CenCal Health
CenCal Health is a payer organization operating in California. For an ASC, what matters isn't the logo. It's how CenCal Health pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete CenCal Health analysis
Tell us where to send it. Our team will prepare an analysis of CenCal Health covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How CenCal Health pays
See how CenCal Health reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
CenCal Health's presence spans California. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for CenCal Health and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive CenCal Health's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking CenCal Health up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with CenCal Health
- Payer ID
- 95386 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to CenCal Health through a clearinghouse.
- Eligibility verification
- Coverage and benefits for CenCal Health members are verified before the date of service, through a clearinghouse using payer ID 95386or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with CenCal Health directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of CenCal Health the way it pays.
- What is CenCal Health's payer ID?
- CenCal Health's electronic payer ID is 95386. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to CenCal Health through a clearinghouse.
- How do ASCs verify eligibility for CenCal Health members?
- Eligibility and benefits for CenCal Health members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 95386) or through the payer's provider portal.
- Does CenCal Health require prior authorization for ASC procedures?
- Prior-authorization requirements for CenCal Health are set per plan and per procedure. Confirm whether an authorization is required with CenCal Health directly before the date of service.
- What type of payer is CenCal Health?
- CenCal Health is a payer organization operating in California.
- How does CenCal Health compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where CenCal Health pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is CenCal Health paying my ASC below market?
- Put your own CenCal Health contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.