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California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more
California Health & Wellness is no longer a Medi-Cal plan starting January 1, 2024. Regardless of the county you live in, your Medi-Cal service and benefits will not be impacted by the health plan changes since you will be assigned to a new health plan. The county you live in determines your new health plan. Learn more

Availity Selected as Primary Gateway for Claims Processing

Date: 12/15/16

In an effort to improve our claims processing, Centene Corporation (our corporate parent) has selected Availity as their primary gateway connection for all plans including California Health & Wellness. This change will allow Centene to better service our providers with more advanced engagement and communication strategies in the future.

There should be no impact to provider claims and other transactions. We are working with each impacted Clearinghouse through a migration effort including claims, eligibility and claims status. Each of these clearinghouses already submits transactions to Availity today. Clearinghouses are being asked to migrate the volume no later than February 17, 2017.

Clearinghouse list:

  • Change Healthcare / Emdeon / Capario / MedAvant / ProxyMed
  • TriZetto Provider Solutions / GatewayEDI
  • Zirmed
  • MedAssets / Xactimed
  • SSI
  • All Scripts / Payerpath
  • SDS – Smart Data Solutions
  • MD Online
  • Practice Insight
  • NEHEN
  • Netwerkes/Optum

No change is required for our provider community.  Providers who currently submit claims through any of the clearinghouses listed above may continue to do so with no interruption to their current business process.  Your connection will remain intact.  Providers who submit directly or through other intermediaries may also continue to do so without interruption.  Your current process will remain intact as well.

If you have questions about this change please do not hesitate to contact Provider Services at 877-658-0305.