Information on this page is intended for healthcare providers, advocates and application assisters.
Authorized Representative Forms and Release of Information Forms
To protect the confidentiality and privacy of those we serve, you will need to have either a completed and up-to-date Authorized Representative form or Release of Information on file in order for Access to provide you information for a case that is not your own. Submitting these forms can be done in following ways:
- Send an e-mail to pubassist.HHSA@sdcounty.ca.gov with “AR Forms” in the subject line. In the body of the e-mail please provide your full name, the name of the company you represent, a contact phone number, full name of your client, the date of birth of your client and the case number of your client. Attach the forms in PDF format and send the e-mail. An Access agent will respond within 3 business days.
- Mail the form to address Access, PO Box 85027, San Diego, CA 92186. Please include the case number on the form when doing so. The form will be scanned into the system and a representative will contact you.
Verify Medi-Cal Eligibility
The Automated Eligibility Verification System (AEVS) is for healthcare providers that are inquiring about the Medi-Cal status of a patient. To access AEVS, have your healthcare Provider Identification Number available and visit the Medi-Cal point of service website or call 1-800-456-2387. If you are unable to use AEVS, you can fax (858-467-9088) your request, including the patient's name, case number and/or social security number, to ACCESS. Your inquiry will be responded to within 3 business days. If you need a response sooner and cannot wait 3 business days, please call Access at 1-866-262-9881 and an agent will assist you.
Verify County Medi-Cal Services (CMS) Eligibility
The provider online verification (POV) website is a site for CMS contracted healthcare providers that are inquiring about the CMS certification status of a patient. If you would like access to the CMS POV site, please contact Rebecca Velie at (858) 495-1360 or Rebecca_G_Velie@uhc.com to inquire about becoming a CMS contracted provider. The query will inform you of the eligibility status and the certification period for the patient. For more detailed instructions, please refer to the Provider Online Verification document.
To verify patient’s coverage status:
1. Enter institutional tax ID number
2. Enter either patient’s SSN OR Member ID (click on appropriate tab)
3. Enter patients date of birth (DOB)
4. Enter today’s date for current coverage information