HOW TO SUBMIT NEW APPLICATIONS
Congratulations on successfully enrolling a new patient!
To submit applications please fax, drop off, or upload the application to our database within 24 hours of the enrollment.
Instructions on how to upload applications to our database can be found here.
CISA
14541 BROOKHURST ST SUITE A5-A7
WESTMINSTER CA 92683
FAX: 1-866-515-8850
Applications must be sent from 9 am to 5pm Monday through Friday. If you are sending applications before 9 am or after 5 pm or on the weekends, you must fax it directly to the health plans and SEND US A COPY. See the fax numbers below for the appropriate carriers.
IT’S IMPORTANT TO
REVIEW ALL THE INFORMATION ON YOUR APPLICATIONS BEFORE SUBMITTING!
Health Plan |
Preferred Method to submit app | Fax Number |
| Alignment | Fax | 562-207-4623 |
| WellCare MA-PD/PDP | Fax | 866-473-9124 |
| WellCare PDP only | Fax | 866-388-1521 |
| Health Net | Fax | 800-845-7429 |
| Scan | Fax | 562-989-5243 |
| UnitedHealthCare MAPD | Fax | 501-262-7070 |
| UnitedHealthCare PDP | Fax | 866-994-9659 |
| UnitedHealthCare Supplement | Fax | 888-836-3985 |
| Blue Shield Care1st Plans | Fax | 323-889-5402 |
| Central Health | Fax | 626-388-2371 |
| Brand New Day | Fax | 657-400-1207 |
| Blue Shield MAPD & PDP | Fax | 877-251-3660 |
| Blue Shield Supplement | Fax | 844-266-1850 |
