We are expanding our strong and growing provider network to serve our members even better. We seek well-qualified and inspired healthcare providers to join us. Here's why you should join the CHA network.
Help Inspire Real Change
We believe in supporting high-quality care for our members.
As a Cascade Health Alliance (CHA) provider, you'll play a major role in shifting systematic change from a reactive health care approach, to a proactive health care approach. Together, we work to empower sense of self for the people in Klamath Falls. When joining our network, you will be part of a large group of providers who share your passion for community well-being.
Gain Valuable Experience
Working in the CHA network gives you the chance to practice preventive medicine in a tightknit community.
Practice Medicine in a Beautiful Setting
Improving the health of our members is the best reason to join the CHA network. In addition, you get to work and live in beautiful Klamath County. Our area is a paradise for outdoor adventurers. Activities we enjoy include:
- Fly-fishing in pristine trout streams
- Kayaking in nearby rivers and lakes
- Miles of hiking trails
- Exploring world-famous Crater Lake National Park
Join the CHA Provider Network
Are you interested in becoming one of our contracted providers? We would like to hear from you. If you are a licensed or certified healthcare provider, let us know more about you and your specialty.
To get started, please do the following:
Submit a new provider form. If you have questions about the new provider form, please contact .
Submit New Provider form
Contact our credentialing specialist. Please reach out to .
Learn About Our Selection Process
We take great pride in giving our members access to exceptional medical care. That is why we assess and verify the credentials of all licensed or certified healthcare providers under contract with CHA.
We have a dedicated committee responsible for all credentialing policies and decisions. They exercise reasonable care in selecting, reviewing and periodically evaluating the physicians and other licensed practitioners in our network.
How do physicians become part of the CHOC Health Alliance? Please contact our Provider Services Department. CHOC Health Alliance
Attn: Provider Relations
1120 W. La Veta Ave, #450
Orange, CA 92868
(800) 387-1103 Or
contact us.
Where do providers send a claim?
For electronic claims submissions, the approved claims clearinghouses are: Office Ally, Emdeon, RelayHealth.
Paper claims and resubmissions (marked as resubmissions on the envelope), please mail to:
Rady Children’s Hospital San Diego
Attn: CHOC/CPN
Claims
3020 Children’s Way, Mail Code 5144
San Diego, CA 92123
Who do providers call with questions about a claim payment or claim status
Providers should contact the Claim Research/Claim Inquiry Unit in our Claims Department at (800) 387-1103. Select option #1.
How do providers order a current Provider Manual, Directory and/or Preferred Drug List?
Providers may call the Provider Services Department at (800) 387-1103, or contact their assigned provider representative. A copy of the preferred drug list is included on this website.
How do I find out who my provider representative is?
CHOC Health Alliance assigns every network a dedicated provider representative. Provider representatives are in regular contact with providers and/or office staff. Providers may confirm the name and phone number of their provider representative by calling the Provider Relations Department at (800) 387-1103.
How do providers obtain authorizations from CHOC Health Alliance?
Providers may contact the Prior Authorization Unit seven days per week, 24 hours a day by calling (800) 387-1103. Providers may also fax requests for authorizations to CHOC Health Alliance at 1-855-867-0868.
How do providers verify enrollment of a patient?
Proactively, Providers can check three systems for eligibility:
CalOptima Website;
CHOC Health Alliance Website;
The California State System (this site’s data is usually 30-45 days behind)
CHOC Health Alliance Member Services Department, toll free at (800) 424-2462 is also available to verify enrollment.
What services are covered by CHOC Health Alliance?
Please refer to the Benefit Summary page on this website for a brief description of covered benefits. For a more complete description of benefits, please refer to the Member Handbook also included on this website.
How can CalOptima members join CHOC Health Alliance?
Members may go directly to the CalOptima office or call CalOptima’s Customer Service Department and request a Health Network Selection form. CHOC Health Alliance’s Customer Service Department can help members complete this form if assistance is necessary.
CalOptima
505 City Parkway
West Orange, CA 92868
(714) 246-8500 or (888) 587-8088
What are carve-out services?
Carve-out services are services for which CHOC Health Alliance is not financially responsible. Carve-outs and the respective responsible organizations are listed below.
Vision Services Vision Services Plan (VSP)
(800) 877-7195
Dental Care DentiCal
(800) 766-7775
CalOptima Mental Health Services
(855) 877-3885
Pediatric Preventive Visits
(Use form PM-160) CHDP
CalOptima
PPS/CHDP Claims
P.O. Box 11037
Orange, CA 92856
What is California Children Services (CCS)? How do providers sign up?
California Children Services (CCS) is a state program for children under 21 whose medical conditions qualify them for CCS assistance. Children that meet medical, residential and financial criteria (as defined by CCS) are eligible for diagnostic evaluations, treatment services, case management, and physical/occupational therapy services. Please contact CCS for more information.
California Children Services
PO Box 6099
Santa Ana, CA
92706
//www.dhcs.ca.gov/services/Pages/cms.aspx
What is the Child Health and Disability Prevention (CHDP) program? How do providers bill for services?
The Child Health and Disability Prevention (CHDP) program is a preventive health program serving California’s children and youth. CHDP provides periodic preventive health services to Medi-Cal beneficiaries under the regulations of the federal Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program. All California Medi-Cal recipients from birth to age 21 are eligible for health assessments. CHOC Health Alliance requires all providers rendering treatment to patients under 21 to be CHDP certified. You may contact the Provider Relations Department to obtain a schedule of training sessions in order to become certified. The phone number is (800) 387-1103.
Claims should be submitted to CalOptima:
CalOptima
PPS/CHDP Claims
P.O. Box 11037
Orange, CA 92856