Service and Quality Requirements
Provider Type
- Physicians (does not apply to Cal MediConnect)
- Participating Physician Groups (PPG)
(does not apply to HSP)
- Hospitals
- Ancillary
Counties Covered
- Fresno
- Kern
- Kings
- Los Angeles
- Madera
- Sacramento
- San Diego
- San Joaquin
- Stanislaus
- Tulare
This section includes information on requirements for adding or removing a participating provider.
Select any subject below:
- Access to Care and Availability Standards
- Open Clinical Dialogue
- Claims Denials
- Claims Payment Requirements
- Authorization and Referral Timelines
- Continued Access to Non-Participating Providers for SPD Members
- Eligibility and Data Entry Requirements
- Quality Improvement Problem Resolution
- Seniors and Persons with Disabilities Training Available