Whole Child Model (WCM)

Effective July 1, 2019 the California Children’s Services (CCS) services will transition to the CalOptima Whole Child Model Program. 

CCS is a statewide program providing medical care and case management for children under 21 with certain medical conditions that were locally administered by the Orange County Health Care Agency. Starting July 1, 2019, t
he Department of Health Care Services (DHCS) is implementing WCM to integrate CCS services into CalOptima for Orange County.  

 

Whole Child Model goals:

  • Combine CCS and Medi-Cal services under one managed care plan.
  •  Improve coordination of services to meet the need of the child and family.
  •  Maintain existing patient-provider relationships when possible.
  •  Retain CCS program standards.
  •  Improve overall health results.
  •  Improve access to care.


WCM Provider Training and Attestation 
The Training can be located by:

  1. Please click on the Whole Child Model Training for training section. 
  2. Please complete the training and submit the attestation form via fax to Provider Services at 714-947-8708.

    WCM Services – Eligibility
    Please contact Noble Mid-Orange County Member Services at 888-880-8811

    WCM Services – Authorization Request

There are two ways to request Authorization(s):

1)      Provider web portal (PCP only) at www.healthsmartmso.com.

2)      Fax Submission
         Authorization (Urgent & Routine) request(s) can be submitted via fax to: 714-947-8700


WCM Services – Case Management

 To reach our Case Management Department please call: 714-947-8600

  • Fax Number: 714-947-8796

 

WCM Services - Claim Processing

For Customer Service claims inquiries for claims with date of services of July 1, 2019 and after please call: 714-947-8600.

Electronic Data Interchange (EDI)

Clearing House: Office Ally (OA) at 360-975-7000 press option #1

Payer ID: HSM01

Paper Claim Submission

Mailing Address:

Noble Mid-Orange County Claims Department
P.O. Box 6301

Cypress, CA 90630

 

Additional Information and Resources

REGISTRATION OF MEDICAL SERVICES BY PHONE
Step 1: CONTACT US NOW
10855 Business Center Drive, Suite C
Cypress, CA 90630-0063
Phone: (888) 880-8811
Step 2: APPOINTMENT
Please call (888) 880-8811 to provide all necessary information to register the appointment card at least one day before your visit.
Step 3: REDUCE WAITING TIMES
On the day you visit, please arrive 15 minutes early for the examination procedure . You just need to bring the appointment card, no need to wait.