Managed Care Contracting

The Community Clinics Health Network serves as a central point of contact for its member clinics with all the participating Medi-Cal health plans-facilitating full professional risk, primary care capitation, and fee-for-service contracts as requested by the health center and accommodated by the payor. 

The Network is organized using a "messenger model" approach, with Network staff serving as the Contracting Agent for clinics purchasing this service.  Contracting assistance includes 1) health plan contracting, analysis, and negotiation; 2) specialist and ancillary provider contracting assistance; 3) other contracts deemed necessary to meet the health centers' business objectives, such as subcontracts with IPAs, dental or vision provider contracts, etc.

Full Professional Risk

The CCHN offers full professional risk support services for health centers with sufficient patient volume and infrastructure to support such activities.  The CCHN, either directly or through its business partners, provides the following services:  eligibility verification and auditing, benefits, finance and accounting, utilization management, client services, contracting, credentialing, and the necessary reporting both back to the clinic and for the contracting health plan.