About This Directory
The Central California Alliance for Health (the Alliance) issues
this directory based on the information supplied to us by physician/provider
offices and hospital credentialing information.
Helpful tips for using
this directory
·
Each provider in this
directory has a National Provider Identifier (NPI) number that is associated
only with that provider.
·
There are several codes in this directory that indicate
participation with one of several programs, listed below. For more information
about these programs, please call the Alliance Member Services department at
(800) 700-3874 between 8:00AM and 5:30PM.
o
CHDP: Y indicates that a
provider is certified to provide Child Health and Disability Prevention program
services.
o
CPSP: Y indicates that a
provider is certified to provide Comprehensive Perinatal Services Program services.
o
CCS: Y indicates that a
provider is able to provide California Children's Services program
services.
Board Certification
·
Board Certification is a voluntary process and is different from
medical licensure. Having a medical license means that the physician meets the minimum
competency requirements to diagnose and treat patients. Board Certification demonstrates
a physician's expertise in a particular specialty or subspecialty of medical practice.
This information is verified with the American Board of Medical Specialties or American
Osteopathic Association by the Alliance or the Medical Group every three years or more
frequently as reported by the provider. Recent changes may not be accurately reflected
until the next verification date.
o
To check a medical doctor's (MD) most current board certification status, go to
the American Board of Medical Specialties' website at
http://www.abms.org/ and click
on the 'Is My Doctor Board Certified?' section.
o
To check an osteopathic doctor's (DO) most current board certification status,
go to the American Osteopathic Association's website at
http://www.osteopathic.org/
and click on the 'For Patients' section.
Choosing Your Primary
Care Provider
Each Alliance member needs to choose a family doctor, called a
Primary Care Provider (PCP). If you do not choose a PCP, you will be
automatically assigned to a PCP in your area.
Please carefully review the provider listings in PCP section of
this directory before choosing your PCP.
·
Note the hospital with
which the PCP is affiliated as this is where you will go for hospital care, if
necessary.
·
Note where the provider’s
office is located, what the office hours are, what the telephone numbers are,
and what languages they speak.
·
Some hospitals and other
providers do not provide one or more of the following services that may be
covered under your plan contract and that you or your family member might need:
family planning; contraceptive services, including emergency contraception;
sterilization, including tubal ligation at the time of labor and delivery;
infertility treatments; or abortion. You should obtain more information before
you choose your PCP. Call your prospective doctor, medical group, independent practice
association, or clinic, or call the Alliance at (831) 430-5500 to ensure that
you can obtain the health care services that you need.
Important Information about Referrals and Authorizations
- Authorization or referral
may be required to access some providers.
- Only your current Primary
Care Provider (PCP) may issue a Referral Authorization Form (RAF).
- When your medical
condition requires services not available through this directory’s list of
contracted physicians/providers, your PCP may request authorization for
the services of physicians/providers outside of the Alliance network. If
you have a question regarding a particular physician/provider’s
participation with the Alliance, please call the Alliance Member Services department
at (800) 700-3874.
- You can access some Allied
Health Services without an authorization from your PCP. Please refer to
your Member Handbook or call the Alliance Member Services department at (800)
700-3874 for more information.
Nondiscrimination and accessibility to services
Alliance members are
entitled to full and equal access to covered services, including members with
disabilities as required under federal law and in compliance with the Americans
with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973.
This directory identifies
providers in the Alliance network who speak languages other than English.
Alliance members also have the right to free interpreter services.
If you
need language assistance, call the Alliance Member Services department at (800)
700-3874.
All Alliance providers
must complete a new provider training on cultural competency, which includes information
on caring for patients with diverse values, beliefs and how to provide care in
a way that meets the patients' language needs.
If you
are an Alliance member and would like a printed copy of the provider directory,
please call the Alliance Member Services department at (800) 700-3874,
email [email protected] or
send a request by mail to:
Central California Alliance for Health
Attn: Member Services
1600 Green Hills Road Suite 101
Scotts Valley, CA 95066
If you are a provider or member of the public
and would like a printed copy of the provider directory, please call (877) 778-3915.
To report any information that appears inaccurate in this
directory, please contact the Alliance’s Provider Directory line at (877) 778-3915,
email [email protected], or fill out this Online Form.
You may submit a complaint if you believe the information that
you received from this directory has been wrong, incomplete or misleading. To
submit a complaint, please call (877) 778-3915 or email [email protected].