Hla mus rau Cov Ntsiab Lus Tseem Ceeb
Qhib hom nkag tau yooj yim dua
Tua tawm hom siv tau ntau dua
Hla mus rau Cov Ntsiab Lus Tseem Ceeb
Medi-Cal Cov Tswv Cuab:
Khaws koj qhov kev pab them nqi kho mob
. Nkag mus rau
koj tus as-qhauj
lossis tiv tauj
koj lub nroog chaw ua haujlwm
kom hloov kho koj cov ntaub ntawv.
Tseem ceeb
Koj puas tau tso npe rau hauv Medi-Cal? Koj cov ntaub ntawv tiv tauj puas tau hloov pauv hauv ob xyoos dhau los? Muab koj lub nroog lub chaw lis haujlwm hauv koj lub nroog koj cov ntaub ntawv tiv tauj tshiab kom koj tuaj yeem nyob twj ywm.
Nrhiav koj lub county office.
Tsev
#
#
#
Tsev
Hais txog DHCS
CA.gov
Ntawv qhia zaub mov
Nrhiav
Tsev
Kev pabcuam
Cov neeg
Cov kws kho mob &
Cov koom tes
Txoj Cai &
Kev cai
Cov ntaub ntawv &
Kev txheeb cais
Cov ntawv &
Kev tshaj tawm
Nrhiav
Nrhiav rau qhov chaw no:
Page Content
Daim Ntawv Qhia Tshuaj Kho Mob Medi-Cal
MC 5120AD - Tus neeg muag khoom pom zoo daim ntawv pov thawj
(PDF)
MC 5121AD - County-Direct Provider Approver Certification
(PDF)
MC 5123AD - DHCS Cov Neeg Ua Haujlwm Pom Zoo Ntawv Pov Thawj
(PDF)
MC 5131AD - County-Direct Provider User Cancellation
(PDF)
MC 5312: Drug Medi-Cal (DMC) Kev Pabcuam Thov Kev Them Nyiaj Rov Qab Los Ntawm Lub Nroog Tus Nqi Se
(Excel)
MC 5312: Drug Medi-Cal (DMC) Kev Pabcuam Thov Kev Them Nyiaj Rov Qab Los Ntawm Lub Nroog Tus Nqi Se rau Lub Plaub Hlis-Lub Rau Hli 2023
(PDF)
MC 5312: Drug Medi-Cal (DMC) Kev Pabcuam Thov Kev Them Nyiaj Rov Qab Los Ntawm Lub Nroog Tus Nqi Se rau Q1 thiab Q2 FY 2023-24
(PDF)
MC 5312: Drug Medi-Cal (DMC) Cov Kev Pabcuam Thov Kev Them Nyiaj Rov Qab Los Ntawm Lub Nroog Tus Nqi Se- Hloov Kho 08/2024
(PDF)
DHCS 5311 Daim Ntawv Thov - DMC-ODS Daim Ntawv Thov rau Kev Them Nyiaj Rov Los Ntawm Kev Pov Hwm Zoo / Kev Siv Tshuaj Xyuas (QA / UR) Tus Nqi
(Excel)
DHCS 5311 Daim Ntawv Thov - DMC-ODS Daim Ntawv Thov rau Kev Them Nyiaj Rov Los Ntawm Kev Pov Hwm Zoo / Kev Tshawb Xyuas Kev Siv (QA/UR) Tus Nqi Pib Pib 7/1/2022 (Excel)
DHCS 5311: Drug Medi-Cal (DMC) Thov Kev Them Nyiaj Rov Los Ntawm Kev Pov Hwm Zoo/Kev Siv Tshuaj Xyuas Tus Nqi- Kho 02/2024
(PDF)
DHCS 6065A Daim Ntawv - Daim Ntawv Pov Thawj Zoo
(PDF)
DHCS 6065A Cov Lus Qhia - Daim Ntawv Pov Thawj Zoo
(PDF)
DHCS 6065B Daim Ntawv Pov Thawj Zoo
(PDF)
DHCS 6065B Cov Lus Qhia - Daim Ntawv Pov Thawj Zoo
(PDF)
DHCS 6700 Daim Ntawv Qhia - Daim Ntawv Pov Thawj Ua Haujlwm Ntau Yam
(PDF)
DHCS 6700 Cov Lus Qhia - Ntau Cov Lus Qhia Txog Kev Sau Npe Pov Thawj
(PDF)
DHCS 100185 Form - DMC Claim Submission Certification - Direct Contract Provider
(PDF)
DHCS 100185 Cov Lus Qhia - DMC Daim Ntawv Tso Cai Xa Ntawv Pov Thawj - Tus Muab Daim Ntawv Cog Lus Ncaj Ncees
(PDF)
DHCS 100186 Form - DMC Claim Submission Certification - County Contracted Provider
(PDF)
DHCS 100186 Instructions - DMC Claim Submission Certification - County Contracted Provider
(PDF)
DHCS 100187 Form - DMC Claim Submission Certification - County Operated Provider Form
(PDF)
DHCS 100224 - Tshuaj Medi-Cal Certification rau Tsoom Fwv Teb Chaws Nyiaj Them Nqi
(PDF) - Kho 04/2025
DHCS 8049 Form - Lub Nroog Certification of Compliance (
PDF) - Kho 04/2024
DHCS 8049 Cov Lus Qhia - Lub Nroog Certification of Compliance
(PDF)
DHCS 5260 Form - SUDCRS Daim Ntawv Pom Zoo
(PDF)
Hnub hloov tshiab kawg: 5/8/2025 11:52 AM
