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.
- In California, the Children’s Health Insurance Program (CHIP) is fully administered through the Medi-Cal program. All Providers who are contracted with a Medi-Cal Managed Care Plan (MCP) to serve pediatric Members also serve CHIP-funded children. There is no separate Network or distinction in service delivery between Medi-Cal and CHIP enrollees; both are covered under the same benefits, funding structure, and Provider access standards.
- 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.
- CHDP: Y indicates that a provider is certified to provide Child Health and Disability Prevention program services.
- CPSP: Y indicates that a provider is certified to provide Comprehensive Perinatal Services Program services.
- 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.
- 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.
- 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].