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Claims

The Alliance Claims Department is committed to processing your claims as quickly and accurately as possible.

We work with DHCS (Medi-Cal and Electronic Data Systems) to maintain the most current Medi-Cal benefits and allowances.

For the most current billing guidelines and updates, please reference the Claims section of the Provider Manual.

Claim Questions

Alliance providers are encouraged to use the Provider Portal for claims inquiries. If there are any additional questions, contact the Claims Department Monday – Friday, 8:30 a.m. to 4:30 p.m.

Phone:

831-430-5503
800-700-3874, ext. 5503

When calling about questions on a claim, please have the following information available:

The Alliance Claims Control Number (CCN) and/or the member’s Alliance ID number (if the inquiry is regarding a newborn claim billed under the mother’s ID number, please indicate this at the beginning of the call).
Date of service.
Dollar amount billed.
Date claim was sent to Alliance.
Provider NPI.

Where to Send Claims

Electronic Data Interchange

If you are interested in submitting electronic claims, complete the EDI Claims Enrollment Form. Contact the EDI Support Team for more information.

Note: The Alliance's SFTP server will be offline the second Saturday of every month from 2:00 to 5:00 p.m. During this time, trade partners may not be able to submit EDI files or download acknowledgment files.

Remittance Advice Information

Supplemental Payments

ICD-10 Information and Resources

Disclaimer: The Alliance is not affiliated with the external organizations listed below. Information on these pages is maintained by external entities and the Alliance is not responsible for their content.

ICD-10-CM Search
A powerful medical coding search engine that allows you to look up ICD-10 codes. Provides an extensive code browser where ICD-10-CM codes are arranged in a tree-like menu fashion based on their chapters and sub-chapters.
Find-A-Code
Simple search for medical and health care billing codes online. Current codes, accurate information on ICD-9 (ICD-9-CM and ICD-9-PCS), ICD-10-CM/PCS, CPT(R), HCPCS, PQRI and other billing codes and code sets. A free trial is available.
ICD-10 Code Search
Mapping tool based on General Equivalency Mapping files published by CMS. Please note that this tool does not guarantee clinical accuracy, and clinical analysis may be needed to determine appropriate codes.
ICD-10 Code Translator
The ICD-10 code online translator tool allows you to compare ICD-9 to ICD-10 codes. ICD-9 was expanded from 17,000 to approximately 141,000 ICD-10 codes, and this online tool can help you map that expansion. (note: this tool only converts ICD-10-CM codes, not ICD-10-PCS.)

Useful CMS Resources

ICD-10 Educational Videos from CMS

ICD-10 Basics

Training to Assist Small Physicians

Practice Manager's Guide to ICD-10

Other External Resources

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