Partnership HealthPlan of California at a glance
| Legal name | Partnership HealthPlan of California |
|---|---|
| Also known as | PHC CA, Partnership HealthPlan |
| Category | Medicaid MCO |
| Parent organization | Partnership HealthPlan (public/non-profit JPA) |
| Claims payer ID | Confirm the current Partnership medical-claims EDI setup and the HealthRules Payer transition instructions. Mental-health claims are directed separately to Carelon Behavioral Health. No single PHC01 route is established for all services. |
| Eligibility (270/271) payer ID | Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing. |
| ERA (835) payer ID | PHC01 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier. |
| NAIC company code | Not established in this registry |
| States covered | California |
| Members covered | ~620k members |
| Provider resource entry point | https://www.partnershiphp.org/providers |
| Provider phone | 1-707-863-4130Claims support; toll free 855-798-8757 |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Partnership HealthPlan of California
This registry lists 365 days as an initial-claim reference for Partnership HealthPlan of California. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
| Submission type | Window |
|---|---|
| Initial claim reference | 365 days (verify applicability) |
| 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 Partnership HealthPlan of California. 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: Partnership HealthPlan of California provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Partnership HealthPlan of California
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 Partnership HealthPlan of California 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 Partnership HealthPlan of California. 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 Partnership HealthPlan of California
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Partnership HealthPlan of California 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 | Confirm the current Partnership medical-claims EDI setup and the HealthRules Payer transition instructions. Mental-health claims are directed separately to Carelon Behavioral Health. No single PHC01 route is established for all services. |
| 270 / 271 eligibility | Listed in registry; verify current scope | Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing. |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | PHC01 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier. |
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.
portal_url
Source comparison: 2026-09-26
The stored legacy provider URL redirects to the current /providers resource, which also announces the HealthRules Payer claims-system transition.
Primary source for portal_urlprovider_phone
Source comparison: 2026-09-26
The claims page lists 707-863-4130 for all providers and 855-798-8757 toll free; 707-863-4100 is not the listed claims-support number.
Primary source for provider_phonepayer_ids.claims
Source comparison: 2026-09-26
Medical EDI goes through Partnership online services; mental health claims are directed separately to Carelon Behavioral Health. A single PHC01 route is not established for all services.
Primary source for payer_ids.claims
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; timely_filing_days: No universal filing scalar established; verify the controlling plan, contract, jurisdiction and start event.; payer_ids.eligibility / payer_ids.era / era_payer_id: No transaction-specific universal eligibility/ERA identifier established; do not copy a claims ID.; electronic_claims_supported / supports_279_271 / supports_278: No blanket transaction-capability or QuickIntell connectivity certification; unauthenticated resources do not establish all stored flags.; appeal_levels / prior_auth_required_codes_sample / qi_module_coverage: No new approval of appeals, code-specific authorization or product integrations in this bounded pass..
Sources used for this guide
State coverage
Partnership HealthPlan of California 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 Partnership HealthPlan of California
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 Partnership HealthPlan of California; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Partnership HealthPlan of California; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Partnership HealthPlan of California before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Partnership HealthPlan of California
Where is the Partnership HealthPlan of California provider portal?
Use https://www.partnershiphp.org/providers as a starting point for Partnership HealthPlan of California 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 Partnership HealthPlan of California?
This registry lists 365 days as an initial-claim reference for Partnership HealthPlan of California. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
Does Partnership HealthPlan of California publish a single claims payer ID?
This registry has not established one all-product claims payer ID for Partnership HealthPlan of California. Claims: Confirm the current Partnership medical-claims EDI setup and the HealthRules Payer transition instructions. Mental-health claims are directed separately to Carelon Behavioral Health. No single PHC01 route is established for all services.. Eligibility (270/271): Stored eligibility references remain unverified for the current product and transaction. Claims identifiers do not establish 270/271 routing.. ERA (835): PHC01 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the current product, clearinghouse and enrollment. This claims comparison does not establish an 835 identifier.. Do not substitute a claims ID for an unverified transaction ID. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Partnership HealthPlan of California accept electronic claims?
Verify Partnership HealthPlan of California 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 Partnership HealthPlan of California denial?
This registry has not established a payer-specific appeal ladder for Partnership HealthPlan of California. 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 Partnership HealthPlan of California 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 Partnership HealthPlan of California provider phone number?
This registry lists 1-707-863-4130 as a contact reference for Partnership HealthPlan of California. Claims support; toll free 855-798-8757
Automate workflows around Partnership HealthPlan of California 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 Partnership HealthPlan of California's current published documents before submission. CPT® is a registered trademark of the American Medical Association.