CenCal Health policy updates
Track new and updated CenCal Health policies impacting reimbursement and clinical operations.
| Policy | Payer | Type | Specialty | Change | Effective |
|---|---|---|---|---|---|
| COVID-19 Antigen OTC Test Coverage | Cencalhealth | Clinical | Pharmacy & Specialty Drugs | Modified | Oct 1, 2024 |
| Timely Access to Care Requirements and Ongoing Monitoring | Cencalhealth | Administrative | — | Modified | Jan 1, 2024 |
| Notification of Utilization Review Determinations | Cencalhealth | Administrative | — | Modified | Jan 1, 2024 |
| Utilization Review - Prior Authorization, Concurrent Review, and Retrospective Review | Cencalhealth | Clinical | Other | Modified | Jan 1, 2024 |
| Member Grievances and Appeals of Grievance Resolutions | Cencalhealth | Administrative | — | Modified | Jul 1, 2023 |
| Member Appeals of Adverse Benefit Determinations | Cencalhealth | Administrative | — | Modified | Jul 1, 2023 |
| Member Appeals | Cencalhealth | Administrative | — | Modified | Jul 1, 2023 |
| Member Grievances | Cencalhealth | Administrative | — | Modified | Jul 1, 2023 |
| Alcohol Misuse: Screening and Behavioral Counseling Interventions in Primary Care | Cencalhealth | Clinical | Preventive Services & Screening | Modified | May 1, 2018 |
| Initial Health Appointment (IHA) | Cencalhealth | Administrative | — | Modified | Apr 1, 2014 |
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OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.
OpenPayer by Trek Health — Policy intelligence for billing and revenue cycle teams.
Coverage data is sourced from publicly available payer medical policy documents and updated as payers publish revisions. Read more about where our data comes from. Always consult the primary payer source for clinical decision-making.