Tsev Cov Ntaub Ntawv & Cov Txheeb Xyuas Cov Lus Nug Feem Ntau Txog Kev Tshaj Tawm thiab Kev Saib Xyuas Cov Ntaub Ntawv ntawm DHCS Webinar Series

DHCS Cov Ntaub Ntawv Qhia thiab Saib Xyuas Webinar Series Cov Lus Nug Nquag

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Rov qab mus rau cov ntaub ntawv webinar

General

Cov no puas yuav nyob rau tib hnub/lub sijhawm txhua hli li lub rooj sib tham hauv online no?
Lub rooj sib tham hauv online no yuav muaj nyob rau hnub Wednesday thib 4 ntawm txhua lub hlis.
Puas yuav swb lawj muab faib tom qab lub webinar?
Cov ntawv qhia swb raug muab tso rau txhua hli ntawm nplooj ntawv web. Lub vev xaib webinar tam sim no nyob. Cov ntaub ntawv hais txog cov webinars yav dhau los, xws li kev nthuav qhia thiab kev kaw suab, FAQs, thiab lub sijhawm webinar tom ntej tuaj yeem pom ntawm qhov txuas no (Quality Webinar Series (ca.gov)).
Puas yog nws yuav tsum tau mus koom lub webinars yog tias peb qhov kev txaus siab tsis yog txog thaum lub Kaum Ib Hlis 2022?
Peb txhawb kom cov neeg tuaj koom tuaj koom ib qho webinar raws li lawv cov kev txaus siab thiab kev ua haujlwm.
Puas yuav muaj ib daim vis dis aus tso rau peb saib yog tias peb tsis nco nws lossis peb tuaj yeem xa mus rau cov neeg ua haujlwm tsim nyog?
Yog lawm, txhua lub rooj sib tham hauv online yuav raug kaw cia, thiab cov yeeb yaj kiab thiab cov ntaub ntawv sau cia yuav raug tshaj tawm rau ntawm nplooj ntawv web Quality Webinar Series (ca.gov).
Puas yog DHCS puas thov muab daim ntawv qhia kev koom tes ntawm EDIM division?
Peb qhia cov neeg ua haujlwm tiv tauj kom raug thaum lub sijhawm webinar. Yog tias koj tsis paub tseeb tias yuav tiv tauj leej twg, peb xav kom koj siv lub thawv xa ntawv hauv qab no.
274 Kev Kho Mob (MCP): MCQMDProviderData@dhcs.ca.gov
274 Kev Noj Qab Haus Huv Tus Cwj Pwm (MHP & DMC-ODS): 274Expansion@dhcs.ca.gov
274 Kev Kho Hniav: DMCdeliverables@dhcs.ca.gov
Kev Sib Tham: MMCDEncounterData@dhcs.ca.gov
BH Short Doyle: MEDCCC@dhcs.ca.gov
Cov kev thov nkag mus rau Chaw Sau Ntawv DHCS: dataexchange@dhcs.ca.gov
PACE: PACECompliance@dhcs.ca.gov
Peb yuav ntxiv cov tib neeg rau Webex series li cas?
Thov xa email ncaj qha mus rau MCDSS@dhcs.ca.gov thiab sau cov npe thiab email ntawm cov neeg uas koj xav caw. Lawv kuj tseem tuaj yeem saib cov webinar thiab cov slides uas peb tshaj tawm txhua hli ntawm nplooj ntawv web no (Quality Webinar Series (ca.gov)).
Puas yog Qhov Kev Ntsuas Zoo thiab Kev Tshaj Tawm Qhov chaw qhib rau leej twg?
Yog, nws muaj rau pej xeem siv. Kev Ntsuas Zoo & Kev Tshaj Tawm (ca.gov)
Puas yuav muaj cov ntsiab lus dav dav ntawm cov ntsiab lus (nrog rau tag nrho los ntawm cov kev nthuav qhia sib txawv) yuav muab tso rau hauv Qhov Kev Ntsuas Zoo & Kev Tshaj Tawm?
Yog. Koj tuaj yeem tshawb xyuas cov npe ntawm cov lus luv thiab cov lus txhais uas siv ntau hauv Quality-Webinar-Glossary (ca.gov). Peb muaj ib txoj kev npaj los txuas ntxiv mus ntxiv thiab hloov kho tshiab. Yog koj muaj lus nug thiab xav paub ntxiv, thov email rau MCDSS@dhcs.ca.gov.
Peb puas muaj lub sijhawm kwv yees kom tau txais cov lus teb los ntawm tus EDIMdatasupport@dhcs.ca.gov pab pawg, lossis ib qho qhia txog thaum twg peb tuaj yeem cia siab tias yuav hnov qab?
Feem ntau yog 1-2 hnub ua haujlwm. Yog koj tsis hnov lus teb, thov rov qab xa dua.
Yuav ua li cas lub nroog nce / thov nkag mus rau Teams View ntawm Doc Center.
Yog xav tau kev nkag mus rau Doc Center, thov xa daim ntawv thov mus rau DataExchange@dhcs.ca.gov

274 PAB

Peb tau tshaj tawm txog kev mob hlwb ntawm peb cov kev kho mob 274, suav nrog cov chij rau thaj chaw kho mob hlwb ntawm cov kws tshaj lij. Puas yog cov no yuav nyob rau ntawm cov ntaub ntawv cais tam sim no?
Cov MCPs yuav txuas ntxiv xa 274 cov ntaub ntawv raws li cov lus qhia hauv 274 MCP Companion Guide. Cov ntaub ntawv Kev Noj Qab Haus Huv Lub Siab uas tau hais txog hauv (CG) yog hais txog cov kev pabcuam kev noj qab haus huv lub siab uas MCP muab tsis yog cov nroog. Qhov no suav nrog ob lub ntsiab lus ntawm cov ntaub ntawv no:
B.9 Cov Cai ntawm Tus Kws Muab Kev Pabcuam Kev Noj Qab Haus Huv Lub Siab (2100EA N202)
B.10 Cov Cai ntawm Tus Kws Muab Kev Pabcuam Kev Noj Qab Haus Huv Lub Siab (2100EA N202)
Puas yuav muaj cov kev hloov tshiab tshiab lossis kho dua tshiab ntawm 274 phau ntawv qhia txog kev pabcuam hauv lub sijhawm ze ze no txog cov APL tshiab tshwj xeeb rau cov hom kws kho mob tshiab xws li Doula thiab kev hloov pauv nyob ib puag ncig Cov Kws Kho Mob uas ua tau raws li cov qauv rau kev tsis tas yuav tsum tau saib xyuas ntawm kws kho mob thiab lwm yam kev hloov pauv uas xav tau?
Phau Ntawv Qhia Tus Khub hloov tshiab yog ua thaum twg APLs tshiab thiab lwm yam kev hloov pauv xav tau hloov tshiab. Thaum cov kev hloov pauv rau Medicaid txoj cai lossis HIPAA cov kev cai cuam tshuam yuav tsum tau hloov pauv hauv txoj hauv kev cov ntaub ntawv tau tshaj tawm ntawm kev hloov pauv uas twb muaj lawm, (xws li 274), Daim Ntawv Qhia Txog Tus khub yuav raug hloov kho kom muaj kev cuam tshuam cov kev hloov pauv no.
Lub koom haum tshiab no puas suav nrog kev saib xyuas cov ntaub ntawv Medi-Cal FFS? Yog tias muaj, cov phiaj xwm / sijhawm yuav txav deb ntawm California cov cai hauv zos yog dab tsi. Cov lej no txuas ntxiv ua rau muaj kev sib tw hauv Chaw Tswj Xyuas Kev Tswj Xyuas?
Qhov no suav nrog kev saib xyuas cov ntaub ntawv FFS, txawm li cas los xij, Phau Ntawv Qhia Tus Muab Kev Pabcuam thiab lwm yam kev taw qhia uas muaj nyob hauv Medi-Cal qhov chaw tsis yog npaj los muab kev qhia lej lossis kev qhia them nqi rau cov kws kho mob uas tau cog lus rau MCPs, lossis leej twg xa daim ntawv thov rau MCPs. Cov chaw muab kev pabcuam uas xa FFS style thov rau MCPs rau kev them nyiaj tseem yuav tsum tau siv HIPAA Raws Li Txoj Cai Hauv Tebchaws. Cov lej hauv zos tsis raug tso cai.
Thov txim rau qhov rov ua dua, tab sis tsuas yog kom paub tseeb tias MCPs TSIS tas yuav xa daim ntawv 274 tshiab, cais rau MH thiab yuav xa tsuas yog ib daim ntawv 274 suav nrog ob qho kev kho mob thiab cov kws kho mob MH?
Cov ntaub ntawv kev pabcuam kev noj qab haus huv hauv nroog raug xa mus cais los ntawm lub nroog, tsis yog MCPs.
Cov lus qhia tshiab tshaj plaws ntawm 274 tus khub yog dab tsi?
Cov ntawv qhia txog Kev Kho Mob/Lub Cev 274 uas siv tau rau cov ntaub ntawv muab kev pab kho mob yog v. 2.2.
Daim ntawv qhia txog Kev Noj Qab Haus Huv Lub Siab (CG) tshiab tshaj plaws yog v.1.7 (Thov nco ntsoov tias, yuav muaj ib daim ntawv qhia txog Kev Noj Qab Haus Huv Lub Siab tshiab uas suav nrog ob daim ntawv qhia txog Kev Noj Qab Haus Huv Lub Siab thiab daim ntawv qhia txog DMC-ODS CG). Tus lej version thiab daim qauv yuav raug muab qhia sai sai no, TBD).
Thaum twg yuav tau tshaj tawm 274 tus khub phau ntawv qhia? Zoo li cov ntaub ntawv hais txog qee tus NP tuaj yeem xyaum yam tsis tau saib xyuas cov kws kho mob yav tom ntej, xav tau kev qhia hloov tshiab yuav ua li cas qhia cov NP ntawm 274 yam tsis tau saib xyuas cov kws kho mob.
Feem ntau, Cov Ntawv Qhia Txog Kev Npaj Ua Haujlwm (CGs) raug luam tawm thawj zaug hauv daim ntawv DRAFT thiab muab faib rau cov phiaj xwm rau kev tshuaj xyuas thiab cov tswv yim. Thaum lub voj voog ntawd tiav lawm, daim ntawv kawg ntawm CG raug tshaj tawm rau DHCS Documentation Center (DDC).
Daim ntawv qhia ua ke rau kev sib pauv cov ntaub ntawv ntawm tus kws kho mob Behavioral Health tab tom raug hloov kho kom suav nrog kev qhia txog Kev Noj Qab Haus Huv Lub Siab thiab DMC-ODS. Ib daim DRAFT tab tom raug tshuaj xyuas tam sim no thiab yuav raug qhia rau cov neeg koom tes ua lag luam kom tshuaj xyuas hauv ib lossis ob lub lim tiam tom ntej.
Thov paub meej tias QMED v2 tseem tab tom ua haujlwm? / Tsis yog 274 muaj feem cuam tshuam, tab sis cov ntaub ntawv ntsib muaj feem cuam tshuam. Peb puas tuaj yeem tau txais qhov hloov tshiab ntawm qhov xwm txheej ntawm QMED v2?
Yog lawm, QMED v2 tseem ua haujlwm.
Koj puas tuaj yeem piav qhia ntxiv txog "kev kho txhua cov lus ceeb toom"? Txog tam sim no, peb tsis tau ua li ntawd.
Cov phiaj xwm yuav tsum tau hais txog cov lus ceeb toom thiab xa cov ntaub ntawv rov qab yog tias muaj cov ntaub ntawv tsis sib xws hauv JSON cov ntaub ntawv. Yog tias cov phiaj xwm tsis txheeb xyuas cov ntaub ntawv teeb meem hauv qhov kev ntsuas tshwj xeeb, cov phiaj xwm yuav tsum tau ceeb toom rau DHCS los ntawm email txog vim li cas rau cov lus ceeb toom.
Peb puas yuav tsum teb rau email txawm tias cov phiaj xwm tau dhau tag nrho cov ntaub ntawv ntsuas MDC?
Yog, peb xav kom koj teb email, txawm tias nws tsuas yog lees paub tias tau txais lawm los xij.
Koj puas tuaj yeem qhia rau peb paub yog tias e-consult tsuas yog cov neeg muab kev pabcuam (uas tsuas yog sib txuas lus nrog lwm tus neeg muab kev pabcuam thiab tsis yog tswvcuab) yuav tsum tau suav nrog 274?
Nws yuav hloov kho sai li sai tau thaum peb muaj cov lus teb sib xws. Ua tsaug rau koj ua siab ntev.
Lub hli tas los no 274 MDC tau suav nrog cov sijhawm ua ntej lub hli tshaj tawm tsis ntev los no. Thov qhia yog tias DHCS tau hloov ntawm kev tshaj tawm txhua hli mus rau cov sijhawm tshaj tawm ua ntej.
274 MDC tsab ntawv ceeb toom npog cov ntaub ntawv los ntawm lub hli dhau los, ua ntej lub hli xa.
Koj puas tuaj yeem txhais QIMR? Hnub mus-nyob rau QIMR yog dab tsi?
QMIR yog Daim Ntawv Qhia Txog Kev Saib Xyuas Kev Siv Txhua Peb Hlis thiab QIMR tau npaj yuav "mus ua haujlwm" thaum lub sijhawm ib nrab xyoo tom ntej ntawm xyoo 2024.
Tam sim no QIMR daim ntawv tshaj tawm (EXCEL) yuav raug txiav tawm txij Lub Ib Hlis 2024?
Tsis yog. QIMR Excel tsab ntawv ceeb toom txuas ntxiv mus txog thaum tag nrho cov ntsiab lus ntawm Excel tsab ntawv ceeb toom hloov mus rau JSON hom.
Muaj 274 cov ntaub ntawv xa los ntawm cov phiaj xwm kho mob, tsis yog los ntawm cov chaw pabcuam kev noj qab haus huv?
Qhov no yog qhov tseeb, 274 cov ntaub ntawv xa mus rau DHCS los ntawm cov phiaj xwm kho mob kho mob, kho hniav thiab kev coj cwj pwm uas tau cog lus rau DHCS.
Cov ntaub ntawv 274 lossis PNR puas muaj cov ntaub ntawv zoo, piv txwv li kev siv fluoride?
Cov ntaub ntawv 274 thiab PNR tsuas yog suav nrog cov ntaub ntawv network ntawm tus neeg muab kev pabcuam xwb, tsis muaj cov ntaub ntawv siv.
Dab tsi depts xa tawm QMED cov ntawv ceeb toom?
Cov Ntaub Ntawv Qhia Txog Qhov Zoo Tshaj Lij xa tawm QMED Cov Ntawv Qhia rau Cov Kev Npaj Kho Mob raws li peb lub hlis twg.
Puas yog PACE cov kev pabcuam xav kom tau txais cov no?
PACE Plans/Organizations yuav tau txais QMED ua ib feem ntawm QMED 2.0 PACE. Cov kev pab cuam uas tam sim no tsis tau txais cov no yuav nyob rau yav tom ntej.
Puas yog PACE cov phiaj xwm xav kom xa 274s?
PACE cov phiaj xwm tam sim no tsis xa 274 kev hloov pauv. Ntau dua yuav muab qhia txog qhov sau cov ntaub ntawv. Tshwj xeeb, Kev Kho Hniav tam sim no tsuas yog tau txais / saib xyuas 274 cov ntaub ntawv los ntawm peb cov phiaj xwm DMC (tsis suav nrog PACE).

Cov ntaub ntawv MCPD/PCPA

Rau cov ntaub ntawv Primary Care Physician Assignment (PCPA) yog qhia rau FQHCs ua tiav ntawm qhov chaw thiab tsis mus rau PCP?
Cov ntaub ntawv PCPA siv cov ntaub ntawv los tshaj tawm Cov Kev Pab Cuam Rau Tus Kws Khomob Ntiag Tug. Kev tshaj tawm yog ua tiav ntawm qib kws kho mob. Tsis muaj qhov chaw cov ntaub ntawv theem.
Peb tau tshaj tawm cov npe ntawm cov peev txheej tshiab tsis txaus siab thiab hom txiaj ntsig ntxiv rau cov npe uas twb muaj lawm ntawm hom kev tsis txaus siab tam sim no hauv MCPD schema v3.02. Peb ntseeg tias cov no txawv ntawm hom kev tsis txaus siab uas twb muaj lawm thiab yuav pab peb kom paub meej txog peb qhov kev tsis txaus siab thiab txhim kho peb qhov kev ceeb toom tsis txaus siab. Thaum twg peb tuaj yeem cia siab tias cov no yuav raug pom zoo thiab muaj los siv?
Kev tsis txaus siab tab tom tham thiab kev hloov kho tshiab ntawm hom tshiab uas tau hais tseg yuav raug qhia sai sai.
Cov lus ceeb toom hauv MCPD thiab PCPA cov ntaub ntawv teb feem ntau cuam tshuam txog cov teeb meem ua tswv cuab uas feem ntau tau txheeb xyuas los ntawm kev xa mus tom ntej. Raws li qhov xwm txheej twg yuav xav tau kom rov xa cov ntaub ntawv MCPD thiab PCPA cov ntaub ntawv hais txog cov lus ceeb toom?
Thaum lub sijhawm ua lag luam kho kom raug siv tau, tej zaum yuav muaj qhov xwm txheej uas cov lus ceeb toom yuav raug txheeb xyuas. Cov lus ceeb toom yuav tsis ua rau tsis lees txais cov ntaub ntawv thiab yog npaj los qhia rau tus neeg xa ntawv txheeb xyuas cov teeb meem yav tom ntej uas yuav dhau los ua qhov yuam kev yav tom ntej. DHCS nug tias MCPs raug ceeb toom thiab xa cov ntaub ntawv rov qab.
Hnub Tim Production Go-Live yog dab tsi rau cov kev hloov no? DHCS puas tuaj yeem thov qhia meej ntawm PCPA Production Go-Live teem rau 01/01/2025?
Hnub tim yuav tshaj tawm sai sai. Kev Xeem Ib puag ncig yuav muaj los ntawm 01/01/2025, nrog rau Kev Tsim Kho Ib puag ncig yuav nyob los ntawm 02/01/2025, uas yuav suav nrog kev tshaj tawm rau Lub Ib Hlis cov ntaub ntawv.
Thaum twg SCHEMA cov ntaub ntawv yuav raug tso tawm kom Plans tuaj yeem kuaj thiab siv tau rau nws?
Daim ntawv qhia txog schema yuav raug tso tawm thiab muaj nyob rau hauv DHCS Doc Center tom qab kev faib tawm ntawm Final Technical Guide kev sib txuas lus.
Rau kev kuaj PCPA, peb yuav tsum txuas ntxiv siv tsuas yog kuaj CINs?
Yog lawm, Cov phiaj xwm yuav tsum tsuas yog siv cov ntawv xeem CINs thaum xa cov ntaub ntawv xeem. Test CINs yog tsim los xyuas kom meej tias cov ntaub ntawv dhau los ntawm kev tso npe / kev tsim nyog tau txais kev pom zoo. Txhua qhov yuam kev uas tau ntsib nrog kev sim CINs hauv cov ntaub ntawv xeem tuaj yeem tsis lees paub. Txawm li cas los xij, yog tias cov ntaub ntawv xeem tsis ua tiav vim qhov kev xeem CIN yuam kev, thov hu rau DHCS rau kev pab.
DHCS puas tuaj yeem muab kev qhia meej ntawm PCPA mus nyob hnub tim 01/01/2025?
Cov phiaj xwm yuav tsum pib xa cov ntaub ntawv xeem pib txij li 01/01/2025, vim qhov chaw xeem yuav muaj nyob rau lub sijhawm ntawd.
Yuav tsum muaj hnub twg tso tawm, thiab qhov txawv ntawm daim version tam sim no thiab daim version kawg ntawm Technical Guide yog dab tsi?
Hnub pib tsim khoom yog teem rau 02/01/2025. Daim Qauv Qhia Txog Kev Siv Tshuab tam sim no suav tias yog Qauv Qhia Zaum Kawg, tsis muaj kev hloov pauv ntxiv rau PCPA qhov qauv lossis daim duab qhia. Phau Ntawv Qhia Txog Kev Siv PCPA yav dhau los yog ib feem ntawm phau ntawv qhia MCPD/PCPA ua ke; tam sim no nws tau raug cais tawm lawm. Daim Qauv Kawg muaj cov ntsiab lus ntxiv rau PCPA schema, uas tau piav qhia nyob rau hauv daim ntawv qhia tshiab kawg.
Puas yog PCPA vs 274 kev sib piv tau ua nyob rau ntawm tus kws kho mob lossis qib chaw, lossis ob qho tib si?
DHCS Cov Ntaub Ntawv Kev Tshawb Fawb, koom tes nrog DHCS cov cheeb tsam kev pab cuam (MCOD, MCQMD, QPHM), ua kev soj ntsuam ntawm cov ntaub ntawv xa tuaj. Yog xav paub ntxiv, thov hu rau koj tus neeg saib xyuas qhov kev pab cuam cheeb tsam.

Sib ntsib cov ntaub ntawv

Cov ntaub ntawv ntsib yog dab tsi?
Cov ntaub ntawv ntsib raug xa mus rau X12 837 EDI kev hloov pauv. Cov ntaub ntawv sib ntsib sawv cev rau cov ntaub ntawv thov uas twb tau txiav txim siab thiab them nyiaj. Cov ntaub ntawv sib ntsib yog siv nyob rau hauv Kev Kho Mob, Kho Hniav, thiab Tus Cwj Pwm Tswj Tus Qauv.
Thaum twg EDQ daim ntawv tshaj tawm yuav raug hloov kho kom tsis suav nrog Rx cov ntaub ntawv?
Rx cov ntaub ntawv yuav raug tshem tawm nrog QMED version tom ntej, uas tau npaj rau hloov tshiab ua ntej xyoo kawg.
Raws li peb paub Cov Ntaub Ntawv Sib Tham yuav tsum muaj cov lej hauv tebchaws rau kev thov nyiaj. Hauv DHCS lub vev xaib peb tuaj yeem pom cov ntawv ceeb toom txog kev hla kev taug kev hauv zos rau HIPAA Raws Li Txoj Cai Hauv Tebchaws, tab sis koj xav tias qhov project no yuav pib thaum twg? Peb pom muaj tsab ntawv ceeb toom pib LTC hauv 2023, tab sis tsis muaj hnub kawg? Ib qho kev nkag siab rau ncua sij hawm rau qhov project no yuav zoo siab heev.
Cov Lus Ceeb Toom thiab cov lus qhia yog rau cov neeg uas tau txais cov nqi them rau kev pabcuam uas xa cov ntawv thov kom them ncaj qha rau DHCS. DHCS tab tom npaj yuav piav qhia txog cov lus qhia uas pom muaj nyob rau ntawm lub vev xaib Medi-Cal, tab sis yuav tsum tau hais tias cov neeg muab kev pab uas xa cov ntawv thov rau Managed Care Plans yuav tsum siv cov HIPAA Compliant National Codes hauv txhua kis. Cov neeg muab kev pab uas xa cov ntaub ntawv thov rau MCPs yuav tsum siv cov HIPAA Compliant National Codes tas mus li.
Daim ntawv FFS LTC qub (LTC-25) tab tom raug tshem tawm. Cov kev hloov tshiab yuav raug siv rau nruab nrab xyoo 2023 tab sis hnub "mus ua haujlwm" rau kev siv 837 thiab cov cai hauv tebchaws tseem tsis tau txiav txim siab vim muaj kev txhawj xeeb txog kev kawm thiab kev cob qhia txog zej zog cov neeg muab kev pabcuam tam sim no. Cov hnub nyob ruaj khov suav nrog lub Kaum Hli 2023.
Koj txhais li cas tias yog kev ntsib ob zaug?
Kev ntsib raug soj ntsuam rau cov kev sib ntsib uas zoo ib yam ntawm theem kab kev pabcuam. Yog tias pom tias ib txoj kab kev pabcuam zoo ib yam li ib txoj kab kev pabcuam uas tau xa ua ntej lawm, tag nrho qhov kev sib ntsib yuav raug tsis lees paub.
Thov koj muab piv txwv txog cov ntaub ntawv theej?
Ib qho kev ntsib/kab kev pabcuam uas zoo sib xws sawv cev rau tib qho xwm txheej zoo li qhov kev ntsib uas tau xa ua ntej. Lub kaw lus ntsib PACES muaj cov logic duplicate uas saib ntau cov ntaub ntawv los txiav txim siab seb qhov kev ntsib puas tau xa ua ntej. Yog tias cov ntsiab lus ntawm cov ntaub ntawv phim qhov kev ntsib dhau los, nws raug tsis lees paub tias yog qhov theej. Tshooj 3.8 ntawm DHCS Encounter Data Companion Guides muab cov ntsiab lus ntawm kev ntsib ob zaug. Koj tuaj yeem rub tawm cov Companion Guides los ntawm DHCS Documentation Center. Yog xav tau kev tso cai nkag mus rau Doc Center thov xa daim ntawv thov mus rau DataExchange@dhcs.ca.gov.
Cov ntaub ntawv no puas siv tau rau txhua hom kev thov, tshwj xeeb, kev thov kev noj qab haus huv ntawm tus cwj pwm?
Vim tias cov lus thov BH raug ua los ntawm Short Doyle system, cov laj thawj uas tau tham txog ntawm no tsis siv rau cov lus thov BH lub sijhawm no. Cov Lus Qhia Sib Txuas uas muab tso rau hauv cov nplaub tshev BHIS yog cov uas siv los hais txog cov lus thov BH.
Cov ntaub ntawv thov uas tsis yog BH thiab cov ntaub ntawv thov uas tsis yog tshuaj thiab cov ntaub ntawv ntsib raug xa mus rau PACES ua cov ntaub ntawv ntsib. Cov ntaub ntawv sib ntsib ob zaug no muaj feem cuam tshuam ncaj qha rau cov lus thov thiab kev ntsib no.
Yog tias peb muaj lus nug txog cov xwm txheej tshwj xeeb thiab/lossis piv txwv, leej twg yog tus neeg zoo tshaj plaws los tiv tauj?
Thov xa email rau Data Quality Reporting Unit MMCDEncounterData@1webteam
Koj puas muab tau daim ntawv teev cov lej txheej txheem uas zoo ib yam, piv txwv li, thaum siv txheej txheem rau txhua lub qhov muag, pob ntseg, thiab lwm yam sib cais?
Peb tsis tuaj yeem muab cov npe ntawm cov lej raws li tau thov. Txawm li cas los xij, thaum muaj kev sib ntsib siv tib hom txheej txheem hauv ntau yam kev pabcuam, cov kev sib piv tuaj yeem zam tau los ntawm kev siv cov txheej txheem hloov kho, xws li 59, 76, thiab 77. Tab sis ntxiv cov kev hloov kho rau qhov kev ntsib, qhov no qhia rau PACES system kom hla dhau qhov kev xav sib npaug thiab kho qhov kev ntsib/kab kev pabcuam ua ib qho xwm txheej tshwj xeeb thiab tsis yog qhov sib npaug ntawm qhov kev ntsib dhau los. Saib Tshooj 3.8 ntawm DHCS Companion Guides
Puas muaj kev sib tham txog kev TSIS suav cov kev lag luam tsis muaj txiaj ntsig rau kev ntsuas sijhawm?
Tsis yog, peb tsis tau muaj kev sib tham ntawd. Peb xav tau cov qhov khoob kom ntseeg tau tias kev sib ntsib tau ua tiav. Yuav tham txog qhov zoo thiab qhov tsis zoo ntawm cov khoom. Yuav muab cov xov xwm tshiab thaum muaj kev sib tham tiav lawm.
Yog tias peb yuav tsum xa ib qho chaw khoob thiab hloov chaw, DHCS puas tuaj yeem xav txog kev nplua rau cov phiaj xwm raws sijhawm rau ib qho ntawm cov kev sib ntsib ntawd es tsis yog ob qho tib si?
QMED DRMT.001 cov qhab nia Cov phiaj xwm ntawm lub sijhawm tig rov qab ntawm thaum qhov kev ntsib thawj zaug raug tsis lees paub thiab thaum twg qhov hloov pauv / tsis muaj dab tsi raug lees txais. Yog koj yuav tsum xa ib daim ntawv hloov thiab ib daim ntawv tsis muaj dab tsi, QMED yuav muab qhab nia rau koj rau thawj daim uas tau txais. Yog tias koj ua raws sijhawm zoo, ces QMED yuav tsis tso koj cov qhab nia tseg. Saib QMED v1.1, Ntu 4.1 DRMT.001 kom paub meej ntxiv txog lub sijhawm tig rov qab ntawm kev ntsib tsis raug cai.
Cov phiaj xwm yuav tsum xa cov ntaub ntawv hloov pauv ntau yam ntsig txog Kev Hloov Kho Tus Nqi Target Rate Increase thaum kawg ntawm lub xyoo no. Puas yog DHCS yuav xav txog kev zam txim rau lub sijhawm teem tseg rau cov kev hloov pauv no?
Peb yuav tham nrog cov thawj coj thiab pab pawg PACES kom paub seb yuav ua li cas txog qhov ntawd. Tsis ntseeg tias qhov ntawd yog qhov tseeb tab sis yuav xyuas kom meej nrog kev tswj hwm.
Puas yog cov algorithm rau kev tsis suav nrog kev hloov pauv tsis yog ib feem ntawm QMED v2?
Peb yuav qhia rau koj txhua tus paub thaum QMED 2.0 ua tiav.
Puas yog DHCS tuaj yeem qhia cov ntaub ntawv/ntawv tshaj tawm txog kev ceev ntiag tug ntawm cov ntaub ntawv thiab kev xa mus rau lwm lub tebchaws? Qhov txuas (link) uas muab rau koj no tsis coj koj mus rau txoj cai/lus qhia/ntawv tshaj tawm ncaj qha.
Qhov txuas yuav raug muab qhia los ntawm koj tus thawj tswj kev sib cuag.
Puas muaj tej qhov chaw loj tshaj plaws uas yuav ua rau cov ntaub ntawv zoo dua rau kev ntsib? Ib qho chaw khaws cov ntaub ntawv lossis hom yuam kev?
Tam sim no peb tab tom ua kev tshuaj xyuas txog cov cheeb tsam uas muaj lub cib fim los txhim kho qhov zoo ntawm cov ntaub ntawv. Kev sib koom tes thiab kev sib txuas lus ntxiv nrog Cov Phiaj Xwm yuav los txog rau qhov ntawd.
Puas yog yuav tsum muaj kev thauj mus los rau PACE?
Yog lawm, PACE cov phiaj xwm yuav xa cov ntaub ntawv ntsib txhua lub sijhawm lawv muab kev pabcuam rau ib qho ntawm lawv cov neeg koom.
Ib qho uas yuav tsum xav txog rau cov kev pab cuam PACE, yog hais txog ob tug tswv cuab ntawm PACE, peb tab tom ua haujlwm los xa tag nrho cov kev ntsib rau txhua yam ntawm kev saib xyuas, kev kho mob, kev kho hniav, kws kho mob tshwj xeeb, chaw zov menyuam thaum nruab hnub, kev qhuab qhia IDT, kev thauj mus los, thiab lwm yam rau CMS thiab DHCS. Peb tab tom yuav ua kom tiav tag nrho cov ntaub ntawv qhia txog kev ntsib rau ob lub koom haum CMS thiab DHCS. Puas muaj tej phiaj xwm los txo qhov kev tshaj tawm cov ntaub ntawv ntsib ob leeg no?
Qhov teeb meem no yuav raug tshuaj xyuas ua ib feem ntawm Encounter Data Improvement Project.
Cov phiaj xwm puas yuav tsum xa cov kev ntsib uas tsis tau lees paub hauv lawv cov ntawv xa tuaj?
a) Yuav kom meej meej - lo lus "tsis lees txais cov lus thov/kev ntsib" txhais tau tias yog cov lus thov uas tus neeg muab kev pab tau xa mus rau txoj kev npaj tab sis txoj kev npaj tsis kam them lossis lees txais .
b) Rau cov kev ntsib uas tau xa los ntawm Txoj Kev Npaj tab sis DHCS tsis kam lees, thov saib DHCS-PACES 837I, 837D, thiab 837P Cov Lus Qhia Sib Koom Tes, tshwj xeeb yog Tshooj 3.4. Cov lus qhia no muaj cov lus qhia rau kev xa cov ntaub ntawv ntsib, suav nrog qhov sib txawv ntawm kev tsis lees paub, kev tsis lees paub, thiab kev lees txais . Cov kev ntsib uas raug tsis lees paub yuav tsum tau kho thiab xa rov qab mus rau DHCS PACES system.
Yuav siv kev ntsuas dab tsi rau cov nyiaj them? Muaj ib txhia neeg xa ntawv tsis kam qhia cov nyiaj uas tau them lawm, MCP puas yuav xav tau qhov no?
Cov Phiaj Xwm Muaj Peev Xwm (Hom Ntawv Cog Lus = 5) yuav tsum xa cov ntaub ntawv xav tau raws li tau teev tseg hauv Cov Lus Qhia Sib Tham, tshwj xeeb yog Tshooj 3.18 - 3.29. Ua tus them nqi Medicaid, DHCS muaj cai yuam kom xa cov nqi them rau txhua qhov kev pabcuam Medicaid uas tau muab, txawm tias los ntawm Capitation lossis kev them ncaj qha rau cov neeg muab kev pabcuam uas tau cog lus los ntawm Managed Care Plan.
Ib tus neeg muab kev pab puas muaj peev xwm muaj ntau hom neeg muab kev pab? Puas yog DHCS saib xyuas txhua hom neeg muab kev pab ib tus zuj ib tus?
Yog, ib tus neeg muab kev pab cuam yuav muaj ntau hom neeg muab kev pab cuam. Yuav kom meej meej, DHCS cais qhov txawv ntawm Hom 1 (cov neeg muab kev pabcuam ib leeg) thiab Hom 2 (cov neeg muab kev pabcuam hauv lub koom haum).
Puas muaj cov peev txheej lossis cov ntaub ntawv cob qhia uas tsom mus rau qhov zoo ntawm kev xa mus ntsib?
Yog, muaj ntau qhov chaw muab kev pab rau kev xa cov ntaub ntawv ntsib:
Phau Ntawv Qhia Txog Tus Muab Kev Pab Medi-Cal
X12 EDI Piv Txwv | X12
HIPAA X12 EDI Kev Kawm Pob Khoom | EDI Blog
Puas muaj phau ntawv qhia siv lossis cov lus nug nquag nug txog cov cai hauv zos thiab cov kev cai ntawm lub xeev/tsoomfwv tebchaws tau?
Phau Ntawv Qhia Them Nqi Medi-Cal tam sim no, uas tau tsim los rau lub kaw lus them nqi thov FFS qub, suav nrog cov lus qhia rau kev xa cov cai hauv zos. Txawm li cas los xij, DHCS qhov kev pab cuam Managed Care tsis txhawb kom siv cov cai hauv zos hauv kev xa daim ntawv thov. DHCS tau muab ib txoj kev hla rau MCPs los txuas cov lej hauv zos mus rau cov lej HIPAA-ua raws li lub tebchaws rau kev ua cov ntaub ntawv ntsib. DHCS kuj tseem tab tom ua haujlwm los muab cov lus qhia tshwj xeeb ntxiv los pab cov neeg muab kev pabcuam hloov mus rau cov cai hauv tebchaws.
Vim li cas cov lus thov tsis raug lees txais los ntawm kev ntsib, thiab puas yog lawv tsim cov ntawv theej?
DHCS tab tom ua haujlwm los daws cov teeb meem ntsig txog kev sau cov lus thov uas tsis tau lees paub. Cov neeg koom tes ua lag luam yuav raug thov kom qhia ob qho tib si cov ntaub ntawv thov/kev ntsib uas tau xa thawj zaug tab sis tom qab ntawd tsis lees paub thiab cov ntaub ntawv teb uas tau muab los ntawm txoj kev npaj.
Puas yog DHCS yuav xav tau ib daim teb tshiab ntawm cov ntawv thov kom paub txog cov ntawv thov uas tsis tau them lossis 0 daim ntawv thov uas tsis tau them?
DHCS lees paub cov teeb meem uas cuam tshuam nrog kev xa cov lus thov tsis raug cai mus rau lub txheej txheem txiav txim siab. Txawm hais tias tsis tau muaj kev txiav txim siab zaum kawg los xij, DHCS tab tom tsim ib txoj kev los xa cov lus thov uas tsis tau lees paub rau PACES. Txoj kev qhia no yuav txiav txim siab txog cov lus thov uas tau txiav txim siab ua ntej xa mus rau DHCS.
DHCS puas tuaj yeem piav qhia qhov txawv ntawm cov lus qhia hauv Phau Ntawv Qhia Txog Kev Them Nqi Medi-Cal thiab Encounter Data Companion Guides?
Rau kev ntsib nrog kev tswj hwm kev saib xyuas, cov phiaj xwm thiab cov neeg muab kev pabcuam yuav tsum xa mus rau PACES 837 Companion Guides. Phau Ntawv Qhia Txog Kev Them Nqi Medi-Cal yog rau cov txheej txheem them nqi thov kev pab cuam Fee-For-Service (FFS) thiab tsis siv tau rau cov ntawv xa tuaj ntsib. Cov kws kho mob uas tau cog lus nrog txoj kev npaj kho mob yuav tsum vam khom DHCS-PACES 837 Encounter Data Companion Guides, tsis yog Medi-Cal Billing Manual, thaum npaj cov ntawv thov thiab kev ntsib rau kev xa ntawv.
Puas muaj peev xwm muab cov lus qhia ntxiv txog cov kev thov nyiaj pab los ntawm lub koom haum, xws li hom nqi thiab hnub tso tawm?
DHCS tab tom ua haujlwm los hloov kho cov Lus Qhia Sib Koom Tes kom suav nrog cov lej tshwj xeeb thiab lwm cov ntaub ntawv, xws li cov lej nyiaj tau los, hom lej them nqi, thiab cov lej tshwj xeeb rau LTC/PACE. Cov kev hloov tshiab no yuav raug tshaj tawm rau DHCS Documentation Center thiab tom qab ntawd rau ntawm lub vev xaib DHCS.
Hais txog Cov Cai Hauv Zos thiab Cov Cai Txog Cov Nyiaj Tau Los, MCPs tau txais kev qhia kom siv cov cai hauv tebchaws, tab sis daim ntawv teev nqi Medi-Cal tseem teev cov cai hauv zos. Muaj kev nce qib dab tsi lawm?
Cov phiaj xwm yuav tsum siv cov lej nyiaj tau los hloov cov lej hauv zos. Yog tias tus lej nyiaj tau los teev nyob rau hauv MCP Local Code Crosswalk, nws qhia tau tias tsis muaj tus lej txheej txheem twg tuaj yeem txuas nrog tus lej hauv zos. Yog xav paub ntxiv txog kev hloov pauv ntawm cov cai hauv zos mus rau lub tebchaws, thov saib cov ntaub ntawv hauv qab no:
Encounter Managed Care Companion Guides - 837I Qhia meej tias yuav tsum ua raws li cov qauv cai hauv tebchaws thaum xa cov txheej txheem thiab cov lej kuaj mob. (nplooj ntawv 24)
Txhua Tsab Ntawv Txog Kev Npaj: Kev Tswj Xyuas Kev Kho Mob Txhua Tsab Ntawv Txog Kev Npaj - 1998 txog Tam Sim No
Tshwj Xeeb Rau Tus Muab Kev Pab
APL 19-001 Daim Ntawv Txuas A: Daim Ntawv Teev Npe Boilerplate Daim Ntawv Pom Zoo Rau Tus Muab Kev Pab Hauv Network (ca.gov)
APL 19-001 (ca.gov) - thov nco ntsoov nplooj ntawv 3 - 4 txog cov kws kho mob uas yuav tsum ua raws li txhua txoj cai lij choj hauv xeev thiab tsoomfwv.
Tshwj xeeb rau Kev Hloov Cov Ntaub Ntawv Sib Ntsib mus rau Cov Cai Hauv Tebchaws
DHS Letterhead (ca.gov) (APL14-009) Kev Npaj Saib Xyuas Kev Tswj Xyuas kev hloov pauv ntawm kev xa cov ntaub ntawv sib ntsib mus rau cov txheej txheem hauv tebchaws
Puas muaj cov kev pabcuam tshwj xeeb lossis kev ntsib teeb meem nrog cov ntim khoom?
Muaj kev txhawj xeeb txog tus naj npawb ntawm kev ntsib xa nrog Daim Ntawv Cog Lus Hom Code = 09, lossis lwm yam (2 lab kev ntsib rau lub Tsib Hlis 2025). Nws raug pom zoo tias Cov Phiaj Xwm Capitated yuav tsum tsis txhob xa cov ntaub ntawv mus rau DHCS PACES nrog Daim Ntawv Cog Lus Hom Code = 09. Thaum Lub Plaub Hlis Ntuj xyoo 2025 thiab Tsib Hlis Ntuj xyoo 2025, tau pom tias muaj ntau tshaj 2 lab qhov kev sib ntsib tau xa nrog hom ntawv cog lus no.
Yuav siv daim ntawv cog lus hom code 09 li cas kom raug?
Hauv cov qauv ASC X12N 837, cov lej Hom Daim Ntawv Cog Lus raug siv hauv ntu CN1 los txheeb xyuas hom daim ntawv cog lus uas cov kev pabcuam tau muab. Thov saib Tshooj 3.18 hauv Phau Ntawv Qhia Ntxiv - Cov Ntaub Ntawv Them Nqi rau cov lej hom ntawv cog lus.
Cov Neeg Xa Cov Ntaub Ntawv yuav tsum muab cov ntaub ntawv them nqi tiag tiag siv cov qauv uas tau teeb tsa hauv 837P. Hom kev npaj siv los them qhov kev sib ntsib yuav tsum tau piav qhia hauv ntu CN1 hauv 2300 lub voj voog - CN101 Daim Ntawv Cog Lus Hom Code. Thaum qhov kev sib ntsib tau them raws li tus nqi them rau kev pabcuam, CN102 yuav sau cov nyiaj tau them. DHCS xav kom muab 2300 CN1 thiab thov kom suav nrog ntu 2400 CN1. Txhua qhov kev them nyiaj rau lwm lub tuam txhab pov hwm kev noj qab haus huv yuav tsum suav nrog rau hauv kev sib koom tes ntawm cov ntu txiaj ntsig.
Cov lej hauv zos puas raug tso cai thaum tus lej cog lus yog 05?
Cov lej hauv zos tsis raug tso cai rau hauv kev xa ntawv ntsib los ntawm Managed Care Plans (MCP), tsis hais hom ntawv cog lus twg los xij. Txhua qhov kev sib ntsib MCP yuav tsum ua raws li cov cai ntawm 837 kev lag luam thiab siv cov lej hauv tebchaws xwb.
Cov lej hauv zos raug siv rau cov Chaw Muab Kev Pabcuam uas tsuas yog Them Nqi rau Kev Pabcuam xwb thiab tsis nyob hauv lub network ntawm Managed Care Plan. Cov kws kho mob uas tau sau npe nrog MCPs yuav tsum xa cov cai hauv tebchaws rau txoj kev npaj.
Puas yuav muaj lub sijhawm los tshuaj xyuas daim ntawv qhia txog Txhua Txoj Kev Npaj (APL) rau cov phiaj xwm no?
Lub sijhawm tshuaj xyuas APL tau npaj rau lub Cuaj Hli 2025.
Yuav tsum tiv tauj leej twg yog tias PACE tsis kam lees cov ntawv thov rov qab?
Yog xav paub txog cov lej yuam kev uas tau tsim tawm hauv Cov Ntaub Ntawv Teb Cov Lus Teb, thov hu rau DataQualityReportingUnit@dhcs.ca.gov
Yog koj muaj lus nug txog PACE, hu rau koj tus thawj tswj hwm daim ntawv cog lus DHCS lossis PACECompliance@1webteam
Peb tau txais cov lej hauv zos uas DHCS tau hais tias raug tso cai. Txawm li cas los xij, yog tias peb xa cov lej hauv zos rau DHCS lawv yuav tsis lees txais.
DHCS PACES yog ib lub tshuab tom qab txiav txim siab uas txawv ntawm CA-MMIS (fee-for-service) uas cov neeg muab kev pabcuam xa cov ntawv thov kev ntsib rau CA-MMIS kom tau nyiaj rov qab los ntawm Lub Xeev. Cov lej hauv zos tsuas yog siv rau cov kev thov FFS uas mus dhau lub kaw lus CA-MMIS xwb. Peb txaus siab rau cov lus taw qhia thiab yuav hais lus rau hauv ib lub rooj sib tham hauv online sib cais.
Thov nco ntsoov: cov chaw muab kev pabcuam uas tsuas yog them tus nqi rau kev pabcuam xwb, tsuas yog xa cov lej hauv zos mus rau CA-MMIS xwb. Txhua tus Kws Muab Kev Pab uas xa cov ntaub ntawv thov kev ntsib mus rau Managed Care Plan nrog cov cai hauv zos yuav tsum tsis lees txais qhov kev thov kev ntsib ntawd thiab kom Tus Kws Muab Kev Pab xa cov ntaub ntawv thov kev ntsib siv cov cai hauv tebchaws rau Managed Care Plan los tshuaj xyuas. DHCS tau nthuav tawm cov kev npaj nrog cov phiaj xwm kom ntseeg tau tias Cov Phiaj Xwm Kev Kho Mob Tswj yuav sau cov ntaub ntawv ntsib raws li 837 X12 cov kev cai ua lag luam.
Yog koj muaj lus nug ntxiv txog cov cai hauv zos, thov hu rau DataQualityReportingUnit@dhcs.ca.gov
Cov ntaub ntawv ntxiv thiab cov peev txheej
Chaw Sau Ntawv DHCS (DDC): Cov Lus Qhia thiab cov ntaub ntawv siv rau Post Adjudicated Claims & Encounters System (PACES), Capitation Payment Management System (CAPMAN), Managed Care Program Data (MCPD), thiab Primary Care Provider Assignment (PCPA) muaj.
Cov kev thov nkag mus rau DDC tuaj yeem xa mus rau dataexchange@dhcs.ca.gov
PACES ua haujlwm nrog 837 thiab 274 cov ntaub ntawv. CAPMAN npog cov ntaub ntawv 820 thiab 834. Cov lus qhia MCPD thiab PCPA JSON raug khaws cia rau hauv cov nplaub tshev tshwj xeeb hauv DDC.
Rau cov phiaj xwm uas muaj tus neeg koom nrog, cov lej Hom Ntawv Cog Lus uas siv tau hauv CN101 yog 01, 02, 03, 04, lossis 06, uas sawv cev rau tus nqi uas phiaj xwm them raws li daim ntawv cog lus nrog Medi-Cal. Tus nqi no sib npaug rau tus nqi AMT*D rau cov neeg them nqi uas tau xaiv nrog SBR09 = "MC." Daim Ntawv Cog Lus Hom Code 09 (Lwm yam) yuav tsum tsis txhob siv rau kev npaj ua tus thawj coj.
Puas muaj lub sijhawm teem sijhawm rau cov theem?
Thov xa mus rau cov kev nthuav qhia hauv webinar yav dhau los hais txog Kev Sib Tham Cov Ntaub Ntawv Kev Txhim Kho Kev Ua Haujlwm Zoo. Kev koom nrog PACE Cov Koom Haum yuav zoo li tsis ntev dua 2027.
Yog tias cov ntaub ntawv qub raug lees txais thiab tom qab ntawd raug tshem tawm hauv tib lub quarter, puas yuav suav nrog cov ntaub ntawv qub ua ib feem ntawm kev xam cov ntaub ntawv raws sijhawm?
Tsis yog, lub sijhawm xa ntawv tsuas yog suav nrog cov kev sib ntsib thawj zaug uas nyob rau hauv Loop 2300, CLM05-3, Tus lej zaus thov yog 1 (kev xa thawj zaug) thiab kev sib ntsib raug lees txais. Cov xwm txheej xws li saum toj no, qhov kev ntsib yuav tsis yog thawj tab sis yuav raug cim tias yog qhov khoob. Thov saib Tshooj 2.4, 3.3, thiab Appendix B hauv DHCS Companion Guides rau 837 I/P/D hom kev lag luam hauv DHCS Documentation Center.
Puas muaj cov ntaub ntawv pov thawj ntawm Medi-Cal uas yuav hloov kho kom haum rau cov kev cai tshiab txog kev ua raws sijhawm? Cov lus qhia tam sim no hauv phau ntawv qhia: Cov sijhawm rau kev thov nyiaj rau rau lub hlis txwv tsis pub them nqi: "Cov ntawv thov Medi-Cal thawj (lossis thawj zaug) yuav tsum tau txais los ntawm Medi-Cal hauv rau lub hlis tom qab lub hlis uas tau muab cov kev pabcuam."
Qhov no yog hais txog Phau Ntawv Qhia Txog Tus Muab Kev Pabcuam FFS. Cov peev txheej no yuav tsum tsis txhob yog qhov chaw rau Cov Phiaj Xwm Kev Kho Mob uas muaj kev npaj ua tus tswv.
Thaum twg phau ntawv qhia txog kev siv tshuab QMED 2.0 yuav raug muab qhia rau cov phiaj xwm?
Lub Hom Phiaj rau Xyoo 2026
Vim li cas qee lub xeev thiaj li raug cim ua 1 thiab lwm lub xeev yog 2?
Daim duab no yog los ntawm cov txiaj ntsig CMS OBA. Thov mus saib https://www.medicaid.gov/medicaid/data-systems/macbis/transformed-medicaid-statistical-information-system-t-msis rau qhov chaw uas daim duab thaij tau los.

Raws li lub xaib no, 1 qhia txog qhov tseem ceeb ntawm Kev Ntsuam Xyuas Qhov Tshwm Sim Tseem Ceeb (OBA) thiab 2 qhia txog Qhov Tseem Ceeb Tshaj Plaws.

Thov mus saib https://www.medicaid.gov/state-overviews/scorecard/measure/T-MSIS-Data-Quality-Outcomes-Based-Assessment?measure=FS.11&measureView=state&stratification=534&dataView=pointInTime&chart=map&timePeriods=%5B%222024%22%5D rau cov ntaub ntawv qhia txog kev tshuaj xyuas.
Tsis yog txhua tus neeg muab kev pabcuam tau cog lus ua haujlwm, yog li peb yuav ua li cas thiaj yuam kom lawv xa daim ntawv thov raws sijhawm?
Los ntawm qhov kev xav ntawm Lub Chaw Saib Xyuas Kev Zoo ntawm Cov Ntaub Ntawv, txhua Txoj Kev Npaj Kho Mob uas muaj kev npaj ua tus tswv cuab yuav tsum muaj cov Kws Muab Kev Pab uas tsuas pom cov tswv cuab Medi-Cal xwb. Daim ntawv cog lus Boilerplate Xyoo 2024 Managed Care Plan (https://www.dhcs.ca.gov/provgovpart/Documents/2024-Managed-Care-Boilerplate-Contract.pdf) teev cov kev cai tshwj xeeb uas Managed Care Plans yuav tsum xyuas kom meej hauv lawv cov cai thiab cov txheej txheem uas Cov Kws Muab Kev Pab thiab lwm cov neeg koom tes hauv daim ntawv cog lus muaj cov kev cai tshwj xeeb ntawm DHCS hauv cov ntawv cog lus no (Daim Ntawv Qhia A, Daim Ntawv Txuas III; Ntu 2.1.2; Tshooj 2.1.4; Daim Ntawv Pov Thawj J).
Puas yog cov nyiaj them los ntawm FFS Medi-Cal raug xa mus rau CMS? Yog tias yog li ntawd, cov kev cai no puas yuav tsis siv rau txhua lub rooj tsavxwm?
Tus nqi rau cov kws kho mob Medi-Cal uas tau sau npe rau hauv PAVE tau txais nyiaj rov qab txawv ntawm cov kws kho mob uas tau sau npe rau hauv Medical Managed Care Plans ua ib feem ntawm nws lub network ntawm cov kws kho mob.
a. Cov Kws Muab Kev Pab FFS uas xa cov ntawv thov ncaj qha mus rau CA-MMIS qhia txog kev ntsib rau cov tswv cuab uas TSIS yog cov tswv cuab ntawm Cov Phiaj Xwm Kev Kho Mob Tswj Xyuas. Cov Chaw Muab Kev Pabcuam no tau txais nyiaj rov qab los ntawm Chaw Haujlwm Saib Xyuas Lub Xeev CA
b. Cov kws kho mob uas tau sau npe rau hauv Medical Managed Care Plan lub network thiab teev npe ua tus Kws Kho Mob uas ua haujlwm hauv nws cov ntaub ntawv 274 Network Provider tau txais nyiaj rov qab los ntawm Medical Managed Care Plan (nyob ntawm Hom Daim Ntawv Cog Lus uas Managed Care Plan muaj nrog Tus Kws Kho Mob) rau cov kev pabcuam uas tau muab rau cov neeg tau txais txiaj ntsig Medi-Cal. Cov no kuj yog cov phiaj xwm kev saib xyuas uas tau txais kev them nyiaj los ntawm DHCS raws li cov nqi uas tau teev tseg ua ntej.
c. Thov saib cov kev nthuav qhia webinar yav dhau los no kom paub meej ntxiv: Lub Ob Hlis, Lub Rau Hli, Lub Yim Hli, thiab Lub Cuaj Hli 2025.
Peb yuav kho cov teeb meem>Please refer to the below APLs that pertain to this question. As of 2015, Local Codes are not accepted by DHCS Post-Adjudicated Claims and Encounters System as DHCS adopted the National Standard Transaction format per guidance from CMS. Please visit https://www.dhcs.ca.gov/formsandpubs/Pages/MgdCareAPLPLSubjectListing ntawm Local Codes li cas?
rau daim ntawv teev tag nrho DHCS Txhua Daim Ntawv Qhia Txog Kev Npaj (APL) los ntawm lub ntsiab lus.
a. https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2014/APL14-009.pdf
b.
https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2014/APL14-020.pdf c. https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2014/APL14-019.pdf
d. https://www.cms.gov/priorities/key-initiatives/burden-reduction/administrative-simplification/hipaa/adopted-standards-operating-rules
Koj puas piav qhia tau meej txog cov hom kev ntsib uas kho tsis tau?
Thov saib daim ntawv qhia webinar https://www.dhcs.ca.gov/dataandstats/Documents/August-2025-Webinar-Presentation.pdf.
Chaw Sau Ntawv DHCS muaj cov peev txheej uas cov phiaj xwm yuav tsum siv, xws li 837 Cov Lus Qhia Sib Koom Tes uas qhia meej txog cov kev ntsib uas tsis tuaj yeem kho tau. Cov ntaub ntawv tshwj xeeb uas yuav tsum tau siv suav nrog
a. "Addenda - PACES Cov Lus Qhia Txog Qhov Yuam Kev v1.9",
b. "MMC-837P-Kev Sib Tham Txog Kev Ua Haujlwm PACES Companion Guide v3.7 - Appendix B",
c. "MMC-837I-Kev Sib Tham Txog Tsev Kho Mob PACES Companion Guide v3.9 - Appendix B", thiab
d. "MMC-837D-Kev Sib Tham Txog Kev Kho Hniav PACES Companion Guide v2.3 - Appendix B"

Data Exchange & Xa

Puas yog 274 mus rau PACES?
Yog lawm. Tag nrho 274 cov ntaub ntawv xa mus rau DHCS yog ua tiav los ntawm PACES.
Txoj Cai Kho Mob Kho Mob yog dab tsi?
Cov kab lis kev cai kho mob hais txog cov cai teev (HCPCS, thiab lwm yam uas yuav tsum tau muaj ntawm X12 EDI thiab lwm yam kev hloov pauv. Feem ntau cov cai teev siv nyob rau hauv 837 kev lag luam tau teev nyob rau hauv ib daim ntawv txuas ntxiv pom nyob rau hauv X12 5010 837 Cov Lus Qhia Ua Haujlwm.
Peb feem ntau pom cov laj thawj tsis kam lees cov ntaub ntawv uas hais tias "Tsuas yog cov lej teev nyob rau hauv daim ntawv teev cov lej 130 thiaj li raug tso cai." Daim ntawv teev cov lej 130 puas muaj rau pej xeem siv?
Txhua Daim Ntawv Qhia Txog Kev Siv X12 luam tawm cov npe ntawm cov Code uas tau hais txog hauv Daim Ntawv Qhia lossis xav tau hauv kev lag luam. Daim Ntawv Teev Cov Cai 130 tau teev nyob rau hauv Cov Lus Qhia Ntxiv A ntawm 837 Cov Lus Qhia Txog Kev Siv, uas muaj los ntawm X12.
Daim ntawv teev cov cai 130 - Kev Kho Mob Common Procedural Coding System (HCPCS)
MUAB TAU LOS NTAWM:
Chaw rau Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, MD 21244
Peb puas tuaj yeem tau txais kev taw qhia txog kev lim dej siv rau FQHC ntim kom peb tuaj yeem sim rov ua dua rau kev sib piv?
Cov lus qhia tau muab faib rau cov koom haum thiab cov neeg thov FQHC APM. Yog koj xav tau ib daim qauv, thov hu rau FQHCAPM@dhcs.ca.gov lub thawv xa ntawv.
Peb tuaj yeem nrhiav Cov Lus Qhia Txog Tus Kheej tam sim no rau EDI kev lag luam nyob qhov twg?
Cov Lus Qhia Txog Kev Sib Tham Txog Kev Kho Mob uas Tswj Xyuas tau muab tso rau hauv DHCS Documentation Center, uas txhua tus Neeg Koom Tes Ua Lag Luam ntawm DHCS tuaj yeem nkag mus tau thaum thov. Thov xa cov lus thov nkag mus rau dataexchange@dhcs.ca.gov. Cov lus qhia muaj nyob rau hauv ntau txoj kev sib txawv hauv DHCS Documentation Center.
Puas muaj ib phau ntawv txhais lus metadata/cov ntaub ntawv uas peb tuaj yeem muab los siv rau hauv tes nrog 274 Phau Ntawv Qhia Tus Khub?
Tsis yog. Txhua txoj cai ua lag luam tau txheeb xyuas hauv 274 Companion Guide thiab X12 274 × 109 Implementation Guide, muaj los ntawm X12.
Cov ntaub ntawv thov tam sim no yog 10 hnub tom qab COM?
Tsis yog. Cov txheej txheem ntawm PACES system cov ntaub ntawv ntsib thiab cov ntaub ntawv txaus ntawm lub network provider. Cov ntaub ntawv ntsib yuav tsum xa tuaj sai li sai tau tom qab ntsib, tab sis tsis muaj hnub kawg. Cov ntaub ntawv txaus ntawm Provider Network xa tuaj qhia txog qhov xwm txheej ntawm txhua lub network provider hauv ib hlis twg. Vim li no, cov ntaub ntawv txaus ntawm Provider Network yuav tsum xa los ntawm kev lag luam X12 274 los ntawm^{hnub tim} 10 ntawm txhua lub hlis.
URL rau "Chaw Sau Ntawv" yog dab tsi?
Here is the launch page for the documentation center. https://teams.microsoft.com/l/team/19%3aMTndJi9glI7WQS1AhqVyLh3AeBMf8syywgxG8KQ1Loo1%40thread.tacv2/conversations?groupId=3862053f-5e17-47be-9fd8-5bbe497e593a&tenantId=265c2dcd-2a6e-43aa-b2e8-26421a8c8526
Puas muaj kev txwv rau Tus lej ntawm cov neeg ua haujlwm uas tuaj yeem nkag mus rau DHCS Documentation Center (DDC)?
Tsis muaj kev txwv tam sim no ntawm tus nqi ntawm cov neeg ua haujlwm ua lag luam uas tuaj yeem tso cai nkag mus rau DHCS Documentation Center (DDC). Yog tias tus lej ntawm cov nyiaj uas muaj kev nkag mus dhau qhov siab tshaj plaws ntawm pawg, Lub Tsev Haujlwm yuav txiav txim siab txog qhov txwv.
Peb tau txais Kev Xeem CIN yav dhau los los ntawm DHCS. Peb puas yuav tsum txuas ntxiv siv Test CIN rau kev sim cov ntaub ntawv Encounter?
Yog, thov siv Test CINs yog tias koj muaj lawv. Cov CINs kuaj tam sim no raug xa mus rau DHCS Documentation Center. Yuav kom meej meej, DHCS yuav muab Test CINs rau txhua qhov kev npaj Managed Care thiab PACE lub sijhawm no. Peb kuj tseem yuav qhia cov ntaub ntawv hais txog Test CINs nrog BHPs thaum lub sijhawm los txog rau BHPs siv lawv. Tam sim no, BHPs tsis tas yuav txhawj xeeb txog Test CINs. Yog koj pom tias Lub Chaw Sau Ntawv tsis muaj Cov CINs Xeem rau koj txoj kev npaj, lossis yog tias Cov CINs Xeem ua rau muaj qhov yuam kev hauv koj cov ntaub ntawv xeem, thov hu rau koj Tus Kws Tshwj Xeeb Txog Cov Ntaub Ntawv Sib Tham.
BHP sawv cev rau dab tsi?
BHP sawv cev rau Cov Kev Npaj Kho Mob Kev Coj Tus Kheej. Cov nroog hauv California muab cov kev pabcuam Behavioral Health rau cov tswv cuab Medicaid. Cov kev pabcuam yog tswj hwm los ntawm cov koom haum hauv nroog, uas hu ua BHPs.
Qhov tseeb tshaj plaws ntawm 837 I thiab P yog dab tsi?
Tus qauv tshiab tshaj plaws ntawm HIPAA uas tau yuam kom ua 837 yog 5010. Thov mus saib x12.org kom paub ntxiv.
Puas muaj cov phiaj xwm los tso cai rau kev siv cov CINs tiag tiag rau MCPs siv rau hauv qhov chaw xeem?
Tsis yog. Kev siv cov CINs tiag tiag sab nraum qhov chaw tsim khoom ua rau muaj qee qhov kev txhawj xeeb txog kev ruaj ntseg thiab lwm yam kev txhawj xeeb txog PHI. Cov CIN kuaj tau muab los txo qhov kev pheej hmoo ntawm PHI breech.
Cov EVR puas yuav nyob rau hauv hom ntawv X12?
Cov EVR nyob hauv .xml hom ntawv, tab sis ua raws li cov qauv ntawm 837. Hauv lwm lo lus, EVR teev cov yuam kev thiab cov lus ceeb toom tib yam li cov ntsiab lus ntawm cov ntaub ntawv nyob hauv 837 cov qauv kev lag luam. Hom ntawv .xml yuav tsis hloov.
Ua ib tug Neeg Xa Ntawv Sab Nraud rau ntau hom phiaj xwm, puas muaj cov lus qhia rau leej twg peb yuav tsum tiv tauj kom ntxiv cov phiaj xwm tshiab rau tus neeg xa ntawv uas twb muaj lawm?
Txhua tus neeg xa cov ntaub ntawv rau Healthy Care Plans tam sim no yuav tsum tau mus saib Health Care Plan kom paub txog cov kev xav tau nkag mus rau DHCS PACES SFTP site. Piv txwv li, yog tias Txoj Kev Npaj Kho Mob siv (lossis yuav siv) EDIFECS los tsim thiab xa cov ntaub ntawv ntsib, EDIFECS yuav tsum kom Txoj Kev Npaj Kho Mob tiv tauj tus Thawj Saib Xyuas Daim Ntawv Cog Lus DHCS kom thov ntxiv cov neeg ua haujlwm EDIFECS rau hauv daim ntawv teev npe nkag mus rau DHCS PACES SFTP ntawm txoj kev npaj kho mob. Cov ntaub ntawv uas Tus Thawj Saib Xyuas Daim Ntawv Cog Lus yuav xav tau suav nrog: Edifecs lub npe neeg ua haujlwm, lub npe, tus xov tooj, e-mail, kev nkag mus rau hauv cov nplaub tshev (xws li seb puas yog rau ob qho tib si Test thiab Production servers), thiab hom kev nkag mus rau hauv cov nplaub tshev (nyeem/sau/rho tawm). Tsis tas li ntawd xwb, yog tias tus neeg thib peb xav tsim kom muaj kev xa cov ntaub ntawv mus rau DHCS PACES SFTP, qhov no yuav xav tau cov txheej txheem txheeb xyuas ntxiv thiab teeb tsa "tus account kev pabcuam tshwj xeeb". Thov xa email rau DataExchange@dhcs.ca.gov thiab Tus Thawj Saib Xyuas Kev Cog Lus ntawm Txoj Kev Npaj Kho Mob kom nug txog hom kev teeb tsa no.
Lub sijhawm ntsuas nruab nrab yog dab tsi?
Lub sijhawm kuaj mob yuav txawv nyob ntawm Txoj Kev Npaj Kho Mob uas tab tom kuaj mob. Qhov tseem ceeb tshaj plaws uas ua rau lub sijhawm kuaj mob ntev dua yog seb Txoj Kev Npaj Kho Mob puas yog qhov tshiab rau Medi-Cal thiab seb cov neeg ua haujlwm puas muaj kev paub ua haujlwm nrog Medi-Cal 837 thiab NCPDP cov ntaub ntawv. Pawg Neeg Saib Xyuas Cov Ntaub Ntawv DHCS yuav ua haujlwm nrog Txoj Kev Npaj Kho Mob kom ntseeg tau tias kev sim tshuaj xyuas tau ua tiav thiab nyob rau lub sijhawm tsim nyog.
Yog tias Txoj Kev Npaj Kho Mob muaj kev paub dhau los hauv kev xa cov ntaub ntawv ntsib uas tau hais los saum toj no, lub sijhawm kuaj mob yuav kav ntev li 1 lub hlis lossis tsawg dua. Yog tias Txoj Kev Npaj Kho Mob siv tus neeg muag khoom sab nraud uas tau tsim tsa zoo los xa cov ntaub ntawv ntsib Medi-Cal, lub sijhawm kuaj yuav raug luv dua yog tias cov ntaub ntawv xa tuaj ua raws li Cov Qauv Xeem.
Kuv yuav tau cov CINs kuaj los qhov twg?
Cov CINs Xeem rau LA Care muaj nyob rau hauv DHCS Documentation Center. Yuav kom koj nkag tau rau hauv lub xaib ntawd, thiab rub tau cov Test CINs rau LA Care, thov xa email rau DataExchange@1webteam.
Vim tias LTC yog ib qho tshiab rau peb thiab kuv tsis xav tias peb tau txais kev thov LTC, puas yog DHCS qhia tias kev thov/kev ntsib LTC zoo li cas?
Cov ntaub ntawv ntsib LTC siv tus qauv kev lag luam 837, tib yam li cov kev thov kho mob / kev ntsib "ib txwm" siv tus qauv 837. Txhua qhov kev hloov pauv tau teev tseg hauv 837 Companion Guides.
Peb tsis paub tias hom nqi thiab tus lej kev pabcuam twg suav tias yog LTC, koj puas tuaj yeem qhia kuv txog daim ntawv them nqi LTC? Peb yeej tsis tau ntsib LTC cov lus thov lossis qhov no zoo ib yam li SNF?
Yog, cov ntsiab lus ntxiv txog cov hom nqi / cov lej kev pabcuam yuav raug qhia sai sai no.
Qhov kev kuaj no puas siv tau rau PACE txoj kev npaj?
Yog, kev kuaj mob kuj siv tau rau PACE Cov Koom Haum/Cov Phiaj Xwm thiab. Cov phiaj xwm PACE uas xa cov ntaub ntawv ntsib rau Institutional, Professional (837 I/P cov ntaub ntawv) yog tib hom ntaub ntawv uas xa los ntawm Managed Care Plans. Qee cov phiaj xwm PACE kuj tseem yuav muaj kev sib ntsib kho hniav (837D) thiab kuj yuav raug kuaj xyuas rau kev xa cov ntaub ntawv no.
Rau cov kev pab cuam PACE uas tam sim no tshaj tawm cov ntaub ntawv Encounter tib yam rau DHCS ncaj qha ib yam li lawv ua rau Medicare. Puas yog lub hom phiaj xa cov ntaub ntawv ntsib tib yam uas twb tau tshaj tawm rau DHCS/Medicare, hauv cov txheej txheem tshiab no mus rau lub xeev los ntawm cov ntaub ntawv uas twb tau xa mus rau Medicare? vim nws zoo li zoo ib yam li cov ntaub ntawv uas twb xa mus rau DHCS lawm. Los yog lub hom phiaj tsuas yog qhia cov ntaub ntawv uas tsis tau qhia rau DHCS, zoo li yuav yog rau Medicare cov qhab nia xwb. Mus tom ntej puas yog lub hom phiaj kom PACE cov kev pab cuam txuas ntxiv tshaj tawm cov ntaub ntawv ntsib ob zaug hauv ob txoj kev sib cais rau lub xeev? Los yog peb puas tuaj yeem cia siab tias qhov no yuav yog ib qho txheej txheem uas siv sijhawm tsawg.
PACE Plans that have not gone through a testing process for 837I, 837P, 837D, or NCPDP files and expect to have these types of encounters will need to go through the testing process. If a PACE plan has already gone through testing will not need to go through testing again, unless the PO undergoes a significant data systems change as discussed in the webinar.
The DHCS PACES SFTP Test server mirrors DHCS PACES SFTP Production so that if Plans would like to “check” the file that will be submitted to Production by submitting to the Test server. The response files produced by the Test server are the same as Production.
If the question is regarding duplicate encounters that are submitted in 837 files to DHCS PACES SFTP, duplicate encounters at the service line need to be corrected. The number of existing duplicate encounters is a known data quality issue that DHCS is focused on improving and a goal for the Encounter Data Quality Improvement Project.
If the question is asking whether the PO needs to submit only one encounter file to Medicare (if beneficiary is enrolled) and does not need to submit that encounter file to DHCS PACES SFTP, that is incorrect. CMS performs and audit of DHCS data and it is important for DHCS to receive the same information the PO is reporting. I would refer to look at this website – Resource Material and Templates (ca.gov) and https://www.dhcs.ca.gov/provgovpart/Pages/PACE.aspx
Tau pom qhov kev hloov pauv ntawm daim duab rau MDCPD (ECM). Puas yog daim schema hloov pauv rau PCPA?
Txhua qhov kev hloov pauv uas yuav tshwm sim lossis tej zaum yuav muaj nyob rau hauv daim schema yuav raug qhia rau Health Care Plans thiab peb cov neeg koom tes hauv Plan kom txheeb xyuas thiab muab cov lus taw qhia ua ntej. DHCS tau sib txuas lus nrog Plan Partners thaum Lub Plaub Hlis 2024 txog cov kev hloov pauv uas tau thov rau MCPD/PCPA Technical Guide kom ntxiv cov Hom Kev Pabcuam ntxiv rau ntu 2.1.4. Koj tuaj yeem nrhiav tau Daim Ntawv Qhia Txog Kev Siv MCPD/PCPA tam sim no ntawm DHCS Docs center ntawm no: MCPD, PCPA Documents and Schemas
Yav dhau los DHCS muaj qee lub sijhawm sim (Lub Ib Hlis-Lub Peb Hlis, Lub Rau Hli-Lub Yim Hli Kuv xav li ntawd). Qhov no puas tseem yog qhov teeb meem?
Peb vam tias yuav rov qab mus rau cov sijhawm xeem xws li cov teev saum toj no. Qhov Kev Zoo ntawm Cov Ntaub Ntawv vam tias yuav muaj kev sim rau lub Rau Hli - Lub Yim Hli rau cov koom haum PACE uas yuav los txog rau lub Xya Hli 2024 uas yuav muaj cov HCPs tam sim no uas tab tom hloov pauv loj.
Puas muaj kev txwv ntawm cov ntaub ntawv pov thawj nkag mus rau PACES rau cov peev txheej kuaj sib txawv?
Tus neeg ua haujlwm txog kev txawj ntse feem ntau yuav xa cov ntaub ntawv mus rau DHCS PACES Test lossis Server yog plaub tus neeg. Yog tias tus HCP xav tau cov neeg sib txuas lus sib txawv rau kev nkag mus rau Test server lossis Production, tus HCP tsuas yog yuav tsum teev cov ntaub ntawv ntawd hauv email nrog tus Thawj Saib Xyuas Daim Ntawv Cog Lus DHCS. Feem ntau, peb xav kom cov koom haum txwv tus naj npawb ntawm SFTP account rau 5, tab sis qhov ntawd tuaj yeem sib tham tau yog tias xav tau kev nkag mus ntxiv.
Puas yog DHCS yuav xa email rau Cov Phiaj Xwm txog lub sijhawm xeem PACES SFTP?
Yog, qhov ntawd yuav ua tiav.
Puas yog daim phiaj xwm yuav tsum kho thiab xa dua yog tias cov ntaub ntawv tau TXAIS YUAV nrog CEEB TOOM? los ntawm lub 10th thiab?
Yog, koj tuaj yeem xa cov ntaub ntawv kho dua tom qab xa thawj zaug.
Peb yuav tau txais cov ntaub ntawv qhia txog cov ntaub ntawv tshiab thaum twg cov ntsiab lus CCM yuav raug suav nrog, puas yog?
Yog. Cov Ntaub Ntawv Txuj Ci yuav raug faib tawm thiab kuj tseem yuav raug xa mus rau DHCS Documentation Center. Yog xav tau kev nkag mus rau Doc Center, thov xa daim ntawv thov mus rau DataExchange@dhcs.ca.gov.
Puas muaj cov ntaub ntawv xa rov qab mus rau qhov chaw sim uas suav nrog rau hauv daim ntawv qhia txhua rau lub hlis? Los yog tsuas yog cov uas tau xa rov qab mus rau qhov chaw ua haujlwm xwb?
Cov ntawv xa rov qab mus rau qhov chaw sim tsis suav nrog hauv cov ntawv qhia semi-Annual.
Puas yog DHCS tso cai rau hnub ntxiv rau kev sim txiav txim siab yuav tso tawm cov qauv tshiab thaum JSON Phase II yuav nyob? Peb tau hais kom siv V2.0 hauv kev sim
Yog. Ib tsab email yuav tawm mus nrog cov schema thiab cov lus qhia txog kev siv tshuab rau lub Yim Hli^1st los ntawm EDIM mailbox nrog cov lus qhia ntawm cov ntsiab lus hloov kho tshiab.
Txoj Kev Npaj yuav tsum ua cov txheej txheem dab tsi rau cov txheej txheem zam rau pawg MDC tsis ua tiav rau cov ntaub ntawv 274?
Thov saib cov APLs tshwj xeeb rau 274 teev nyob rau hauv kev nthuav qhia. Qhov no yog ib txoj cai uas raug nug txog uas yuav tsum tau xa mus rau MCQMD@dhcs.ca.gov vim tias lub chaw haujlwm no ua raws li cov ntawv cog lus thiab saib xyuas qhov zoo ntawm cov ntaub ntawv.
Los ntawm kev paub dhau los, qhov chaw sim tsis ib txwm zoo ib yam li qhov chaw tsim khoom. Kaw tab sis tsis yog tag nrho.
Yog koj hais txog lub kaw lus PACES, Kev tsim khoom yeej ua raws li qhov chaw sim/staging. Cov txheej txheem ib txwm yog xa cov code tshiab mus rau qhov chaw sim ua ntej, thiab 2 lub lis piam tom qab xa mus rau Production. Peb tsis paub txog qhov sib txawv ntawm ib puag ncig. Yog koj pom qhov txawv, thov xa email rau DataExchange@dhcs.ca.gov.
Tej zaum yuav muaj qee qhov teeb meem nrog cov CINs - ntxiv rau, lub server kuaj kuj tseem yuav ua lub luag haujlwm tawm cov qauv ntaub ntawv uas yuav los tom ntej uas tso cai rau Managed Care Plans lub sijhawm los hloov kho rau cov qauv tshiab. Piv txwv li, cov ntaub ntawv MCPD hauv lub server kuaj suav nrog cov hom txiaj ntsig ntxiv uas tau sib txuas lus rau Managed Care Plans thaum Lub Plaub Hlis 2024. Tam sim no, lub Prod server yuav tsis lees txais cov ntaub ntawv "tshiab" MCPD no kom txog rau lub Yim Hli 2024. Kuv yuav xa mus rau Data Exchange kom paub hnub tim tseeb.
Thiab, thov qhia rau MCQMDProviderData@dhcs.ca.gov paub yog tias muaj qhov sib txawv loj rau lub server kuaj uas cuam tshuam koj lub peev xwm siv tau zoo.
Yog xav paub ntxiv txog PACE?
Yog xav paub ntxiv txog PACE cov koom haum thiab txoj cai, thov mus saib All Inclusive Care for the Elderly. Koj kuj tseem yuav tiv tauj tau: PACECompliance@1webteam
Puas yog qhov tseeb tias "Hom Kev Tsis Txaus Siab" yuav tsis tas yuav muaj rau Kev Thov Rov Qab Txiav Txim Dua lawm?
Yog, qhov ntawd yog lawm.
"Hom Kev Tsis Txaus Siab" tsis raug tshem tawm ntawm cov ntaub ntawv thov rov hais dua hauv MCPD Cov Ntaub Ntawv Txuj Ci (Lub Kaum Ob Hlis 2024) hauv qab cov lus piav qhia txog kev hloov pauv. Qhov no puas tuaj yeem piav qhia meej?
Cov kev hloov pauv tau pom nyob rau hauv version 3.05 ntawm MCPD Technical Document, uas tau muab tso rau hauv DHCS Documentation Center thaum Lub Ib Hlis 24, 2025.
Thaum twg daim schema tshiab 3.05 yuav pib siv rau hauv kev tsim khoom, thiab kev sim yuav pib thaum twg?
Lub sijhawm kawg rau kev xa cov ntaub ntawv MCPD yuav tseem yog hnub tim 10 ntawm txhua lub hlis rau cov ntaub ntawv ntawm lub hlis dhau los. Kev sim yuav pib rau lub Ob Hlis 1, 2025, thiab hnub tsim khoom tau teem rau lub Plaub Hlis 1, 2025. Hnub kawg rau kev xa cov ntaub ntawv MCPD version 3.05 thawj zaug yuav yog lub Plaub Hlis 10, 2025, rau cov ntaub ntawv Lub Peb Hlis 2025. Pab neeg PACES yuav xa cov lej MCPD tshiab mus rau Kev Xeem rau lub Ob Hlis 1, 2025, thiab rau Kev Tsim Khoom rau lub Plaub Hlis 1, 2025. Tom qab Lub Plaub Hlis 1, 2025, tag nrho cov ntaub ntawv tsim tawm ntawm MCPD yuav tsum xa tuaj rau Lub Plaub Hlis 10, 2025. Lub sijhawm kawg rau hnub tim 10 ntawm lub hlis no siv rau txhua cov ntaub ntawv tsim khoom xa tuaj rau hauv cov ntaub ntawv MCPD.
Qhov "Kev Tsis Kam Them Nyiaj Thov" yog ib qho ntawm peb cov Hom Kev Tsis Txaus Siab saum toj kawg nkaus. Zoo li nws tau raug tshem tawm lawm, tab sis zoo li tsis muaj kev xaiv txog kev them nqi ntxiv rau Hom Kev Tsis Txaus Siab. Koj puas tuaj yeem piav qhia meej?
Raws li lub ntsiab lus ntawm tsoomfwv, qhov no yuav tsum tau tshaj tawm tam sim no ua kev thov rov hais dua es tsis yog kev tsis txaus siab.
Kev Hloov Pauv rau MCPD Cov Ntaub Ntawv:
Kev hloov kho tshiab thiab ntxiv rau 3.05 MCPD Cov Ntaub Ntawv Phau Ntawv Txhais Lus uas twb muaj lawm, suav nrog:
Cov nqi ntawm Appeal Type 7 uas tau hloov kho tshiab (A1 txog A7).
Ntxiv Vim Li Cas Appeal.
Tshem tawm 9 tus nqi ntawm Hom Kev Tsis Txaus Siab.
Cov Hom Kev Tsis Txaus Siab raug tshem tawm:
Kev Txo / Kev Ncua / Kev Txiav Txim Siab ntawm Kev Pabcuam Uas Tau Tso Cai Yav Dhau Los
Cov Tswv Cuab Nyob Deb nroog raug tsis lees txais Kev Thov Tawm Ntawm Lub Network {

Kev Saib Xyuas Txuas Ntxiv
Kev Tsis Pom Zoo Kev Thov Them Nyiaj
Kev Tsis Pom Zoo Kev Thov Tsis Pom Zoo Txog Kev Lav Nyiaj Txiag LTC (Kev Saib Xyuas Ntev) {
LTC (Kev Saib Xyuas Ntev) - Kev Tsis Txaus Siab Txog Chaw/Tus Muab Kev Pabcuam
LTC (Kev Saib Xyuas Ntev) - Lwm Yam
Ntxiv tus nqi rau "Kev Saib Xyuas Txuas Ntxiv (Cov Neeg Muab Kev Pabcuam)" nyob rau hauv Hom Kev Tsis Txaus Siab.
Cov nqi tshiab rau "Kev Saib Xyuas Txuas Ntxiv (Cov Kev Pabcuam Them Nqi)", "Kev Hloov Pauv", thiab "Kev Saib Xyuas Pom Zoo Txog Poj Niam Txiv Neej" nyob rau hauv Hom Kev Pabcuam.
Schema tau hloov kho mus rau version 3.05 lawm.
Cov kev hloov tshiab kuj suav nrog kev hloov kho rau MCPD Cov Ntaub Ntawv Tsim (Ntu 2.2), MCPD Cov Ntaub Ntawv Teb (Ntu 3), Piv Txwv MCPD Cov Ntaub Ntawv (Ntu 4), thiab MCPD JSON Cov Ntaub Ntawv (Ntu 4.2).
Yog tias koj tseem nrhiav tsis tau daim teb Grievance Type uas raug tshem tawm ntawm cov ntaub ntawv thov rov hais dua, thov xyuas kom tseeb tias koj tau siv cov ntaub ntawv MCPD tshiab tshaj plaws.
Hauv MCPD Cov Ntawv Qhia Txog Kev Siv Tshuab V3.05, nws tau hais tias Hom Kev Tsis Txaus Siab "Kev Txuas Ntxiv Kev Saib Xyuas" yuav hloov mus rau "Kev Txuas Ntxiv Kev Saib Xyuas (Cov Neeg Muab Kev Pabcuam)," tab sis qhov kev hloov pauv no tsis tau teev nyob rau hauv daim ntawv qhia rau Kev Hloov Hom Kev Tsis Txaus Siab. Qhov kev hloov no puas tseem yuav siv tau?
Yog lawm, qhov kev hloov pauv no tseem tau teem sijhawm los siv rau hauv version 3.05. Thov nco ntsoov tias tsis yog txhua qhov kev hloov pauv tau suav nrog hauv cov swb.
Muaj pes tsawg tus lej ntawm cov CIN kuaj uas siv tau?
Tus naj npawb siab tshaj plaws ntawm Test CINs uas DHCS tuaj yeem tshaj tawm lub sijhawm no tsuas yog txwv rau tsib (5). Muaj tej lub sij hawm, cov Test CINs siv tau dua, tiam sis muaj kev pheej hmoo uas lub system yuav kho lawv zoo li cov uas theej lawm, uas yuav ua rau cov ntaub ntawv raug tsis lees txais thaum lub sij hawm sim.
Vim muaj tsawg tsawg ntawm Test CINs, DHCS pom zoo kom cov neeg koom tes ua lag luam xav txog kev siv "dummy" Test CINs. Cov "dummy" Test CINs no yuav tsum ua raws li cov cai ntawm Test CIN formatting: yim (8) tus lej ua raws li ib (1) tus lej alpha, xws li "A". Txawm hais tias kev siv cov "dummy" Test CINs yuav ua rau muaj lus ceeb toom, yuav tsis muaj kev tsis lees txais cov ntaub ntawv, thiab cov lus ceeb toom no tuaj yeem tsis quav ntsej thaum lub sijhawm kuaj.
Peb puas siv 274 Cov Ntaub Ntawv Tsim Khoom ntawm Lub Nroog Muab Kev Pabcuam lossis daim nplaub tshev BHIN PACES los xa cov ntaub ntawv tshiab?
Cov npe ntawm PACES yog DHCS-PACES/Production/Counties/CountyName_XX/Submit thiab DHCS-PACES/Production/Counties/CountyName_XX/Response.
(CountyName yog lub npe ntawm koj lub Nroog) - Hauv qhov no, DHCS-PACES/Prod/Counties/Los Angeles_19/Submit thiab lwm yam.
Yog tias cov suav suav txawv txawv tab sis cov lus teb raug lees txais; puas yuav tsum tau xa rov qab?
Yog lawm. Yog tias cov ntaub ntawv tau txais tab sis suav tsis tau raws li qhov xav tau lossis xav tau, koj yuav tsum kho thiab xa cov ntaub ntawv rov qab raws li cov lus qhia tau hais hauv CG.
Qhov txuas mus rau VRF 1.4 tshiab yog dab tsi?
Txuas mus rau daim schema thiab cov ntaub ntawv: DHCS Documentation Center | Dav Dav | Microsoft Teams
Txuas mus rau BH CG 3.01: Behavioral Health 274 Cov Ntaub Ntawv Qhia Txog Tus Muab Kev Pab

JSON, ECM/CS

What’s a JSON file?
JSON cov ntaub ntawv yog ib hom ntawv tshwj xeeb siv hauv kev xa cov ntaub ntawv.
Kuv tseem tsis meej tias SRF JSON yog dab tsi. Tej zaum yuav pab tau yog sau lub npe luv.
SRF = Cov Ntaub Ntawv Sib Tham Txog Kev Xa Khoom
JSON = JavaScript Object Notation
SRF JSON = Cov Ntaub Ntawv Sib Tham Txog Kev Xa Khoom xa tuaj rau hauv hom ntawv JSON
DHCS tau xa ib daim ntawv qhia ECM-CS kho dua tshiab uas yuav siv tau rau lub Kaum Ib Hlis rau Q3 2023 cov ntaub ntawv. Lawv puas yuav raug hloov thaum kawg ntawm lub xyoo?
Xav paub ntau ntxiv tuaj. Thov nyob twj ywm!
Peb tau pib xa ECM ntsib, yog li peb puas yuav tau xa cov ntaub ntawv JSON rau ECM yav tom ntej?
Yog lawm, MCPs yuav tsum xa ob daim ntawv JSON thiab ntsib rau ECM.
Koj puas tuaj yeem muab cov ntsiab lus ntxiv txog ECM thiab CCM cov ntaub ntawv uas yuav hloov mus rau JSON hom tshiab? Cov ntaub ntawv twg yuav raug hloov?
Xav paub ntau ntxiv tuaj. Thov nyob twj ywm!
Koj puas tuaj yeem hais qhia ECM / CS Cov Lus Qhia yuav tsim rau JSON cov ntaub ntawv?
Xav paub ntau ntxiv tuaj. Thov nyob twj ywm!
Puas yog ECM/CS cov ntaub ntawv (JSON) xa mus rau txhua hli?
Yog lawm.
Rau tus chij tshiab uas tsis muaj tsev nyob uas yuav tsum tau muaj rau cov kev pabcuam ECM/CS, cov ntaub ntawv no yuav tsum raug xa mus rau cov chaw muab kev them nqi hluav taws xob li cas ntawm 837 lossis los ntawm daim ntawv ntawm CMS 1500 daim ntawv?
Nws yuav hloov kho sai li sai tau thaum peb muaj cov lus teb sib xws. Ua tsaug rau koj ua siab ntev.
JSON cov ntaub ntawv cais los ntawm MCPD cov ntaub ntawv?
Yog, nws yuav cais.
Puas muaj kev npaj hloov 274 cov ntaub ntawv rau JSON?
274 cov ntaub ntawv hom ntawv yog cov ntaub ntawv tus kheej delimited ntawv tsim thiab muaj los ntawm X12 lub koom haum. X12 yog Lub Koom Haum Txhim Kho Cov Qauv uas muaj npe nyob rau hauv HIPAA cov cai raws li tus tsim tawm cov ntaub ntawv tawm tswv yim rau Electronic Data Interchange. Cov ntaub ntawv 274 yog tsim los siv tib hom ntawv raws li X12 837 Cov Ntaub Ntawv Thov / Sib Tham, cov ntaub ntawv qhia txog kev them nyiaj 835, cov ntaub ntawv sau npe 834 tus tswv cuab, thiab lwm yam kev hloov pauv rau kev siv cov ntaub ntawv kho mob sib pauv. Tsis muaj cov phiaj xwm tam sim no los hloov 274 hom ntawv rau JSON. Tab sis nws yuav nthuav.
Thaum twg cov phiaj xwm tuaj yeem cia siab tias yuav muaj ECM / CS / CCM cais Phau Ntawv Qhia? Puas yuav muaj tsab ntawv qhia ntxov ntawm ECM/CS/CCM tus khub phau ntawv qhia rau cov lus pom?
Xav paub ntau ntxiv tuaj. Thov nyob twj ywm!
Peb siv email dab tsi los xyuas kom meej tias peb nyob rau hauv daim ntawv teev npe tau txais cov ntawv ceeb toom ECM/CS JSON?
Cov ntawv ceeb toom no yuav raug xa tawm mus rau MCPs siv peb cov npe email uas twb muaj lawm ua haujlwm uas peb muaj nyob hauv.
Thaum twg qhov kev xeem ECM/CS Json theem 2 yuav tiav?
Kev xeem ECM yuav ua tiav los ntawm Lub Yim Hli 1, 2024.
Thaum twg 274 qhov kev xa tawm yuav yog ib feem ntawm JSON Hom Ntawv rau Cov Nroog?
Tus 274 yog tus qauv kev lag luam X12, thiab yog li ntawd TSIS yog hom ntawv JSON. Cov Txheej Txheem Kev Sib Txuas Lus ntawm Cov Ntaub Ntawv yog ib daim ntawv qhia txog seb cov ntsiab lus ntawm cov ntaub ntawv raug teeb tsa li cas (qhov kev txiav txim uas lawv raug tshaj tawm, thiab lwm yam nrog rau cov cai rau txhua cov ntsiab lus ntawm cov ntaub ntawv). JSON yog hom ntawv ntaub ntawv kev txawj ntse, zoo ib yam li .xml
Puas muaj cov ntaub ntawv json schema rau ECM/CS? Peb nrhiav tsis tau nws hauv Teams?
Yog, nyob rau hauv cov ntaub ntawv template cov ntaub ntawv, muaj schema thiab tech qhia rau nws
Puas muaj lus qhia rau cov cuab yeej uas tuaj yeem hloov cov ntaub ntawv Excel rau JSON?
Notepad++, Zappysys, excel2jason tsev qiv ntawv uas yog python tsev qiv ntawv.

274 MHP thiab 274 DMC-ODS

DHCS puas tau nug txog cov neeg sib cuag (txog plaub) twb raug xa mus rau MHP/DMC-ODS Lub Nroog?
DHCS tau thov kom MHP thiab DMC/ODS tiv tauj los ntawm 274 lub rooj sib tham txhua hli ntawm County Workgroup. Lub hom phiaj yog kom muaj plaub tus neeg tiv tauj ntawm lub nroog rau ib hom phiaj xwm (piv txwv li, MHP piv rau DMC-ODS). DHCS tseem tsis tau xa daim ntawv thov rau plaub tus neeg tiv tauj xwb. Peb siv daim ntawv teev cov neeg uas cov nroog xa tuaj tam sim no.
Koj puas yuav xav kom muaj 274 cais rau txhua pawg? Ib qho rau kev noj qab haus huv ntawm tus cwj pwm, ib qho rau cov tshuaj thiab ib qho rau kev kho hniav? Los yog ib qho los suav nrog lawv txhua tus?
DHCS xav tau 274 daim ntawv xa EDI sib cais rau cov qauv kev saib xyuas kev kho mob, kev kho hniav thiab kev noj qab haus huv tus cwj pwm.
MHP thiab DMC-ODS yuav muaj 274 daim ntawv xa sib cais? Puas yog nws yuav yog ib qho kev xa tawm?
Yuav tsum muaj 274 daim ntawv xa mus rau EDI sib cais rau MHP thiab DMC-ODS cov ntawv xa mus. Phau Ntawv Qhia Txog Kev Noj Qab Haus Huv Tus Cwj Pwm 274 yuav muab cov lus qhia rau kev xa cov ntaub ntawv MHP thiab DMC-ODS. Lub npe ntawm cov ntaub ntawv EDI thiab tus lej ntawm Txoj Kev Npaj Kho Mob (HCP) yuav qhia qhov txawv ntawm hom phiaj xwm.
Rau 274 BH, puas yog qhov kev cia siab tias MCPs yuav xa ib daim 274 sib cais uas tsuas yog suav nrog lawv lub network BH ntxiv rau lawv daim ntawv xa 274 tam sim no?
DHCS yuav txuas ntxiv muaj 274 daim ntawv xa EDI sib cais rau Cov Phiaj Xwm Kev Kho Mob Hlwb Hauv Lub Nroog (MHP thiab DMC-ODS).
Puas yog qhov ntawd txhais tau tias txoj hauv kev tam sim no xa MHP 274 (X12 EDI hom) yuav raug hloov los ntawm JSON mus tom ntej?
Tus 274 tsis raug hloov nrog hom ntawv JSON. Lub X12 4050 274 × 109 yog formatted nyob rau hauv lub proprietary thiab HIPAA mandated Electronic Data Interchange (EDI) hom ntawv, uas yog tsim thiab tswj los ntawm lub koom haum X12.
Cov Ntaub Ntawv Sib Tham Txog Kev Xa Cov Ntaub Ntawv Pabcuam (PDSRF) uas siv MS Excel yuav raug hloov los ntawm cov ntaub ntawv zoo sib xws siv hom ntawv JSON. Cov ntaub ntawv hloov no hu ua "Cov Ntaub Ntawv Sib Tham Txog Kev Xa Ntawv (SRF)". Qhov kev hloov pauv ntawm PDSRF mus rau hom ntawv JSON tseem tsis tau tshwm sim.
Peb muaj 274 cais rau SUD/(kev siv tshuaj yeeb tsis raug) thiab kev noj qab haus huv ntawm lub hlwb ces koj hais li cas?
DHCS tab tom npaj yuav muaj 274 daim ntawv xa EDI sib cais rau Cov Phiaj Xwm Kev Noj Qab Haus Huv Lub Siab thiab Cov Txheej Txheem Kev Xa Khoom Tshuaj Medi-Cal.
Puas muaj qhov hloov tshiab thaum twg DMC-ODS 274 tus khub qhia yuav muaj? Koj puas tuaj yeem thov qhia qhov twg daim ntawv qhia kev pom zoo tuaj yeem pom?
Daim Ntawv Qhia Draft twb muaj rau DMC-ODS 274. Nws tuaj yeem pom ntawm 274 Expansion Website; nws yog Version 2 ntawm Tus Thawj Coj Qhia.
Sab nraum 274 lub thawv xa ntawv, cov nroog yuav txheeb xyuas lawv cov neeg sib txuas lus li cas?
Liaison tseem tsis tau muab vim tsis nyob rau hauv ntau lawm. Tag nrho cov kev txhawb nqa hauv nroog yuav nyob hauv pawg neeg ua haujlwm coj los ntawm Sara Rivera, kom txog rau thaum cov nroog nyob hauv cov xwm txheej tsim khoom.
Nrog rau kev hloov pauv tau tshwm sim hauv cov nroog, lub nroog yuav ua li cas thiaj paub cov neeg sib cuag tam sim no ntawm DHCS, hloov kho cov neeg nyob hauv nroog tam sim no (nrhiav leej twg tam sim no nyob rau hauv cov ntaub ntawv nrog DHCS raws li kev sib cuag thiab kev sib txuas lus)?
Yog muaj lus nug txog lub nroog 274 Expansion Project yuav tsum xa mus rau 274Expansion@dhcs.ca.gov. Peb kuj muaj lub thawv xa ntawv rau cov lus nug txog Network Adequacy: NAOS@dhcs.ca.gov.
Lub sijhawm kwv yees rau DHCS tso tawm cov lus qhia ntawm QMED 2.0?
Lub sijhawm ua haujlwm tam sim no yuav yog lub hom phiaj 2025 rau cov ntsiab lus ntxiv ntawm QMED 2.0.

Kev coj cwj pwm noj qab haus huv Short Doyle

Puas yog cov ntaub ntawv Short-Doyle yuav raug rub tawm txhua hnub los ntawm SDMC qhov kev thov nyiaj pab, lossis MHP puas yuav tsum xa cov ntaub ntawv sib txawv txhua hnub?
MHPs tuaj yeem xa daim ntawv thov kev mob hlwb tshwj xeeb rau Short Doyle txhua hnub. Feem ntau, txawm li cas los xij, MHPs tuaj yeem xa cov ntaub ntawv thov 1-3 zaug hauv ib hlis.
Puas yog qhov txwv ntawm plaub (4) tus neeg tiv tauj ib lub nroog tsuas yog cuam tshuam nrog qhov zoo ntawm cov ntaub ntawv lossis qhov ntawd puas yog thoob plaws? Piv txwv li, peb muaj plaub lossis tsib tus neeg tiv tauj MedCCC rau cov lus nug txog kev thov, ob peb tus neeg nug txog kev txawj ntse, lwm tus nug txog kev tshaj tawm, thiab lwm yam. Peb puas yuav tsum hloov pauv txoj kev peb xaiv/muab cov lus nug?
Puas yog qhov hais txog 4 tus neeg uas koj tiv tauj yog hais txog tus naj npawb ntawm 'cov tswv' rau Short Doyle? (2 rau SMHS, 2 rau DMC) Cov tswv pom zoo thiab rho tawm cov neeg siv cov ntaub ntawv rau ib lub nroog.
Rau MEDCCC, tsis muaj kev txwv rau tus naj npawb ntawm cov neeg ua haujlwm hauv nroog uas tuaj yeem xa cov lus nug.
Puas muaj cov cai kho mob hlwb tshiab uas peb yuav tau siv? Puas muaj cov lej qub uas yuav tas sijhawm? Yog tias muaj, cov lej qub no puas yuav tas sijhawm rau cov chaw muab kev pabcuam, lossis cov no puas yuav tsum tau hla kev taug kev zoo li cov lej hauv zos?
Pib txij thaum 7/1/23, nyob rau hauv CalAIM, DHCS tab tom hloov mus rau CPT cov lej rau kev coj tus cwj pwm kev noj qab haus huv thov hauv Short Doyle. Cov nroog tuaj yeem tau txais cov npe ntawm CPT thiab HCPCS cov lej thiab thov cov cai hauv Cov Kev Pabcuam Kev Puas Siab Puas Hlwb Tshwj Xeeb thiab Tshuaj Medi-Cal Phau Ntawv Sau Nqi Tshaj Tawm hauv MEDCCC Library. Cov peev txheej thov nyiaj ntxiv muaj nyob rau ntawm nplooj ntawv MEDCCC.

QMED 2.0

Lub sijhawm kawm rau QMED 2.0 yuav tso tawm rau hauv Q2 2025 yog dab tsi? Q1 2025 Cov Ntawv Xa Mus?
Cov ntawv qhia txog peb lub hlis twg rau QMED 2.0 yuav ua raws li cov qauv ntawm QMED 1.1. Piv txwv li, Daim Ntawv Qhia QMED rau Q2 2025 yuav ntsuam xyuas cov ntaub ntawv ntsib uas xa mus rau DHCS thaum lub Plaub Hlis - Lub Rau Hli 2025. Feem ntau cov daim ntawv qhia qhab nia yuav raug muab tawm li ib hlis tom qab lub quarter xaus vim yog cov txheej txheem sab hauv uas tsis pub leej twg paub tus kheej thiab lub sijhawm pom zoo.
Cov phiaj xwm PACE puas zam tau los ntawm QMED 1-2?
a) Yog lawm. Cov phiaj xwm PACE tam sim no tsis raug rau QMED 1. Tsis tas li ntawd xwb, QMED 2.0 yuav raug nthuav tawm ua ntu zus. Cov Phiaj Xwm Kev Kho Mob uas twb tau txais Daim Ntawv Qhia QMED lawm yuav yog thawj cov uas tau txais Daim Ntawv Qhia QMED 2.0 pib txij li Q2 2025, nrog rau kev ua kom muaj kev siv zog pib kwv yees li 12 lub hlis tom qab Daim Ntawv Qhia QMED 2.0 thawj zaug tau muab tawm.
b) Cov Koom Haum PACE thiab lwm cov phiaj xwm uas tam sim no tsis tau txais Daim Ntawv Qhia QMED 1.1 yuav raug hloov mus rau kev txais Daim Ntawv Qhia QMED 2.0. Cov kev ua tau zoo thiab cov qhab nia yuav tsis siv rau kev ua raws li txoj cai li ntawm 12 lub hlis tom qab daim ntawv qhia QMED 2.0 thawj zaug ntawm txoj kev npaj. Lub sijhawm 12 lub hlis yuav muab sijhawm txaus rau Cov Phiaj Xwm los hloov kho rau qhov qhab nia, thiab lwm yam.
Puas yog theem pib siv tau muab sijhawm txaus rau cov phiaj xwm kev saib xyuas kom nkag siab thiab siv cov kev hloov pauv?
DHCS tso cai rau Managed Care Plans 12 lub hlis (txais plaub daim Ntawv Qhia) los tshuaj xyuas daim ntawv qhia QMED 2.0 ua ntej yuav ua raws li txoj cai, xws li Txoj Kev Npaj Kho (CAP) lossis xa mus rau DHCS Enforcement Committee. Lub sijhawm no pub sijhawm txaus rau cov phiaj xwm los tshuaj xyuas lawv cov qhab nia thiab siv cov kev hloov pauv tsim nyog.
DHCS tau qhia rau Lub Nroog MH/ODS/Integrated Health Plans tias lawv yuav tsum suav nrog tag nrho cov pej xeem uas tau sau npe rau Medi-Cal hauv lub nroog los xam cov kev ntsuas HEDIS uas yuav tsum tau ua, tsis yog tsuas yog cov tswv cuab uas tau sau npe rau hauv txoj kev npaj kho mob hauv lub nroog xwb. Cov ntaub ntawv PDF tau yog ib feem ntawm cov ntaub ntawv siv rau hauv cov kev ntsuas ntawd. Nrog rau qhov kev nthuav dav ntawm cov pej xeem ntsuas HEDIS no, DHCS puas yuav nthuav dav cov ntaub ntawv hauv PDF xa rov qab APCD-CDL cov ntaub ntawv rau txhua tus neeg tau txais Medi-Cal hauv nroog (piv rau cov txheej txheem tam sim no ntawm kev muab cov neeg uas tau txais kev pab los ntawm lub nroog MH txoj kev npaj)?
DHCS tab tom soj ntsuam qhov no kom paub seb qhov kev hloov pauv puas tsim nyog thiab ua raws li txoj cai lij choj thiab cov cai tam sim no. Yog tias DHCS ua qhov kev hloov pauv peb yuav qhia nws siv cov txheej txheem piav qhia hauv kev nthuav qhia webinar thaum Lub Kaum Ib Hlis 2025.
Cov nroog yuav nrhiav tau cov lus qhia txog kev siv tshuab los nyeem/txais cov ntaub ntawv PDF uas tau xa rov qab los ntawm DHCS qhov twg?
Yog xav paub txog cov lus qhia txog APCD-CDL, thov rub tawm APCD-CDL los ntawm APCD Council ntawm: https://www.apcdcouncil.org/common-data-layout. Thov nco ntsoov tias koj yuav tsum rub tawm version 3.0.1, peb tseem tsis tau hloov kho mus rau version 4. Yog xav paub cov lus qhia txog kev siv cov ntaub ntawv Supplemental thiab TAR, nrog rau lwm cov ntaub ntawv, thov saib DHCS Plan Data Feed General Channel/Files tab. Yog xav paub ntxiv txog kev tsim ib daim Finder File (Cov Phiaj Xwm Hauv Lub Nroog xwb), thov mus saib ntawm qhov General/Files tab lossis ntawm MHP, DMC, DMC-ODS Project Implementation channel, Files tab. Qhov version tshiab tshaj plaws yog Finder File Submission Specification 1.2.
Yog xav nkag mus rau DHCS MS Teams Plan Data Feed site, thov xa ib daim ntawv thov mus rau PlanDataFeed@1webteam.
Puas muaj cov phiaj xwm ntxiv cov ntaub ntawv ntxiv rau PDF xws li Ntshav Lead lossis Waiver uas tam sim no raug xa mus ua cov ntaub ntawv tiaj tus?
Lub sijhawm no tseem tsis tau muaj kev npaj ntxiv cov ntaub ntawv teev cia. Txawm li cas los xij, yog tias muaj ib qho kev siv tshwj xeeb rau cov ntaub ntawv tshwj xeeb uas xav tau thov xa cov ntaub ntawv siv mus rau lub thawv xa ntawv plandatafeed@dhcs.ca.gov kom txiav txim siab.
Peb puas muaj cov neeg uas peb xav tau los tiv tauj txog tej teeb meem tshwj xeeb txog cov ntaub ntawv, xws li Kev Kuaj Mob Tsis Tau lossis lwm cov lej?
Kuv xav kom koj xub xyuas kom meej tias koj cov lus nug tseem tsis tau teb los ntawm kev saib PDF - Phau Ntawv Qhia Txog Kev Tshuaj Xyuas thiab Cov Lus Nug Nquag Nug ntawm DHCS Plan Data Feed Microsoft Team. Yog tias koj cov lus nug tseem tsis tau teb, ces xa email rau lub thawv xa ntawv plandatafeed@dhcs.ca.gov thiab muab koj tus thawj tswj hwm daim ntawv cog lus tso rau hauv. DHCS yuav siv zog los tshawb nrhiav thiab teb cov lus teb. Thov nco ntsoov tias cov lus nug no yuav siv sijhawm vim muaj ntau pab pawg thiab ntau txoj kev uas yuav tsum tau soj ntsuam kom txiav txim siab tau cov lus teb. Nws tsim nyog rov hais dua tias Daim Ntawv Qhia Txog Cov Ntaub Ntawv Npaj xa cov ntaub ntawv uas muaj nyob hauv DHCS cov ntaub ntawv khaws cia. Feem ntau cov lus nug txog cov ntsiab lus ntawm cov ntaub ntawv tshwj xeeb muaj feem cuam tshuam nrog cov txheej txheem thiab cov cai rau kev xa cov lus thov thiab kev ntsib.
Ua ntej Lub Ib Hlis Ntuj xyoo 2022, MCPs tau tswj hwm cov txiaj ntsig ntawm kev muag tshuaj. Kuv puas tuaj yeem nug koj seb koj qhov kev tshuaj xyuas cov ntaub ntawv pub thiab kev ntsib pom qhov ntawd li cas?
Vim tias Cov Ntaub Ntawv Npaj Khoom Noj tsuas yog siv tau 12 lub hlis xwb, cov kev ntsib no yuav tsis muaj nyob hauv cov ntaub ntawv Npaj Khoom Noj.
Peb puas tuaj yeem tau txais cov ntaub ntawv ntawm Tus Muab Kev Pabcuam rau cov ntaub ntawv uas muaj IHSS Code Flag teeb tsa hauv Cov Ntaub Ntawv Ntxiv?
Cov lus thov IHSS muaj nyob hauv cov ntaub ntawv kho mob. Cov ntaub ntawv ntawm tus neeg muab kev pab muaj nyob rau hauv Cov Ntaub Ntawv ntawm Tus Neeg Muab Kev Pab. Rau kev tshuaj xyuas kom zoo ntawm cov kev thov IHSS, txoj kev npaj yuav tsum txuas cov ntaub ntawv kho mob mus rau cov ntaub ntawv ntxiv thiab cov ntaub ntawv kho mob mus rau cov ntaub ntawv tus kws kho mob. Tom qab ntawd tus neeg siv tuaj yeem siv tus chij IHSS los txheeb xyuas cov ntaub ntawv thov kev kho mob thiab cov ntaub ntawv ntawm tus kws kho mob raws li cov ntaub ntawv muaj nyob rau ntawm daim ntawv thov thiab tau xa mus rau DHCS cov ntaub ntawv khaws cia hauv qhov chaw thawj zaug. Yog xav paub ntxiv txog seb cov ntaub ntawv kho mob raug xa mus rau cov ntaub ntawv ntxiv thiab cov ntaub ntawv ntawm tus kws kho mob li cas thov saib PDF - Phau Ntawv Qhia Txog Kev Tshuaj Xyuas thiab APCD-CDL ™ .
Yuav xaiv cov ntaub ntawv Medicare FFS li cas?
Thov xa email thov rau koj tus thawj tswj kev cog lus thiab xa cc mus rau lub thawv xa ntawv plandatafeed@dhcs.ca.gov nrog koj qhov kev thov. Tom qab ntawd lawv mam li xa cov ntawv thiab cov lus qhia uas yuav tsum tau ua kom tiav. Thaum cov ntawv tau txais kev pom zoo thiab xa mus rau pab pawg neeg Plan Data Feed lawm, cov ntaub ntawv Medicare FSS yuav raug ntxiv rau hauv Plan Data Feed. Thov nco ntsoov tias cov ntaub ntawv Medicare FFS suav nrog rau hauv cov ntaub ntawv Plan Data Feed uas twb muaj lawm, tsis yog cov ntaub ntawv sib cais. Phau Ntawv Qhia Txog Kev Tshuaj Xyuas APCD-CDL ™ thiab PDF muab kev pab txheeb xyuas cov lus thov no hauv cov ntaub ntawv teeb tsa.
Thov koj rov hais dua daim slide 19, txog Fetching, PUAS yog SFTP lossis Data from System?
Cov Ntaub Ntawv Txog Kev Npaj yuav raug thauj mus rau DHCS MOVEit SFTP server rau hnub Monday^thib 3 ntawm lub hlis. Lub phiaj xwm muaj lub luag haujlwm rau kev nkag mus rau hauv SFTP server thiab rov qab tau cov ntaub ntawv Plan Data Feed hauv 45 hnub ntawm lub sijhawm nws tau thauj khoom. Cov ntaub ntawv raug rho tawm ntawm lub server tom qab 45 hnub.
Qhov xwm txheej koj piav qhia:
Lub Kaum Hli - Tus Tswv Cuab nyob hauv (saib rov qab 12 lub hlis), Lub Kaum Ib Hlis - Tus Tswv Cuab tawm, Lub Kaum Ob Hlis - Tus Tswv Cuab nyob hauv (saib rov qab 12 lub hlis)
} Qhov no puas piav qhia tau tias tau txais cov ntaub ntawv zoo ib yam ob zaug hauv peb lub system (cov ntaub ntawv ob zaug)?
Rau Cov Phiaj Xwm Kev Kho Mob Tswj, yog qhov ntawd yuav piav qhia txog cov ntaub ntawv theej. Rau Cov Phiaj Xwm Kev Noj Qab Haus Huv Tus Cwj Pwm, cov ntaub ntawv raug rov ua dua txhua lub hlis (piv txwv li, tsis muaj cov ntaub ntawv delta rau cov phiaj xwm kev noj qab haus huv tus cwj pwm).
Peb yog IBHPs, koj puas muaj lus qhia txog kev muab cov ntaub ntawv MH/SUD ua ke ua ib qho?
Cov IBHP yuav tsum muab tag nrho cov tswv cuab uas tau ua haujlwm rau 6 lub hlis dhau los tso rau hauv ib daim ntawv Finder File uas tau tseg rau cov npe tswv cuab ntawm MHP xwb [##FinderFileYYYYMM.txt] thiab upload cov ntaub ntawv ntawd rau hauv daim nplaub tshev FinderFileUpload. IBHP yuav tau txais ib pawg ntaub ntawv rau txhua tus tswv cuab. Thov saib cov ntawv tshaj tawm hauv qab no ntawm DHCS Plan Data Feed Microsoft Team: Gentry, Jason@DHCS: Integrated Behavioral Health Plan (IBHP) – Finder File Instruction… | DHCS Plan Data Feed > MHP, DMC, DMC-ODS Project Implementation | Microsoft Teams
Puas yog qhov plandatafeed@dhcs.ca.gov tus email account tseem yog tus neeg tiv tauj tsim nyog los thov nkag mus? Kuv tau tos ntau tshaj ib hlis lawm. Zoo li tsis tau saib xyuas tus email.
Yog, qhov no yog qhov chaw raug. Muaj teeb meem ntawm cov neeg ua haujlwm nrog kev saib xyuas lub thawv xa ntawv uas DHCS tab tom ua haujlwm los daws. Peb kuj xav kom koj xa daim ntawv cog lus cc rau koj ntawm txhua qhov kev sib txuas lus.
Peb lub Nroog BH thov kom peb (MCP) xa cov ntaub ntawv PDF uas peb tau txais mus rau lawv. Txawm li cas los xij - yog tias kuv nkag siab zoo - Lub Nroog BH twb muaj txoj hauv kev los txais cov ntaub ntawv PDF los ntawm kev siv cov ntaub ntawv nrhiav. Koj puas tuaj yeem lees paub qhov no puas yog?
Yog, lub nroog txoj kev npaj kho mob tus cwj pwm tuaj yeem tau txais Cov Ntaub Ntawv Npaj rau cov tswv cuab Medi-Cal uas lawv tau pom hauv 6 lub hlis dhau los raws li Cov Ntaub Ntawv Finder uas lawv xa mus rau DHCS.
Cov BHPs hauv lub nroog tsis tau txais cov ntaub ntawv ntawm txhua tus tswv cuab hauv lub nroog. Tsuas yog cov uas peb twb tau pab lawm xwb.
Cov ntaub ntawv PDF feem ntau yog hais txog kev thov nyiaj. Raws li kev txhais, cov ntaub ntawv ntsig txog kev thov tsuas yog tsim los ntawm cov tswv cuab uas tau txais kev pabcuam thaum lub hlis twg. Cov ntaub ntawv ntawm lwm tus tswv cuab muaj nyob rau ntawm lwm cov ntaub ntawv DHCS thiab cov chaw muab cov ntaub ntawv.
Thov cov MCPs puas tau txais kev qhia txog seb puas tsim nyog muab peb cov ntaub ntawv PDF tag nrho rau Lub Nroog BH?
Daim Ntawv Qhia Txog Kev Npaj DHCS tam sim no xav kom lub nroog txoj kev npaj kho mob tus cwj pwm tshaj tawm cov tswv cuab Medi-Cal uas tau txais kev pab dhau 6 lub hlis dhau los hauv Cov Ntaub Ntawv Finder kom ntseeg tau tias cov ntaub ntawv siv keeb kwm uas DHCS muaj tsuas yog qhia rau lub nroog rau cov tswv cuab uas lawv muaj kev sib raug zoo nrog. DHCS txhob txwm tsis siv qhov tsim nyog Medi-Cal rau cov tswv cuab ntawm lub nroog cov phiaj xwm kev noj qab haus huv tus cwj pwm vim tias feem ntau ntawm cov tswv cuab Medi-Cal tsis nrhiav kev pabcuam los ntawm lub nroog cov phiaj xwm kev noj qab haus huv tus cwj pwm. DHCS tab tom tshawb nrhiav cov kev xaiv rau kev hloov kho tus tswv cuab ntawm Plan Data Feed raws li kev hloov pauv thev naus laus zis thiab txoj cai txij li thaum Plan Data Feed tau siv thawj zaug. Txog seb puas tsim nyog rau MCP los qhia cov ntaub ntawv nrog lub nroog txoj kev npaj kho mob tus cwj pwm thov ntiav cov kev pab cuam kev cai lij choj ntawm koj txoj kev npaj los daws koj cov teeb meem siv tshwj xeeb.
Puas yog ib txwm muaj cov ntaub ntawv TCM sib txawv ob peb lub hlis (piv txwv li cov ntaub ntawv txog rau lub Rau Hli 2025 tau txais thaum lub Cuaj Hli 2025)?
Yog. Feem ntau cov kev thov thiab kev ntsib muaj qhov sib txawv ntawm hnub muab kev pabcuam mus txog thaum nws muaj nyob rau ntawm Plan Data Feed.
Koj puas tau tsim lwm tus neeg txheeb xyuas qhov kev thov kom pom cov kab thov sib cais thiab cov lej sib lawv liag, kuv puas nkag siab raug? Nws sib haum xeeb li cas nrog tus neeg laus?
Tsis muaj kev hloov pauv hauv Cov Ntaub Ntawv Npaj rau qhov kev txheeb xyuas cov ntawv thov thiab cov kab ntawv thov. Thov saib APCD-CDL ™ thiab PDF - Phau Ntawv Qhia Txog Kev Tshuaj Xyuas kom paub meej ntxiv.
Peb puas muaj tau qhov URL ntawm EDIP Website?
Lub vas sab URL ntawm EDIP yuav raug qhia rau lub caij nplooj ntoos hlav xyoo 2026.
Cov neeg muab kev pabcuam EDIP yog leej twg?
Cov neeg muag khoom tseem tsis tau raug xaiv. Cov txheej txheem ntawd tab tom ua tiav tam sim no.
Puas yog EDIP yog ib qhov project tshiab uas pib xyoo 2026? Thiab puas yog qhov yuav tsum muaj rau txhua txoj kev npaj?
EDIP tau raug tsim kho rau lub xyoo dhau los. Nws tsis yog qhov yuav tsum tau ua rau txhua txoj kev npaj.

Encounter Data Improvement Project

Puas yog cov lej hauv zos yog qhov tseem ceeb tshaj plaws ntsib cov ntaub ntawv zoo?
Yog lawm, cov lej hauv zos yog qhov tseem ceeb tshaj plaws uas tau hais txog.
Tsis tau hloov kho 274 Provider Data Companion Guide hauv Documentation Center? Cov qauv ntaub ntawv xa email tsis qhib kom raug.
Daim ntawv ceeb toom tshaj tawm txog qhov version tshiab ntawm 274 Companion Guide(s) tau xa yuam kev. Nws yog qhov tshwm sim ntawm kev ua haujlwm tsis siv neeg uas tau tso tseg tsis txhob txwm ua haujlwm thaum nws yuav tsum tau kaw. Daim ntawv ceeb toom tau raug kaw lawm, thiab yuav tsis muaj kev hloov tshiab tsis siv neeg xa mus rau cov neeg koom tes ua lag luam.
Daim ntawv ceeb toom tau tshwm sim los ntawm kev xa cov ntaub ntawv qauv ntsig txog kev hloov pauv hauv 274 Validation Response File (VRF). VRF yog cov ntsiab lus luv luv ntawm cov txiaj ntsig ntawm kev ua tiav / kev lees paub thaum muaj 274 cov ntaub ntawv xa mus rau DHCS raug ua tiav.
Daim 274 VRF tau hloov kho kom suav nrog cov lej suav txog cov ntaub ntawv 274 xa tuaj. Cov suav sau luv luv no tau raug ntxiv los hloov cov ntaub ntawv sib haum xeeb xa ntawv uas tsis tau tso tseg. Cov ntaub ntawv hais txog cov kev hloov pauv no yuav raug ntxiv rau 274 Cov Lus Qhia Sib Koom Tes thiab rau 274 Cov Lus Qhia Txog Qhov Yuam Kev, thiab cov neeg koom tes ua lag luam yuav raug ceeb toom thaum cov kev hloov pauv tshiab tau tshaj tawm.
Ntxiv rau:
Phau Ntawv Qhia Txog Kev Kho Mob Tswj Xyuas (MMC) 274 v.3.0 tseem tab tom tos kev tshaj tawm tom qab kev tshuaj xyuas sab hauv los ntawm cov neeg ua haujlwm ntawm DHCS Program thiab Policy.
Phau Ntawv Qhia Txog Kev Noj Qab Haus Huv Kev Coj Tus Kheej (IBH) 274 v.3.0 tau luam tawm tsis ntev los no. Tom qab luam tawm, pom muaj qhov yuam kev. Qhov yuam kev no tab tom raug kho, thiab phau ntawv qhia txog kev noj qab haus huv ntawm tus cwj pwm sib koom ua ke 274 v. 3.01 uas tau hloov kho tshiab yuav raug tshaj tawm sai sai no. (txij li hnub tim 3/10/2025)
Cov ntawv ceeb toom yuav raug xa los ntawm DHCS thaum MMC 274 CG uas tau hloov kho tshiab, lossis IBH 274 CG uas tau kho lawm tau luam tawm.
Dab tsi yog qee qhov piv txwv ntawm qhov tsis sib xws thiab sib xws?
Kev Tshwj Xeeb: cov kab kev pabcuam zoo sib xws: kev ntsuas sib cais rau 837 Kev lag luam hauv tsev thiab 837 Kev Tshaj Lij. Cov ntsiab lus ntawm cov ntaub ntawv uas tau txhais nyob rau hauv Tshooj 3.8 ntawm phau ntawv qhia ua ke yuav raug suav hais tias yog cov kab kev pabcuam uas ob daim.
Kev Sib Xws: Feem Pua ntawm Cov Neeg Muab Kev Pabcuam Hauv Tebchaws (NPIs) ntawm kev ntsib uas pom muaj nyob rau ntawm Daim Phiaj Xwm cov ntaub ntawv 274 xa tuaj.
Puas yog cov kev tsis pom zoo uas cuam tshuam txog kev tsim nyog yuav raug suav hais tias tsis kho tau
Nws nyob ntawm qhov laj thawj ntawm kev tsis pom zoo. Yog tias tus lej CIN tsis raug rau ib tug tswv cuab uas tsis muaj nyob raug xa mus, ces qhov ntawd yuav kho tsis tau thiab yuav tsum raug tshem tawm. Yog tias nws tsuas yog ib qho kev sau ntawv yooj yim hauv CIN uas siv tau thiab tsim nyog, lossis yog tias (piv txwv li) muaj qhov tsis sib xws ntawm hnub ua haujlwm thiab hnub tsim nyog rau cov tswv cuab, ces nws tuaj yeem kho tau nrog kev hloov pauv.
Puas yog DHCS xav kom cov kev ntsib yuav raug xa rov qab yog tias muaj kev them nyiaj ntxiv rau cov kev ntsib ntawd ua ib feem ntawm qhov yuav tsum tau ua ntawm 2024 TRI? Yog tias yuav tsum tau xa dua, qhov no yuav cuam tshuam li cas rau kev xam lub sijhawm ntawm QMED rau txoj kev npaj?
DHCS yuav coj lo lus nug no los xav txog ua ib feem ntawm QMED 2.0 project.
Puas yuav tshem cov lej hauv zos tawm ntawm daim ntawv teev nqi Medi-Cal?
Cov nqi rau cov lej yog ib feem ntawm kev daws teeb meem ntawm cov lej hauv zos. Cov lej hauv zos muaj feem cuam tshuam ncaj qha rau kev them nqi rau kev pabcuam piv rau kev ntsib. Nyob twj ywm mloog kom paub ntxiv.
Puas yog DHCS yuav tshaj tawm phau ntawv qhia txog kev muab cov ntaub ntawv ntsib los daws cov teeb meem them nqi uas phau ntawv qhia txog kev them nqi Medi-Cal FFS siv tau thiab tsis siv tau rau cov ntaub ntawv ntsib? Piv txwv li yog kev siv cov ntu NTE tshwj xeeb rau FFS daim ntawv them nqi, SV109 ED cov cim qhia uas Medicare tso qhov chaw dawb paug, cov kev hloov kho kev thauj mus los.
Yog, kev them nqi kom raug yog ib feem ntawm peb lub hom phiaj ntawm Encounter Data Improvement Project.
Puas yog DHCS xav txog kev tso tseg qhov kev ntsuas raws sijhawm hauv Q4 2024 QMED vim yog kev xa cov kev sib ntsib rau TRI kev hloov kho?
DHCS yuav coj lo lus nug no los xav txog ua ib feem ntawm QMED 2.0 project.

Medi-Cal Connect FAQ Tej zaum/2025

Lwm tus

Koj puas yuav muab cov txheej txheem uas koj tau siv los xam cov nqi sib tw? Koj puas tseem yuav muab kev taw qhia txog yuav ua li cas cov #s tuaj yeem txhim kho?
DHCS tau muab txoj kev sib phim rau FQHCs thiab MCPs. Yog koj xav tau ib daim qauv, thov xa email rau FQHCAPM@dhcs.ca.gov. DHCS tab tom ua haujlwm los txheeb xyuas cov laj thawj uas ua rau muaj qhov sib phim qis hauv cov neeg thov rau APM. Peb yuav muab cov lus qhia txog peb cov kev tshawb pom thiab peb yuav pom zoo li cas rau FQHCS thiab MCPs ua haujlwm ua ke los txhim kho cov ntaub ntawv.
Puas yog DHCS muaj ib qho kev txhais tus qauv rau Kev Saib Xyuas Kev Pom Zoo Txog Txiv Neej thiab Poj Niam, thiab cov lej no puas tau txheeb xyuas?
Yog xav tau ib qho lus txhais tus qauv, thov hu rau koj tus neeg saib xyuas thaj chaw ntawm qhov kev pab cuam.
Cov ntaub ntawv txuj ci 834 uas muaj kev hloov pauv rau Kev Saib Xyuas Kev Pom Zoo Txog Poj Niam Txiv Neej yuav muaj thaum twg?
Thov mus saib CAPMAN Documentation channel ntawm DHCS Documentation Center, uas muaj cov version tam sim no ntawm 834, nrog rau cov version tom ntej uas yuav siv tau rau hnub tim 02/24/2025. Yog tias koj muaj lus nug ntxiv, thov hu rau koj tus Thawj Saib Xyuas Daim Ntawv Cog Lus DHCS lossis koj tus neeg sawv cev rau kev sau npe/kev tsim nyog ntawm DHCS, yog tias tau muab rau koj lub koom haum.

DHCS Cov Ntaub Ntawv Qhia thiab Saib Xyuas Webinar Series Cov Lus Nug Nquag​​

General​​

274 PAB​​

Cov ntaub ntawv MCPD/PCPA​​

Sib ntsib cov ntaub ntawv​​

Data Exchange & Xa​​

JSON, ECM/CS​​

274 MHP thiab 274 DMC-ODS​​

Kev coj cwj pwm noj qab haus huv Short Doyle​​

QMED 2.0​​

Encounter Data Improvement Project​​

Medi-Cal Connect FAQ Tej zaum/2025​​

Lwm tus​​