Gold Coast Health Plan
Also covers / subsidiaries: GCHP
Core Payer & Clearinghouse Profile
Electronic Payer ID
77160
EDI vendor changed to Edifecs (mandatory Sept 1, 2024); payer/receiver ID 77160 unchanged.
Timely Filing Limit (TFL)
365 days from date of service (claims over 180 days subject to Medi-Cal payment reduction)
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse Gateway
Edifecs
Provider Services
888-301-1228
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Gold Coast Health Plan, Attn: Claims, P.O. Box 9152, Oxnard, CA 93031-9152
Provider Portal
https://www.goldcoasthealthplan.org/for-providers/provider-portal/
County-organized Medi-Cal (Medicaid) plan for Ventura County (CA); also operates Total Care Advantage HMO D-SNP.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for Gold Coast Health Plan.
Resolution Tools for Gold Coast Health Plan Claims
Values vary by plan, line of business, and provider agreement. Confirm in the payer portal or with your clearinghouse gateway before submitting electronic claims.
Tired of Chasing Gold Coast Health Plan Denials & Delayed Payments?
Aethera's billing specialists work Gold Coast Health Plan every day — handling EDI clearinghouse rejects, prior authorizations, payment posting, and 30-day AR aging recovery.