CalViva Health Medi-Cal Member Services Department
To ensure appropriate coverage of medical services for Medi-Cal members, CalViva Health requires the provision of timely responses and accurate information. If prompt and accurate information is not provided, a member may misuse the program, resulting in medical services not being covered. To avoid these problems, CalViva Health directs inquiries from members to CalViva Health's Medi-Cal Member Services Department. Inquiries from providers are directed to the CalViva Health regional provider network administrator where one is available.
The CalViva Health Medi-Cal Member Services Department ensures that translation services are available for members when they call. In addition, the CalViva Health Member Handbook and other member-informing materials are translated into the required threshold languages.
CalViva Health's Medi-Cal Member Services Department handles telephone calls and correspondence from members. Problems are forwarded to CalViva Health management. This department is responsible for:
- Medi-Cal questions and explanations.
- Information about access to and delivery of care.
- Professional and hospital services, bills and claims.
- Member problems and inquiries.
- Address changes.
- Identification card requests.
- Primary care physician (PCP) selection and transfer requests.
- Handling complaints about CalViva Health programs or staff.
The CalViva Health Medi-Cal Member Services Department's 24-hour toll-free number is printed on the back of the member's identification card. While telephone assistance is the PCP's responsibility, the CalViva Health Medi-Cal Member Services Department can assist members in reaching their PCP when needed. CalViva Health's Medi-Cal Member Services representatives can provide the telephone number for the member's PCP, or the call can be routed to the CalViva Health Advice Nurse Telephone Triage program.
Customer Contact Center
Po Box 10413
Van Nuys, CA 91499-6207
Fax: (818) 676-5161 or 1-800-281-2999