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New Provider Attestation Form

After reviewing the information acknowledge that you have completed the training. Please note that the review must be completed prior to the 10th business day of the month.

Contact Provider Services

General	831-430-5504
Cov Kev Thov 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
Lub Tsev Muag Tshuaj Authorizations, general pharmacy information or questions	831-430-5507