Frequently Asked Questions

For Members

What is Community Care Health's service area?

Community Care Health is Fresno’s only locally based, commercial health plan. We serve members based in Fresno and neighboring counties. See a list of CCH’s service area included in Community Care Health’s service area.

CCH Service Area
Yes, as a Community Care Health member you’re covered for emergency care wherever you are, although routine care is only covered at home in our service area. If you think you’re having a medical or psychiatric emergency call 911 or go to the nearest hospital.
You and your primary care physician (PCP) will determine the best specialist for your particular needs. In some cases you may be able to see a specialist directly without a referral from your PCP. No referral is required for participating mental health providers, pediatricians, and obstetricians and gynecologists. If you have any questions about how to see a specialist call customer service at 559-724-4995 or Toll Free at 844-516-0181.
Community Care Health is a comprehensive health care service plan that offers a full range of medical care. Covered services always include coverage for doctor office visits, hospital stays, surgery, outpatient procedures, preventive services (periodic immunizations, physical exams, and routine screenings) and much more. These services are provided at varying levels of copayments and/or coinsurance. Coverage varies depending on the benefit plan you’re enrolled in. Contact member services if you have questions about which services are covered under your plan and your cost share.

You can obtain a Summary of Benefits from your human resources department or you can contact us to have a benefits summary sent to you.

Call 911 or go to the closest emergency room anytime you have a life-threatening emergency. If you’re not sure it’s an emergency call your doctor’s office for advice. It’s an emergency if your symptoms are so severe that you believe not getting medical care right away could place your health or someone else’s (or the health of an unborn child) at risk OR cause major harm to a body part or function. If you feel you’re having an emergency, you don’t need an OK from us or your primary care physician to get care.
As a Community Care Health member you have access to great resources like:
  • Mental health care services for all ages
  • Inpatient hospital services.
  • Outpatient services
  • Access to Community Care Health providers without primary care physician referral
For more information about your benefits call our customer care team toll-free at 559-724-4995 or Toll Free at 844-516-0181.

You don’t need a referral from your primary care physician to get access to mental health services. However, only services offered through plan providers will be covered. So the best way to ensure coverage is to find a doctor in your network before taking the next step.

Find a provider at  CCH Provider Search

CCH Provider Search
In most cases, yes. If you’re a Community Care Health member when your spouse loses group coverage through his/her employer, your spouse may enroll as a dependent under Community Care Health, so long as enrollment occurs within 31 days of the date coverage ended under the former health plan.
Yes, as long as there has been a qualified family change, such as marriage. Enrollment must occur within 31 days of the time your dependents first become eligible to join (that is, within 31 days of marriage or domestic partnership.)

For Providers

What is Community Care Health's service area?

Community Care Health is Fresno’s only locally based, commercial health plan. We serve members based in Fresno and neighboring counties. See a list of CCH’s service area included in Community Care Health’s service area.

CCH Service Area
Community Care Health is a comprehensive health care service plan that offers a full range of medical care. Covered services always include coverage for doctor office visits, hospital stays, surgery, outpatient procedures, preventive services (periodic immunizations, physical exams, and routine screenings) and much more. These services are provided at varying levels of copayments and/or coinsurance. Coverage varies depending on the benefit plan you’re enrolled in. Contact member services if you have questions about which services are covered under your plan and your cost share.
Enrollees will have the opportunity to choose a primary care physician (PCP). If a participant does not choose a PCP at the time of enrollment Community Care Health will assign them one. If at any time the enrollee would like to change their PCP they may call Community Care Health for assistance at 559-724-4995 or Toll Free at 844-516-0181.

CCH Providers should send claims to the following addresses:

Medical Claims:
Community Care Health
P.O. Box 45016 Fresno, CA 93718

Electronically using Payor ID CCH25

Behavioral Health Claims:
SimpleBehavioral
PO Box 25159
Fresno, CA 93729-5159

Electronically through: OfficeAlly – Payor ID: HALCY
Fax: (855) 486-1341

Physical Medicine Claims:
SimpleMSK
PO Box 25220
Fresno, CA 93729-5220

Electronically through:
OfficeAlly – Payor ID: PM001
Fax: (855) 486-1343

Please contact Community Care Health at 559-724-4995 to verify eligibility, benefits and copayment information.

Please send an email to providerrelations@communitycarehealth.org and a representative will contact you within two (2) business days.

For Employers

What is Community Care Health's service area?

Community Care Health is Fresno’s only locally based, commercial health plan. We serve members based in Fresno and neighboring counties. See a list of CCH’s service area included in Community Care Health’s service area.

CCH Service Area

Community Care Health offers both Large (+101 employees) and Small (100 employees and less) Group Medical Plans, along with Dental, Pharmacy and Vision coverage. For more information, please review our plans or email us at sales@communitycarehealth.org.

Yes, members are covered for emergency care wherever they are, although routine care is only covered at home in our service area. If you think you’re having a medical or psychiatric emergency call 911 or go to the nearest hospital.
Community Care Health is a comprehensive health care service plan that offers a full range of medical care. Covered services always include coverage for doctor office visits, hospital stays, surgery, outpatient procedures, preventive services (periodic immunizations, physical exams, and routine screenings) and much more. These services are provided at varying levels of copayments and/or coinsurance. Coverage varies depending on the benefit plan you’re enrolled in. Contact member services if you have questions about which services are covered under your plan and your cost share.

For Brokers

What is Community Care Health's service area?

Community Care Health is Fresno’s only locally based, commercial health plan. We serve members based in Fresno and neighboring counties. See a list of CCH’s service area included in Community Care Health’s service area.

CCH Service Area

Community Care Health offers both Large (+101 employees) and Small (100 employees and less) Group Medical Plans, along with Dental, Pharmacy and Vision coverage. For more information, please review our plans or email us at sales@communitycarehealth.org.

To become a broker please contact us using the form on the contact us page or via email at sales@communitycarehealth.org.