Provider Directory

Font Size: + -

Print

The provider directory gives members, potential members and providers access to the two networks that serve the Contra Costa Health Plan:

Regional Medical Center (RMC)
Community Provider Network (CPN)

Both networks consist of physicians, pharmacies, hospitals and ancillary service providers. Search the directory to find a provider that meets your needs.

Begin Your Search

About the Provider Networks

Regional Medical Center Network

The RMC network spans nine health centers located throughout the county and Contra Costa Regional Medical Center hospital in Martinez. This network contains both primary and specialty care providers to choose from.

Members who are enrolled in County Employee Plan A, Plan A2, or IHSS Plan A2, must choose providers from this network.

If the specialty needed is not available within the network, we may arrange for whatever referrals, authorizations, and treatments are necessary with a specialist that is available in a non-assigned network.

Community Provider Network

The CPN network consists of community-based private providers of primary and specialty care. CPN providers include Lifelong Medical Care, and most hospitals in Contra Costa and the immediate surrounding area. This directory is for informational use only. Members who are enrolled in our Medi-Cal plan or County Employee Plan B can choose providers from the CPN or RMC network.

There may be times when a specialty is not accessible within the network of the member’s assigned primary care provider (PCP) for various reasons. When this happens, CCHP and the assigned PCP may arrange for referrals, authorizations, and treatments necessary with a specialist that is available in a non-assigned network.

Services that are currently not available or without sufficient capacity within the RMC network include mental/behavioral health, optometry, home health, SNF, and hospice services. Therefore, all members may also use the CPN provider network for these particular services.

If you are a member and would like to choose one of our PCPs, please contact Member Services at 1-877-661-6230 - option 2. Potential members may contact Marketing at 1-877-661-6230 - option 6.

Helpful Links

Directory Updates

The information in your search results reflects our records at the time of our last update to the search website, is updated at least weekly when CCHP is notified and has confirmed:

provider is no longer accepting new patients or an individual provider within a group is no longer accepting new patients.
provider is no longer under contract for a particular plan product.
practice location or other required information under subdivision (h) or (i) has changed.
change is necessary after completion of Plan’s investigation based on a complaint that a provider was not accepting new patients, was otherwise not available, or whose electronic directory contact information was listed incorrectly.
Change in any other information that affects the content or accuracy of the provider directory.

CCHP deletes provider from the directory or directories upon confirmation that the provider has;

retired or otherwise ceased to practice

or

provider or provider group is no longer under contract with the plan for any reason

or

a contracting provider group has informed the Plan that a plan is no longer associated with the provider group and is no longer under contract with the Plan.

To report incorrect provider information, members can contact member services by calling:

1-877-661-6230 option 2 or by email: member.services@cchealth.org

Providers or the general public can contact Provider Relations at:

providerrelations@cchealth.org or by calling 1-877-800-7423 option 6.

We update provider and facility information within thirty (30) business days after we are notified of a change.

Access for People with Disabilities

Members are entitled to receive full and equal access to covered services, including members with disabilities as required under the Americans with Disabilities Act of 1990 and in section 504 of the Rehabilitation Act of 1973.

Validations and Limitations

Definitions

Accepting New Patients

This provider accepts both new and existing patients. We collect this information when providers join the network and is reviewed quarterly at the time of the provider network update. If the provider no longer accepts new patients, the provider is required to notify CCHP within five (5) business days. We are dependent on the accuracy and timeliness of changes to the information being reported to CCHP by the providers.

Board Certification

Information on board certification is verified at the time of credentialing and re-verified at least every three years at the time of re-credentialing. The most current board certification status can be verified at The American Board of Medical Specialties website. Board certifications for most Doctors of Osteopathic Medicine (D.O.) can be viewed free at osteopathic.org

CalAIM

Enhanced Care Management (ECM) and Community Supports (CS) require prior authorization and are limited to members who meet specific eligibility criteria.

Hospital Affiliation

This information is collected from the provider at the time they initially join the network and verified upon initial and recredentialing, quarterly through the Network Update link, and reviewed on an annual basis. PCP's are not required to have hospital privileges. All of CCHP contracted hospitals utilize hospitalists to admit and provide services to inpatient members.

Languages Spoken

These abilities are self-reported by the providers in the CPN network when the provider joins the network and at the time of recredentialing. CCHP does not verify these skills. Providers in the CCRMC network are certified in languages spoken in addition to English. Language interpreter services are available 24 hours a day, 7 days a week at no cost to the member. CCHP discourages the use of family members, friends or minors to interpret or translate materials. Members have the choice to refuse professional interpreters and use adult family members or friends. Providers must document this choice in the member's medical record. For further assistance, members can contact Member Services at 1-877-661-6230 option 2 and providers can access interpreter services at 1-877-800-7423 option 4 or directly at 1-866-874-3972.

Medical Group

This information is collected from the group at the time they initially join the network. On a quarterly basis, CCHP emails a Network Update link for the group to report any changes to the information CCHP has on file.

Specialty

A provider's specialty is identified when they join the health plan network. Specialty is verified when the practitioner joins the network and at the time of recredentialing through state licensing and board certification. In addition, on a quarterly basis, CCHP emails a Network Update link to each provider to report any changes to the information CCHP has on file.

Facility

CCHP updates facility information daily as changes are reported by the facility. In addition, on a quarterly basis, CCHP emails a Network Update link to each facility to report any changes to the information CCHP has on file.

Pharmacy

CCHP Commercial members can refer to the online search engine for pharmacies but also can access all Walgreens and Rite Aid locations. CCHP Medi-Cal members should contact the DHCS Medi-Cal Rx Help Line for any pharmacy questions (1-800-977-2273, TTY 1-800-430-7077). Medi-Cal members can also go to the Medi-Cal Rx webpage to find Medi-Cal Rx participating pharmacies.

Quality Data

Hospital quality data is available through the Joint Commission website, through the link to Quality Check. By entering a hospital name, the accreditation status and quality measures are listed. Information regarding quality is obtained by the Joint Commission at the time of survey, as new information becomes available and at resurvey.

Accreditation

This information is collected at the time the facility initially joins the network and then every three years thereafter. Verification is obtained either by contacting the accrediting agency directly or by obtaining a copy of the approval letter or report provided by the facility. Facilities may also notify us at any time regarding changes to their accreditation status. To verify the current status of a hospital visit jointcommission.org

Timely Access to Care

The California Department of Managed Health Care (DMHC) has regulations set forth in Title 28, Section 1300.67.2.2 for health plans to provide timely access to care for our members.

Timely access standards include:

Urgent care appointments not requiring prior authorization: within 48 hours of request
Urgent care appointments requiring prior authorization: within 96 hours of request
Non-urgent appointments for primary care: within 10 business days of request
Non-urgent appointments with specialists: within 15 business days of request
Non-urgent appointments for ancillary services for the diagnosis or treatment of injury, illness or other health conditions: within 15 business days of request
Emergency Care: Immediate
First Prenatal Visit: within 14 calendar days of request
Mental Health – Routine Non-Urgent: within 10 business days of request
Mental Health – Routine Non-Urgent Follow-Up: within 10 business days of request
Mental Health – Urgent: within 48 hours of request
Mental Health – Emergency: immediate
Follow-up on missed appointments: Providers are expected to review all members that do not show up for scheduled appointments and to identify those requiring follow-up, based on their medical condition.
Telephone wait time for practice/plan to answer: within 10 minutes
Telephone call back wait time – practice/provider office: by the end of the next business day
Telephone call back wait time – triage: within 30 minutes
Waiting time in provider office: within 45 minutes or less from the time of the patient’s appointment until they are taken to the exam room.
Skilled Nursing Facility/Intermediate Care Facilities: within 5 business days of request

Exceptions may apply to the timely access standards if the DMHC has found exceptions to be permissible. Interpreter services are available at all CCHP points of contact where members may reasonably need such services.

If you have a timely access concern, you can contact CCHP's Utilization Management at 1-877-661-6230 option 4 or file a complaint with the California Department of Managed Health Care by calling the DMHC Toll-free provider complaint line at: 1-877-525-1295.

Availability of Hard Copy Directories

Members may request printed directories or have web pages printed and mailed to them by visiting the link at the top of the page. Documents will be mailed within five (5) business days of receiving request. To report any errors, visit the link at the top of the page.