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California Integrated Health Providers

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Welcome Ontrak Providers!

Thank you for being a part of our network. Please use this site as a resource for managing your relationship with us.

Billing & Important Forms

Treatment Plan & Visit Summary Submission

An initial treatment plan is required (only one per member), and submission must be by member’s third visit. All other visits, both before/after treatment plan submission, require a visit summary submission. Please submit visit summaries within five business days of each service. Here are copies of each form:

Treatment Plan Form
Visit Summary Form

To ensure faster pay, better coordination, and lower no-show rates, please fax all treatment plan and/or visit summaries, immediately after each service, to the Care Coaches at (888) 972-9589. Or send via secure email: [email protected].

Please note: the date of service in the visit summary/treatment plans must match the date of service submitted on the claim.

Claim Form Submission

Timely Claim

Please submit a complete claim to Ontrak’s TPA, Keenan and Associates. Claims should be submitted electronically.

Electronic:
Payor ID KEE01 (Office Ally)
Payor ID 95279 (All Others)

Billing Support:
Phone: 310-444-4395
Email Billing

Ontrak Newsletter & Important Notifications

In this newsletter, we’re sharing our updates regarding COVID-19 and how we’re here to help. You can find important reminder information regarding timely filing guidelines. Take a moment and provide your biography and areas of expertise information. This allows us to better serve you as our provider as well as our enrolled members. Check it out for our latest updates!

If you’d like to subscribe to our newsletter, please email Ontrak Provider Services.

Contacts

Mailing Addresses
California Integrated Health, Inc. Office: 2120 Colorado Ave., Suite 230, Santa Monica, CA 90404
Keenan and Associates: P.O. BOX 2744, Torrance, CA, 90509

Billing / Claims Questions
Phone: 310-444-4395
[email protected]

Provider Network Management / Contracting Questions
Provider Network Phone: 855-840-3627, Option 3
Provider Network Fax: 833-908-0144
Provider Network Help: [email protected]

Care Coach Questions / Referrals / Member Eligibility
Phone: 866-321-6560
[email protected]