Welcome to Contra Costa Health Plan's Provider and Pharmacy Search Engine
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Contra Costa Health Plan has been serving the health care needs of Contra Costa County for over 40 years. We are proud to bring you this easy to use search engine. This search engine gives members, potential members and providers' access to our network of physicians, pharmacies, hospitals and ancillary providers.
Here you can search for providers that participate with Contra Costa Health Plan's two networks consisting of over 5000 primary care providers and specialists. If you are a member or potential member it is important for you to understand how our two networks are organized.
CCHP has 2 Provider Networks to choose from.
Our Regional Medical Center Network (RMC) has 10 Health Centers conveniently located throughout the county and the Regional Medical Center in Martinez. This network contains both primary and specialty care providers to choose from. Members who are enrolled in County Employee Plan A, Plan A2T, Plan A2P, IHSS Plan and Senior Health Basic Plan must chose providers from this network only.
Our Community Provider Network (CPN) is a network of community based private providers of primary and specialty care. Most hospitals in Contra Costa County and the immediate surrounding area are participants. Members who are enrolled in our Medi-Cal Plan, County Employee Plan B, and Senior Health Plus Plan can chose providers from this network or from the Regional Medical Center Network.
Medi-Cal members who have had Kaiser Permanente within the past twelve months may be assigned to our Kaiser network. To reach the Kaiser Network's 24 hour Call Center for CCHP's Medi-Cal members call: 1-800-464-4000. To access the Kaiser online directory, go to https://healthy.kaiserpermanente.org.
This search engine is for informational use only. If you are a member and would like to choose one of our Primary Care Providers, please contact our Member Services department at 1-877-661-6230 option 2.
Members seeking specialty care may be required to obtain referral or authorization. Look for the symbol if a referral or authorization is required for a specialty.
Members are entitled to receive full and equal access to covered service including members with disabilities as required under the American with Disabilities Act of 1990 in section 504 of the Rehabilitation Act of 1973.
Potential members may contact our Marketing Department at 1-877-661-6230 option 6. They will be able to assist you in making the best health plan choice for you.
The information in your search results reflects our records at the time of our last update to the search website, which is updated nightly. To report incorrect provider information, members can contact member services by calling 1-877-661-6230 option 2 or by email: email@example.com and Providers or the general public can contact Provider Relations at firstname.lastname@example.org or by calling 1-877-800-7423 option 6.
Validations and Limitations
The information reported on this Web site is based on the information provided to CCHP from the participating provider and/or verified by licensing and accrediting entities. This information is subject to change without notice.
In an effort to provide CCHP members and providers with useful information to make decisions, CCHP updates provider and facility information daily as changes are reported. In addition, on a quarterly basis, CCHP faxes a Network Update form to each provider, provider group or facility to report any changes to the information CCHP has on file. Hospital information is verified by viewing the information listed on their website.
Accepting New Patients: This provider accepts both new and existing patients. We collect this information when providers join the network and is reviewed quarterly at the time of the provider network update survey. If the provider no longer accepts new patients, the provider is required to notify CCHP within five (5) business days. We are dependent on the accuracy and timeliness of changes to the information being reported to CCHP by the providers.
Accreditation: This information is collected at the time the facility initially joins the network and then every three years thereafter. Verification is obtained either by contacting the accrediting agency directly or by obtaining a copy of the approval letter or report provided by the facility. Facilities may also notify us at any time regarding changes to their accreditation status. To verify the current status of a hospital visit www.jointcommission.org
Quality Data: Hospital quality data is available through the Joint Commission website located at www.jointcommission.org, through the link to Quality Check. By entering a hospital name, the accreditation status and quality measures are listed. Information regarding quality is obtained by the Joint Commission at the time of survey, as new information becomes available and at resurvey.
Board Certification: Information on board certification is verified at the time of credentialing and re-verified at least every three years at the time of re-credentialing. The most current board certification status can be verified at The American Board of Medical Specialties website at www.certificationmatters.org. Board certifications for most Doctors of Osteopathic Medicine (D.O.) can be viewed free at www.osteopathic.org
Facility: CCHP updates facility information daily as changes are reported by the facility. In addition, on a quarterly basis, CCHP faxes a Network Update form to each facility to report any changes to the information CCHP has on file.
Hospital Affiliation: This information is collected from the provider at the time they initially join the network and verified upon initial and recredentialing and reviewed on an annual basis. PCP's are not required to have hospital privileges. All of CCHP contracted hospitals utilize hospitalists to admit and provide services to inpatient members.
Languages Spoken: These abilities are self-reported by the provider when the provider joins the network and at the time of recredentialing. CCHP does not verify these skills. Language interpreter services are available 24 hours a day, 7 days a week at no cost to the member. CCHP discourages the use of family members, friends or minors to interpret or translate materials. Members have the choice to refuse professional interpreters and use adult family members or friends. Providers must document this choice in the member's medical record. For further assistance, members can contact Member Services at 1-877-661-6230 option 2 and providers can access interpreter services at 1-877-800-7423 option 4.
Medical group: This information is collected from the group at the time they initially join the network. On a quarterly basis, CCHP faxes a Network Update form for the group to report any changes to the information CCHP has on file.
Specialty: A provider's specialty is identified when they join the health plan network. Specialty is verified when the practitioner joins the network and at the time of recredentialing through state licensing and board certification. In addition, on a quarterly basis, CCHP faxes a Network Update form to each provider to report any changes to the information CCHP has on file.
Timely Access to Care: The California Department of Managed Health Care (DMHC) has regulations set forth in Title 28, Section 1300.67.2.2 for health plans to provide timely access to care for our members.
Timely access standards include:
- Urgent care appointments not requiring prior authorization: within 48 hours
- Urgent care appointments requiring prior authorization: within 96 hours
- Non-urgent appointments for primary care: within 10 business days
- Non-urgent appointments with specialists: within 15 business days
- Non-urgent appointments with a non-physician mental health care provider: within 10 business days
- Non-urgent appointments for ancillary services for the diagnosis or treatment of injury, illness or other health conditions: within 15 business days
- Telephone triage waiting time not to exceed 30 minutes
Exceptions may apply to the timely access standards if the DMHC has found exceptions to be permissible. Interpreter services are available at all CCHP points of contact where members may reasonably need such services.
If you have a timely access concern, you can contact CCHP's Utilization Management at 1-877-661-6230 option 4 or file a complaint with the California Department of Managed Health Care by calling the DMHC Toll-free provider complaint line at: 1-877-525-1295.
Availability of Hard Copy Directories: Members may request printed directories or have web pages printed and mailed to them by calling Member Services at 1-877-661-6230 option 2 or emailing email@example.com or by mail: Contra Costa Health Plan Attn: Member Services, 595 Center Ave., Suite 100, Martinez, CA 94553. Documents will be mailed within five (5) business days of receiving request.
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