Gold Coast Health Plan provider portal, phone and payer ID quick facts
| Provider resource entry point | https://www.goldcoasthealthplan.org/for-providers/provider-portal/ |
|---|---|
| Payer contact reference | 1-888-301-1228 |
| Claims payer ID | 77160 — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: Edifecs supports 835 delivery, but this comparison did not establish the ERA enrollment identifier. Do not reuse the former GCHP1 value or infer eligibility routing from claims receiver ID 77160. |
| Timely filing | Medi-Cal: 180 days before late-filing reductions |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- This registry has not established a payer-specific appeal ladder for Gold Coast Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
- Edifecs supports 835 delivery, but this comparison did not establish the ERA enrollment identifier. Do not reuse the former GCHP1 value or infer eligibility routing from claims receiver ID 77160.
Gold Coast Health Plan at a glance
| Legal name | Gold Coast Health Plan |
|---|---|
| Also known as | GCHP, Ventura County Medi-Cal |
| Category | Medicaid MCO |
| Parent organization | Ventura County Medi-Cal Managed Care Commission (public) |
| Claims payer ID | 77160 — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility (270/271) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA (835) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: Edifecs supports 835 delivery, but this comparison did not establish the ERA enrollment identifier. Do not reuse the former GCHP1 value or infer eligibility routing from claims receiver ID 77160. |
| NAIC company code | Not established in this registry |
| States covered | California |
| Members covered | ~210k members |
| Provider resource entry point | https://www.goldcoasthealthplan.org/for-providers/provider-portal/ |
| Provider phone | 1-888-301-1228 |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Gold Coast Health Plan
Gold Coast's Medi-Cal claims FAQ applies payment reductions after 180 days from service or discharge and denial beyond 365 days. File within the earlier window; confirm the applicable product, provider agreement and any exceptions. The 365-day outer limit is not an unreduced-payment filing target.
| Submission type | Window |
|---|---|
| Initial claim reference | Medi-Cal: 180 days before late-filing reductions |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Gold Coast Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Gold Coast Health Plan provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Gold Coast Health Plan
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Gold Coast Health Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Gold Coast Health Plan. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Gold Coast Health Plan
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Gold Coast Health Plan volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | 77160 — registry reference; verify the member product, transaction and clearinghouse |
| 270 / 271 eligibility | Listed in registry; verify current scope | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: Edifecs supports 835 delivery, but this comparison did not establish the ERA enrollment identifier. Do not reuse the former GCHP1 value or infer eligibility routing from claims receiver ID 77160. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
payer_ids.claims, provider_phone, electronic_claims_supported
Source comparison: 2026-09-18
The current claims page gives receiver ID 77160, Edifecs claims/835 onboarding and claims-question customer service 1-888-301-1228. GCHP1 was replaced for claims only; this does not establish an eligibility ID or automatically certify an ERA routing identifier.
Primary source for payer_ids.claims, provider_phone, electronic_claims_supportedtimely_filing_days, filing_rule
Source comparison: 2026-09-18
Claims received after 180 days from service/discharge may be reduced; those beyond 365 days are denied under the cited Medi-Cal guidance. The former 365-day headline concealed the earlier reduction boundary.
Primary source for timely_filing_days, filing_rule
Not checked in this pass: All fields outside the specifically scoped findings, including legal-entity/NAIC identifiers, current enrollment and geographic coverage; Product-complete initial, corrected, secondary and appeal rules; applicable contracts and exceptions; Transaction-specific payer IDs, ERA enrollment and X12 278 unless explicitly established above; Prior-authorization code samples and current clinical criteria; QuickIntell capability/outcome claims and historical DataForSEO demand values; Accountable whole-record editorial approval (not supplied).
State coverage
Gold Coast Health Plan operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for Gold Coast Health Plan
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Gold Coast Health Plan; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Gold Coast Health Plan; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Gold Coast Health Plan before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Gold Coast Health Plan
Where is the Gold Coast Health Plan provider portal?
Use https://www.goldcoasthealthplan.org/for-providers/provider-portal/ as a starting point for Gold Coast Health Plan provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Gold Coast Health Plan?
Gold Coast's Medi-Cal claims FAQ applies payment reductions after 180 days from service or discharge and denial beyond 365 days. File within the earlier window; confirm the applicable product, provider agreement and any exceptions. The 365-day outer limit is not an unreduced-payment filing target.
What is the Gold Coast Health Plan payer ID?
Claims: 77160 — registry reference; verify the member product, transaction and clearinghouse. Eligibility (270/271): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. ERA (835): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: Edifecs supports 835 delivery, but this comparison did not establish the ERA enrollment identifier. Do not reuse the former GCHP1 value or infer eligibility routing from claims receiver ID 77160.. Do not substitute a claims ID for an unverified transaction ID. Check current source findings and the member ID card before submitting.
Does Gold Coast Health Plan accept electronic claims?
Verify Gold Coast Health Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Gold Coast Health Plan denial?
This registry has not established a payer-specific appeal ladder for Gold Coast Health Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Gold Coast Health Plan prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Gold Coast Health Plan provider phone number?
This registry lists 1-888-301-1228 as a contact reference for Gold Coast Health Plan. Confirm the number and service scope against the member ID card and current product-specific directory; claims, eligibility and authorization inquiries may use different teams.
Automate workflows around Gold Coast Health Plan requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Gold Coast Health Plan's current published documents before submission. CPT® is a registered trademark of the American Medical Association.