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- CA Preferred IPA Referral/Authorization Request 2016
Get CA Preferred IPA Referral/Authorization Request 2016-2024
REFERRAL / AUTHORIZATION REQUEST Fax authorization request to: (800) 8742093 Phone (800) 8742091DATE SUBMITTED: LAST TWO OFFICE VISIT NOTES and LAB/DIAGNOSTIC RESULTS PERTAINING TO THIS REQUEST.
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Cpt FAQ
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California Health & Wellness provides the same benefits as Medi-Cal, plus more. In this section, you can learn about the health benefits, pharmacy services and value added services California Health & Wellness offers.
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Providers will submit appeals of PA adjudication results, clearly identified as appeals, via fax (800-869-4325), the Medi-Cal Rx provider web portal, or they can be mailed to: Medi-Cal CSC, Provider Claims Appeals Unit P.O. Box 610 Rancho Cordova, CA, 95741-0610.
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Toll Free: 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the Member Services number: 1-877-658-0305).
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As a California health plan option, California Health & Wellness can help you find a provider, find local resources, plan an appointment and find transportation. Call Member Services at 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the 1-877-658-0305 number).
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The form a provider uses to request authorization is called a Prior Authorization ​(PA).
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