Community Health Plan of Imperial Valley Provider Services Department
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As a prepaid health care delivery system, Community Health Plan of Imperial Valley has some unique characteristics that make timely response and accurate information necessary. If prompt and accurate information is not provided, a member may misuse the program, resulting in medical services not being covered. To avoid this, Community Health Plan of Imperial Valley directs inquiries from providers to Community Health Plan of Imperial Valley 's Medi-Cal Provider Services Department or to CHPIV's Provider Engagement Network Specialists, where available. Members are directed to the Medi-Cal Member Services Department.
Community Health Plan of Imperial Valley s Medi-Cal Provider Services Department Customer Service Advocates are available 24 hours a day, 7 days a week, to assist providers with:
- Member eligibility, effective dates, and eligibility research
- Primary care physician (PCP) selection and transfer requests for members
- Questions about the CHPIV Medi-Cal Recommended Drug List (RDL)
- Benefit information
- Professional and hospital billing
- Claims
- Questions regarding claims status
- Exceptions and administrative decisions
- Complaints and grievances regarding provider care, delivery of care or participating physician group (PPG) staff
- Requests for removal/ PCP/PPG reassignment for non-compliant members
The Community Health Plan of Imperial Valley Medi-Cal Provider Services Department toll-free telephone number is printed on the back of the member's identification card. The servicing provider is responsible for confirming the member(s) eligibility at the time of service.
Community Health Plan of Imperial Valley Provider Services Department Phone Number: 833-236-4141
Fax: 844-837-5947 or 800-281-2999
Eligibility and claims status available online.
Provider’s may use the Medi-Cal Claims Inquiry email box for claim status only if the provider portal is down or not working. This box is only for claim status and denial inquiries.