Provider Reference Material
BMI Tables From CDC
California Advance Health Care Directive
Male Sterilization Booklet From DHCS – English
Male Sterilization Booklet From DHCS – Spanish
Female Sterilization Booklet From DHCS – English
Female Sterilization Booklet From DHCS – Spanish
Instructions for Sterilization Consent Form PM-330
Sterilization Consent Form PM-284
Sterilization Consent Form PM-330
List of Reportable Diseases- Department of Public Health
Claims Settlement Practices Provider Packet
Fair Hearing Policy
W-9 Information – Preferred IPA requires providers to submit updated W-9 forms on an annual basis. Please complete the form and fax to 818-332-4298.
Blue Shield of California Promise Health Plan- How to Become a CCS Provider
Blue Shield of California Promise Health Plan- Lead Declination Form (English)
Blue Shield of California Promise Health Plan- Lead Declination Form (Spanish)
LA Care Direct Access Memo (Breast & Cervical Cancer Screenings)
- BMI Tables From CDC
- California Advance Health Care Directive
- Male Sterilization Booklet From DHCS – English
- Male Sterilization Booklet From DHCS – Spanish
- Female Sterilization Booklet From DHCS – English
- Female Sterilization Booklet From DHCS – Spanish
- Instructions for Sterilization Consent Form PM-330
- Sterilization Consent Form PM-330
- List of Reportable Diseases- Department of Public Health
- Claims Settlement Practices Provider Packet
- Fair Hearing Policy
- W-9 Information – Preferred IPA requires provider to submit updated W-9 forms on an annual basis. Please complete the form and fax to 818-332-4298.
- Blue Shield of California Promise Health Plan- How to Become a CCS Provider
- LA Care Direct Access Memo (Breast & Cervical Cancer Screenings)