State of California

Medicaid Third-Party Carrier Codes

Name: Medicaid Third-Party Carrier Codes
Creator: State of California

Basic information about third parties who may be liable for medical expenses that would otherwise be paid by Medi-Cal. Maintained by the State of California.

Example records

Carrier Coderegistration	Carrier Namelegal entity	Carrier Addressaddress	Carrier Phonephone number	Ohc Coderegistration	Coverage Typeclassification
B	Blue Cross of California	PO Box 9051, Oxnard, CA 93031	8005270204	B	Cost-avoided
E	Aetna	151 Farmington Ave, Hartford, CT 06156	8002328585	E	Cost-avoided
K	Kaiser Foundation Health Plan	PO Box 12916, Oakland, CA 94604	8007771370	K	HMO

Use cases

Health Insurance Carrier Entity Resolution

A KYB analyst onboarding a new health plan partner cross-checks the carrier name and address against state Medicaid records to confirm the entity is recognized as a legitimate third-party payer in California, reducing counterparty risk before executing a claims processing agreement.

Carrier NameCarrier AddressCarrier CodeCarrier Phone

Coordination of Benefits Fraud Detection

A fraud investigator at a managed care organization reviews which carriers are classified under specific coverage types to identify claims where a provider may have billed Medi-Cal as primary payer despite a known third-party liability carrier being on file, flagging potential cost-shifting schemes.

Carrier NameCarrier CodeOhc CodeCoverage Type

Insurance Market Coverage Mapping

A sales intelligence team at a healthcare data vendor maps the universe of carriers recognized by California Medi-Cal to size the addressable market for coordination-of-benefits software, segmenting carriers by coverage type to prioritize outreach toward those handling cost-avoided claims.

Carrier NameCarrier AddressCoverage TypeCarrier Code