Specialty Care
Contra Costa Health Plan (CCHP) covers a wide range of specialized care for its members through its network of providers.
- Your primary care provider (PCP) will make referrals and coordinate with most specialists.
- Some specialty-care requires pre-approval from CCHP before you can see a specialist.
- In other cases, you can simply self-refer without needing a referral or pre-approval.
- If you have questions, call CCHP Member Services at 877-661-6230 (TTY 711) Monday - Friday 8 a.m. to 5 p.m.
Continuity of Care
If you had previously been seeing a provider that is not in CCHP's network, and you want to continue to see that provider, ask CCHP for "Continuity of Care." Just call Member Services. CCHP will review your case and let you if you are approved to continue to see your previous provider for a certain amount of time (up to 12 months), and have it covered by CCHP.
Pre-Approval (Prior Authorization)
In order to get certain services, pre-approval or prior authorization from CCHP may be required. Your doctor will submit the request to CCHP. Both you and your doctor will get a written notice about CCHP’s decision on whether the request was approved.
If CCHP denies or modifies the requested service, you can appeal CCHP’s decision.
Either file your appeal online, by calling Member Services, or by sending us a letter or fax within the timeframe on the written notice. If you want a copy of the criteria or guidelines that the health plan used to make its decision, contact Member Services. Fill out and submit the member form for criteria and guidelines or call Member Services.
Self-Referrals
There are certain specialty services where you do not need a referral from your primary care provider nor pre-approval from CCHP. You can self-refer or look for and go to certain specialists on your own. Some services that you can self-refer to are listed below.
Contact Us
CCHP Member Services
Monday – Friday, 8 a.m. – 5 p.m.
1-877-661-6230 (Option 2)
(TTY 711 for hearing or speech impaired)