Provider Manual

Why You Need the Manual

Your Provider Manual specifically addresses the contractual and regulatory requirements of .
This manual is intended as a guideline for the provision of covered services to Members.
This manual contains policies, procedures and general reference information including minimum standards of care, which are required of Providers.
Following requirements defined in the manual ensures that our members receive comprehensive care.

We'll Keep You Updated

From time to time we will need to update our website as our policies change, or as L.A. Care, CMS, and/or DHS requirements change. We will keep you informed of those changes as they occur. As a Provider, we hope this information will help you better understand how operates.

Additional Information

Although this manual contains a comprehensive summary of policies and procedures, additional protocols regarding plan administrative practices, full plan medical policies, and other detailed information are available to the provider upon request by calling Provider Relations Department at (800) 468-9935.

California Department of Health Care Services

Instructions related to Transactions based on ASC X12 Implementation Guides, version 004050.

Health Care Provider Directory (EDI 274)
Standard Companion Guide Transaction Information

Health Care Provider Directory Flat File Version for EDI 274
Flat File Version for EDI 274 Provider Information