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Today the complexity of the health care system following the passage of comprehensive insurance health care reform legislation sometimes confuses the public and medical providers alike. The large insurance provider CalCare alleviated some of the potentially perplexing details associated with submitting and processing medical claims by transferring its operations to a completely online, computerized form some time ago.

CalCare operates largely behind the scenes as one of the larger medical health care insurers by working through a number of widely based, well known health care provider networks. The company’s website, www.calcareipa.com, established in 2011, contains a wealth of detailed information for physicians and hospital claims departments (and for members of the general public, as well). The website reports that CalCare’s insurance plans include several offered through large provider networks in California: Health Net, Molina Health Care, Care 1st Health Plans, Anthem (a Blue Cross entity) and Easy Choice HMO. This information holds particular importance at the moment, since open enrollment periods for the current annual cycle for Californians seeking affordable health insurance continue between November 15, 2014 and February 15, 2015.

As a paperless company utilizing online computerized medical records, CalCare can provide expedited information to members of the public in search of a physician covered by an applicable plan. This data also holds significance for medical offices falling within the coverage network, however. CalCare’s website reports that the company partnered with the firm Office Ally to streamline the submission of electronic claims and processing. The website provides contact directions that providers can use to help inform their staff members about the most current procedures for claim processing and submission.

This process is different in the State of Oregon, especially for medical and dental providers. Be sure to check local laws and changes in HIPPA affecting electronic medical records and security. Another advantage of CalCare’s computerized record system will please both physicians and their patients. The website contains a reference page where members of the public can go to check to see whether or not a particular medical care giver falls within one of CalCare’s coverage networks, including a roster of preapproved emergency care providers. Clients can search for a provider by location, medical practice area or even using the doctor’s name. This feature should alleviate a significant stress factor that sometimes burdens medical office staff members, who frequently take valuable time away from other duties to conduct research for patients requiring referrals to other providers. Finally, the website’s “resources” section contains several important forms for the use of providers within its networks. Consulting these materials can improve efficient claim submission.