CenCal Health

Select Your Plan Health Initiative Healthy Families AIM In-Home Support Healthy Kids SB Healthy Kids SLO Health Education

Para Miembros

Seleccione Su Plan Health Initiative Healthy Families AIM In-Home Support Healthy Kids SB Healthy Kids SLO HIPAA Privacy Practices & Confidentiality Reporte Fraude y Abuso

For Providers

Care Management

Care Management Program Description Care Management Referral Form Care Management Fillable Form

Claims and Billings Contracted Provider List Contracting with CenCal Health Eligibility Verification Ensuring Quality

HEDIS Report Disease Management Programs Provider Audit Process Clinical Guidelines Preventive Health Guidelines Medical Advisory Committee Members Quality Assessment & Improvement Program Combating Obesity

FAQ Formulary Health Education

Introduction Mission Statement Statutes Management Team Medical Advisory Committee Members Board Members

Board Agendas Board Meeting Schedules Board Packet Request

CenCal Health Budget Annual reports Audited Financial Statements Glossary of Terms Careers at CenCal Health

Current Job Opportunities Benefits Summary Mission & Values Apply Now!

	For Members > Approving Treatment Requests
	For Members - Approving Treatment Requests



	When You Need Prior Authorization There may be times when you need services that require prior authorization from the Health Plan. Your Primary Care Physician is responsible for knowing which services need to be authorized in advance by the plan. Services that must be authorized in advance include: Non-emergency hospitalization Care at skilled or intermediate nursing facilities Certain outpatient laboratory and diagnostic imaging procedures Certain medications Certain medical equipment like wheelchairs If you need a service or medication that requires prior authorization, your doctor will send a form called a Treatment Authorization Request (TAR) to the Health Plan (CenCal Health). The TAR will then be reviewed by our Health Services Department staff that will be in touch with your doctor to notify him or her that the request has been approved or denied. If a request is denied, you and your doctor will be notified