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Quality reporting

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Quality of care

Medi-Cal and every health plan must offer quality (good) health care to help you stay healthy. The reports below tell you how we’re doing. You can view each report by selecting the link.

  • Accreditation Status of Health Plans Report
  • Periodic Audit Results
    DHCS performs periodic audits regarding the accuracy, truthfulness, and completeness of the encounter and financial data submitted by each managed care plan. The results of these audits will be posted upon completion.
  • Program Integrity Report - Coming soon
  • Provider Network Certification
    Beginning in State Fiscal Year 2018 and annually thereafter, DHCS will conduct network certifications for each Medi-Cal managed care health plan (MCP). DHCS will certify that each MCP has adequate capacity to serve the expected enrollment in its service area in accordance with Federal and state regulations. The network certification for each MCP will be posted annually upon completion.

Medi-Cal contracts with medical, specialty and dental plans

Medi-Cal works with many different plans. You can view a sample contract that we have with those plans by selecting the link below.

Each health plan has a member handbook. It gives you more details about your health plan benefits and services. You can view a sample member handbook by selecting the link below.

Each health plan uses the sample above to make their own member handbook. It includes the benefits and services that the health plan offers. Your benefits and services will depend on the health plan you choose. The sample above is just an example. It is not the exact benefits and services you will get.

You can find contact information for each health plan below.

Medical plan contact information

  • Alameda Alliance for Health
    • Phone: 1-510-747-4567 (TTY 1-800-735-2929)
       
  • Anthem Blue Cross Partnership Plan
    • Phone: 1-800-407-4627 (TTY 1-888-757-6034 or 711)
       
  • Aetna Better Health of CA
    • Phone: 1-855-772-9076 (TTY 711)
       
  • Blue Shield of California Promise Health Plan
    • Phone: 1-800-605-2556 (TTY 1-800-735-2929)
       
  • California Health & Wellness
    • Phone: 1-877-658-0305 (TTY 1-866-274-6083)
       
  • CalViva Health
    • Phone: 1-888-893-1569 (TTY 1-800-431-0964)
       
  • Community Health Group Partnership Plan
    • Phone: 1-800-224-7766 (TTY 1-800-735-2929)
       
  • Contra Costa Health Plan
    • Phone: 1-877-661-6230 (TTY 1-800-735-2929)
       
  • Health Net Community Solutions, Inc.
    • Phone: 1-800-675-6110 (TTY 1-800-735-2929)
       
  • Health Plan of San Joaquin
    • Phone: 1-888-936-7526 or 1-209-942-6320 (TTY 1-209-942-6306)
       
  • Inland Empire Health Plan
    • Phone: 1-800-440-4347 (TTY 1-909-890-0731 or 1-800-718-4347)
       
  • Kaiser Permanente California, LLC
    • Phone: 1-800-464-4000 (TTY 888-464-4000 or 711)
       
  • Kern Family Health Care
    • Phone: 1-800-391-2000 (TTY 1-800-735-2929)
       
  • L.A. Care Health Plan
    • Phone: 1-888-839-9909 (TTY 711)
       
  • Molina Healthcare of California Partner Plan, Inc.
    • Phone: 1-888-665-4621 (TTY 711)
       
  • San Francisco Health Plan
    • Phone: 1-800-288-5555 (TTY 1-415-547-7830 or 1-888-833-7347)
       
  • Santa Clara Family Health Plan
    • Phone: 1-800-260-2055 or 1-877-688-7234 (TTY 1-800-567-7759)
       
  • UnitedHealthcare Plan
    • Phone: 1-866-270-5785 (TTY 711)

County Organized Health System (COHS) plans

COHS serves about 1.9 million beneficiaries through 6 medical plans in 22 counties: Del Norte, Humboldt, Lake, Lassen, Marin, Mendocino, Merced, Modoc, Monterey, Napa, Orange, San Luis Obispo, San Mateo, Santa Barbara, Santa Cruz, Shasta, Siskiyou, Solano, Sonoma, Trinity, Ventura and Yolo.

How it Works: In the COHS Model counties, DHCS contracts with a medical plan created by the County Board of Supervisors. Local government, health care providers, community groups, and Medi-Cal beneficiaries are able to give input as the plan is created. The medical plan is run by the county. In a COHS county, everyone is in the same managed care plan.

  • CalOptima
    • Phone: 1-888-587-8088
       
  • CenCal Health
    • Phone: 1-877-814-1861
       
  • Central California Alliance for Health
    • Phone: 1-800-700-3874 ext. 5505  
       
  • Gold Coast Health Plan
    • Phone: 1-888-301-1228
       
  • Health Plan of San Mateo
    • Phone: 1-650-616-0050 or 1-800-750-4776 
       
  • Partnership Health Plan of California
    • Phone: 1-800-863-4155

Specialty plan contact information

  • Family Mosaic Project
    • Phone: 1-415-206-7600 
       
  • PHC California, HIV/AIDS Specialty Managed Care Plan
    • Phone: 1-800-263-0067  

Dental plan contact information

  • Access Dental Plan
    • Los Angeles County phone: 1-877-821-3234 or 866 682 9904 (TTY 1-800-735-2929)
    • Sacramento County phone: 1-866-682-9904 or 1-877-821-3234  (TTY 1-800-735-2929)
  • Health Net
    • Los Angeles County phone: 1-800-977-7307 (TTY 1-800-735-2922)
    • Sacramento County phone: 1-866-871-0396 (TTY 1-800-735-2922)
       
  • Liberty Dental Plan
    • Los Angeles County phone: 1-888 703-6999 (TTY 1-800-430-7077)
    • Sacramento County phone:1-888-703-6999 or 1-877-550-3875 (TTY 1-800-430-7077)