23-1341 Find an Updated Prison Health Care Provider Network Operations Manual Online
Date: 11/22/23
Providing one complete source for your service needs
You can easily access relevant and current information on the provider website. We recently finished a complete review of the Prison Health Care Provider Network Provider Operations Manual and updated documents, as appropriate. Refer to the table below for a list of updated documents.
Section | Document |
|---|---|
California Correctional Health Care Services Formulary | California Correctional Health Care Services Formulary |
Claims and Provider Reimbursement | CMS-1500/CMS-1450 Billing Instructions |
CorrectCare Integrated Health | |
Electronic Claims Submission | |
Oral And Maxillofacial Surgeons Claim Form | |
Paper Claims Submission | |
Compliance and Regulations | Notification |
| Credentialing | California Correctional Health Care Services Onsite Credentialing Requirements |
Dispute Resolution and Appeals | Appeal Submission |
Dispute Submission | |
Safety and Security Procedures | Mail and Phone Procedures |
Closure of California’s Youth Prisons
As of June 30, 2023, all Divisions of Juvenile Justice (DJJ) are closed. Juvenile offenders are no longer committed to the DJJ as of this date. In September 2020, the California State Legislature passed Senate Bill 823, which required the DJJ to close by June 30, 2023, and to transfer juveniles back to their "home" counties.
Effective July 1, 2023, claims for health care services rendered to the DJJ youth should be directed to the county where the patient is located. Claims for services rendered on or prior to June 30, 2023, will continue to be the responsibility of California Department of Corrections and Rehabilitation (CDCR).
Go to provider library and select Prison Health Care Provider Network > Provider Manual to access the Provider Operations Manual.
Additional information
If you have questions regarding the information contained in this update, contact the PHCPN Provider Services Center by email or by telephone at 877 899 0561.
This information applies to Physicians, Hospitals, and Ancillary providers.