Partnership

Claim Address:

PO BOX 1368

SUISUN CITY California 94585

General Knowledge

• Partnership allows one year from the date of service to submit the claim
• 1 year for an appeal/provider dispute from the denial date.
• Old Evaluation and Management codes such as 99245, 99244, 99243
• No Modifier 51 should be applied to 93000
• A referring provider is required on the CMS 1500
• The CIF appeals dispute can be accessed on the portal, and the most efficient and convenient method is to submit it through the portal.
• Retroactive prior authorization, also known as RAF, can be RETRO.

Authorization

If a patient is qualified under CCS Eligibility or American Indian - or a DIRECT MEMBER. Patient does NOT REQUIRE A RAF

Partnership - Fetal patients

RAF IS REQUIRED unless the patient is a DIRECT MEMBER

RAF is required for the evaluation and management (E/M) codes 99245/99215.

RAF is not necessary for performing fetal echocardiograms of codes 76825, 96827, and 99325.

Direct Member

Does not require a RAF

Partnership/CCS

PARTNERSHIP/CCS

Partnership is currently undergoing significant changes. With the addition of new counties, please ensure that the claims are sent directly to CCS corresponding to the specific county. For the old counties, please send the claims to Partnership.

Please refer to the the table below

Department Contact Information

Articles

Please click below for more information

Online Services User GuideEligibility Modules

Online Services User GuideClaims Modules

Online Services AuthorizationModules User Guide

Last updated on: 08/03/2024