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Member Handbook (EOC)

Select your health plan to view the Member Handbook (EOC)

Medi-Cal

Public program for low income people

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CommuniCare Advantage

Medicare and Medi-Cal benefits

Select plan

Community y Más

Medicare plan for chronic care needs

Select plan

Referral Request

Resources for Providers

Referral Request Resources

Online Forms

CCS Service Authorization Request(SAR) Form
View
Referral and Service Request Form
View
ABA Referral Form
View
Non-Specialty Mental Health (NSMHS) Treatment Authorization Form
View
Medi-Cal Managed Care Plan (MCP) Intermediate Care Facility/Home for the Developmentally Disabled (ICF/DD) Authorization Request
View
Complete List of Services Requiring Authorization and a Complete List of Services Not Requiring Authorization
View
PCS/NEMT Form
View

How to submit PCS/NEMT form

During normal business hours 8:00am - 5:00pm, please fax completed PCS/NEMT form to: 1-800-870-8781

During after-hours/weekend/holidays, please fax completed PCS/NEMT form to: 619-382-1210

For hospital discharge, please fill out PCS/NEMT form first before calling and fax to: 619-382-1210  

Provider Services Specialists

We're glad to help you!

1-619-240-8933

or

ooaprov@chgsd.com