Billing for Services FAQs (PED)
1. When can providers start billing for services? After an application has been approved, Medi-Cal providers receive a Welcome Letter and package from Xerox State Healthcare, LLC (Xerox), which contains billing information. Usually within 2-3 weeks after receiving the Welcome Letter and package, the provider receives a separate notification from Xerox with their Provider Identification Number (PIN). Once the provider has received their PIN, they can begin verifying eligibility of their Medi-Cal patients and begin their billing process.
NOTE: Prospective Medi-Cal providers must apply for and be enrolled in the Medi-Cal program and agree to conditions of participation before claim submission or payment can be made for services furnished to Medi-Cal recipients. Prior to approval of the application, an applicant’s decision to see Medi-Cal patients is at their own personal risk for payment.
2. Who bills Medi-Cal for the services of rendering providers and locum tenens physicians?
Rendering providers cannot bill directly; it is the group entity that bills Medi-Cal for the services rendered by the providers enrolled in their group. In reimbursement for locum tenens/reciprocal billing, the recipient’s regular physician may submit the claim and receive payment for covered Medicaid services (including emergency visits and related services) provided by a locum tenens physician who is not an employee of the regular physician.
3. Where can providers find answers to other billing questions? For assistance with billing and claims, please contact the Telephone Service Center at
(800) 541-5555 or online at "Contact Medi-Cal". For the most current information about billing and claims submission, refer to the "Medi-Cal Newsroom" area on the Medi-Cal home page and also the Medi-Cal Quick Start Guide.
4. Who do providers contact when payments (warrants) for billed services are not received? If a provider is not receiving payment (warrants) for services that have been billed to the Medi-Cal program, a provider may need to request a change of pay-to address on file with DHCS. Providers are required to notify DHCS within 35 days of the date of a change to the business, and/or pay-to address. Please refer to the additional information on reporting a change, and to access the correct form, go to the Provider Enrollment page on the Medi-Cal Web site at www.medi-cal.ca.gov and click on Application Forms by Form Name and Number. When the address change has been made, providers will be instructed by Provider Enrollment Division about how to request payments be re-issued. Providers also may contact Provider Enrollment Division, Returned Warrant Unit, at (916) 319-8413, or via email at email@example.com.
If interested in applying for Electronic Funds Transfer (EFT), review the EFT Enrollment Authorization form. Complete and send a notarized EFT Enrollment Authorization form and a voided check to:
Attn: EFT Unit
Xerox State Healthcare, LLC
P.O. Box 13029
Sacramento, CA 95813-4029