Publications and Forms
If you need a publication or form that is not available here, please contact Provider Relations.
- AHF 2019 Cultural Competence Program
- Homeless Provider Communication
- NPI Tax ID Flyer
- eHealth Suite Provider Portal Training
- Comprehensive Formulary (effective March 2018)
- Prescription Drug Authorization Request
- Direct Referral Authorization Form
- Authorization Request Form
- Claim Dispute Submission Form
- Provider Grievance Form
- Injectable Drugs Requiring Pre-Service Approval (last updated May 1, 2013)
- California Pre-Service Injectable Drug Authorization Request
- PHC California Provider Manual
- Quick Reference Guide
- To find a network provider, search online using our Network Provider/Facility/Pharmacy Search application.
- Provider and Pharmacy Directory (effective September 1, 2020)
To report any errors in the PHC California Provider and Pharmacy, please send an email to california.directory.errors@positivehealthcare.org, or send a message using our web form. You may also report directory errors by calling Provider Relations at (888) 726-5411 between the hours of 8:30 am and 5:30 pm, Monday through Friday. |
You will need the Adobe Acrobat Reader program to view the above forms. To download this free program click here or use the link above – the link will open a new window and take you to the Adobe website.
DHCS 030716 PHC Form 1.0