Why Join
When you join the Alliance, you join a network of providers committed to providing accessible, quality health care guided by local innovation. Together, we work to achieve our vision of Healthy People, Healthy Communities.
As the Medi-Cal managed care health plan for Santa Cruz, Monterey and Merced counties, we partner with more than 11,600 providers. Over 85 percent of primary care providers and 84 percent of specialists within our service areas are contracted to provide services to our members.
We’re proud to support providers with a wealth of care management resources to deliver the highest quality of services to Alliance members. Alliance providers can also receive Care-Based Incentives and Value Based Payments for optimizing member care.
Ready to get started? Find out more about us and how to join the Alliance today. You can also reach out to Provider Services at 831-430-5540.
Care-Based Incentives
The Alliance offers Care-Based Incentives (CBIs) for providers to improve member experience and reduce disparities. The CBI program defines a set of measures encouraging preventive health services and member connection with primary care providers (PCPs).
CBIs include financial incentives and technical assistance for PCPs. Incentives encourage providers to support members in self-managing their care and reducing proximal health care costs in the following areas:
- Care Coordination.
- Quality of Care.
- Performance Targets.
- Exploratory.
- Practice Management.
Incentives are distributed on the Programmatic and Fee-For-Service (FFS) levels. To learn more, visit our Care-Based Incentives page for providers.
Value Based Payment
The Value Based Payment (VBP) program allocates increased payment for improving care in certain high-cost or high-need populations. These populations include members diagnosed with substance use disorder, serious mental illness or homeless or inadequate housing.
VBPs encourage providers to improve data quality and standards of practice in four key areas:
- Prenatal/postpartum care.
- Early childhood preventive care.
- Chronic disease management.
- Behavioral health integration.
Value Based Payments are funded by the California Department of Health Care Services (DHCS).
Contact Provider Services
General | 831-430-5504 |
Claims Billing questions, claims status, general claims information |
831-430-5503 |
Authorizations General authorization information or questions |
831-430-5506 |
Authorization Status Checking the status of submitted authorizations |
831-430-5511 |
Pharmacy Authorizations, general pharmacy information or questions |
831-430-5507 |