Children's Medical Services Network (CMS Net) Provider Electronic Data Interchange (EDI)
The Children’s Medical Services (CMS) developed a web-based tool that enables approved CCS providers, Medi-Cal Managed Care Plans and Healthy Family Plans to electronically access the status of Requests for Services/Authorizations. In addition to viewing authorizations each approved facility shall have the ability to print authorizations, denials and Notices of Action.
Provider Responsibilities
Access
CMS Net Provider EDI Liaisons
CMS Net Provider EDI User Guide
Provider Responsibilities
CCS providers/plans/facilities wishing to participate in the CMS Net Provider EDI shall be aware of the following facts and requirements upon applying for access:
- The information obtained through CMS Net Provider EDI is not real time. The information obtained shall be current as of the previous day. (i.e. one day delay)
- The site that shall be used to access CMS Net Provider EDI is best supported with Internet Explorer 5.5 or higher. If an alternate Internet Browser is used the CMS Branch cannot guarantee results.
- Each provider/plan/facility shall have a designated CCS liaison(s) who shall be responsible for all communication with the CCS Regional Office and Information Technology Unit, coordination of users within the organization and dissemination of id’s and passwords. (After assigned by the Information Technology Unit). The CCS liaison(s) shall also be responsible for notifying the CCS Regional Office of staffing changes (provider separation, user modification, etc.) including status of their position. Such requests shall be submitted on the attached account request form.
- Each provider/plan/facility must have internal agreements at their site between services including, but not limited to: Inpatient Services, Outpatient Clinics, Emergency Services, CCS Special Care Centers, and Billing regarding the internal distribution of CCS authorizations.
- Each provider/plan/facility must assure that they have written permission from the providers within their domain to access the providers individual authorizations. (This requirement is not applicable to health plans.)
- Each provider/plan/facility must be willing to eventually forgo having CCS send a hard copy of all authorizations, denials and Notices of Action.
- Where feasible each provider/plan/facility must be willing to enter into reciprocal agreements with State and local CCS programs permitting electronic access to medical information regarding CCS beneficiaries.
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Access
Contact the CMS Net Help Desk if you would like access to the CMS Net Provider EDI.
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CMS Net Provider EDI Liaisons
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