- Fraud, Waste, and Abuse Training – Fraud, Waste and Abuse (caloptima.org)
- EPSDT Training – Medi-Cal for Kids & Teens Provider Training
Re-credentialing occurs every 36 months after the initial approved credentialing date. A few months before the deadline, the provider will receive a pre-populated application from CHOC Health Alliance’s Credentialing department. The provider is required to:
- Complete the application and verify that the pre-populated information is correct.
- Send the application to CHOC Health Alliance’s Credentialing Department for review.
For any questions related to the credentialing process, the provider may email the CHOC Health Alliance’s Credentialing department at firstname.lastname@example.org
Notification of changes within your practice, group, or facility
If you make changes within your practice, CHOC Health Alliance (CHA) requires 90 days prior notification. All changes may be faxed or mailed to Provider Services. If a primary care provider reports changes, we are required to notify our affected members within 30 days.
For the following changes:
- Phone and/or fax numbers
- Location and/or address
- Additions, terminations, deletion of services
You must submit.
- provide written notification on letterhead of change, including the effective date. If terminating, include where members should be moved. If no provider is designated; CHA will move members accordingly.
If you make changes to business ownership and/or changes in tax identification number, you must submit the following documentation and forms:
- Written notice on letterhead of changes, including the effective date.