Forms Library

Welcome to the Forms Library. Contained below are links to most forms used by CenCal Health. Some forms may require providers to log in to the restricted section of the website to access. If you’re unable to find what you were looking for, please contact Provider Services at (805) 562-1676 or via email.

Authorizations

Behavioral Health

To learn more about Behavioral Health click here

Pharmacy

Pharmacy Forms and downloads

Radiology

To learn more about Radiology click here

Contracting/Credentialing

For more information about joining our network click here

Claims

For claims forms click here

Health Education

For health materials click here

Member

Member Rights and Responsibilities – English

Member Rights and Responsibilities – Spanish

Member Grievance Form SBHI & SLOHI – English

Member Grievance Form SBHI & SLOHI – Spanish

Member Grievance Form HF,HK,PP2,IHSS – English

Member Grievance Form HF,HK,PP2,IHSS – Spanish

Resources for disabled and Special Needs

Community Resources

California Minor Consent Laws

Cultural & Linguistic

For more information click here

Fraud and Abuse Reporting

Fraud and Abuse Reporting for more info click here

Fraud by a Provider

Fraud by a Member (English)

Fraud by a Member (Spanish)

Cultural Competency, Health Literacy & Seniors and Persons with Disabilities

CenCal Health strives to provide Cultural Competency and Health Literacy tools to our providers to improve provider-patient communication. These tools provide appropriate health care and services for our members regardless of race, color, national origin, creed, ancestry, religion, language, age, marital status, sex, sexual orientation, gender identity, health status, physical or mental disability, or identification with any other persons or groups.

Click here to learn more!

Community Support

Community Supports-Medically Tailored Meals Information and Referral form

Recuperative Care Information and Referral Form

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