Electronic Transactions

Important Update

Starting January 1, 2024, California Health & Wellness Plan will no longer serve Medi-Cal members. The information and resources provided on this webpage are applicable to services rendered on or before December 31, 2023.
 

If you are a provider in Amador, Calaveras, Imperial, Inyo, Mono, or Tuolumne counties, who is part of the Health Net provider network starting January 1, 2024, please visit Health Net for services rendered on or after January 1, 2024.

California Health & Wellness is committed to providing our participating providers with the best tools possible to support their administrative needs.  Our electronic transactions capabilities will speed up the processing and payment of your claims.

PaySpan (PDF)

California Health & Wellness and PaySpan are in partnership to provide an innovative web based solution for Electronic Funds Transfers (EFTs) and Electronic Remittance Advices (ERAs).

Secure Web Portal

Partial list of secure website functions include verify member eligibility, check/submit claims and submit/confirm authorizations.

EDI

Electronic Transactions (EDI) support for HIPAA transactions is provided for the health plan by Centene Corporation. Centene is currently receiving professional, institutional, and encounter transactions electronically, as well as generating an electronic remittance advice/explanation of payment (ERA/EOP). To conduct other HIPAA transactions not listed, please contact our EDI department at 1-800-225-2573, ext. 25525.

The following list contains contact information for the trading partners currently active with our health plan. All providers are encouraged to contact one of these trading partners to utilize our electronic transaction options.

Clearinghouse/Direct Submitter List
Clearinghouse/Direct Submitter Payer ID
Ability (Inovalon) 68069
Availity 68069

Other Payment Resources

HIPAA x12 Transactions Standard Companion Guide (PDF)

If you have any questions, please contact:

California Health & Wellness
c/o Centene EDI Department
1-800-225-2573, ext. 6075525, or
1-314-505-6525

Or by email at EDIBA@centene.com