Information If You Are Interested In Becoming A Qualified Provider
To become a Presumptive Eligibility provider for the purposes of offering Presumptive Eligibility (PE) for pregnant women to your pregnant patients, an application, QUALIFIED PROVIDER APPLICATION FOR PRESUMPTIVE ELIGIBILITY PARTICIPATION, MC311, provided below, must be completed, submitted, and approved by the Department of Health Services Presumptive Eligibility Support Unit
WHAT’S NEW!!! -
Assembly Bill 2307 was passed on September 10, 2004 which, effective July 1, 2005, allows Primary Care Clinics to simultaneously apply to be a Qualified PE provider while applying to become a Medi-Cal provider.
Learn about the process and obtain the forms to simultaneously apply for the following health programs as you apply for a clinic license: Medi-Cal Presumptive Eligibility (PE) for Pregnant Women; Child Health and Disability Prevention (CHDP) Program; Comprehensive Perinatal Services Program (CPSP); and Family Planning, Access, Care and Treatment (Family PACT).
This link will take you to the Department of Health Services, Licensing and Certification Unit which, processes provider applications for primary care clinics among other types of providers.
For more information about Licensing and Certification and for contacts, please go to the Licensing and Certification Website at Centralized Applications Unit - Home