Eligibility & Claims

Providers are responsible for verifying members’ eligibility for all medical services rendered. Providers may verify member eligibility in the ways below.

To Verify

  • Access the member’s health plan website or call the individual’s health plan (Health Net, United Healthcare, or Western Health Advantage – see the member’s ID card).
  • Call Canopy Health Provider Services between 8:30am - 5:00pm (Pacific Time) Monday through Friday at 844.315.4645.
  • Call Canopy Health’s Contact Center between 7:00am - 5:30pm (Pacific Time) Monday through Friday at 888.822.6679.
  • Canopy Health also distributes current eligibility lists to its participating Medical Groups on a monthly basis.

Filing a Claim

Providers are encouraged to file claims electronically whenever possible. Submitted claims should provide all required information; those submitted with missing data may result in a delay in processing or denial.

All Canopy Health facility claims are processed by Conifer Value-Based Care. Professional claims will continue to be processed by the participating Medical Groups and/or their respective vendors.

Electronic Claim Submissions

Clearinghouse Phone Number Payer ID
Office Ally 866.575.4120 CAPMN
Change Healthcare 877.363.3666 95399
MDX 562.256.3800 CAPMN

Paper Claim Submissions
P.O. Box 260890
Encino, CA 91426

Appeals & Provider Disputes
P.O. Box 261760
Encino, CA 91426

Claims Dept. Phone
844.315.4645 or 818.461.5055; IVR available 24/7

All Other Provider Inquiries

Website Information

  • Conifer Value-Based Care website - www.coniferhealth.com - This portal provides access to query and view status on facility claims, eligibility status, contracted providers, and other important information. Select Client Login and then Cap Connect to enter the provider portal. Call Provider Services at 844.315.4645 for login assistance.
  • Canopy Health Website - www.canopyhealth.com – This portal provides general information about Canopy Health as well as a searchable Physician and Hospital directory.

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