Cov Kev Xav Tau ntawm Tus Muab Kev Pab Cuam Rau Medi-Cal Tus Nqi-rau-Kev Pabcuam
Pib txij Lub Xya Hli 1, 2025, Medi-Cal Fee-for-Service (FFS) cov kws kho mob yuav tsum muab cov ntaub ntawv ntxiv hauv qab no (ntxiv rau cov ntaub ntawv uas twb tau sau los ntawm Medi-Cal daim ntawv thov nkag). Raws li Lub Chaw Pabcuam Medicare thiab Medicaid (CMS), Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom ua cov kev taw qhia ntawm Cov Kev Pabcuam Cov Cai rau FFS cov chaw muab kev pabcuam raws li Division H, Title V, Tshooj 5123 ntawm Consolidated Appropriations Act, 2023 (CAA, 2023), thiab State-Section 034 Tus Thawj Saib Xyuas Kev Noj Qab Haus Huv 24. 5.
Thov xa mus rau peb cov lus nug nquag nug kom paub ntau ntxiv.
Hloov kho koj cov ntaub ntawv qhia chaw muab kev pab tam sim no
Cov kws kho mob tsis them nqi
Nkag mus rau npe rau ib tus neeg them nqi-rau-Service (FFS) cov chaw muab kev pabcuam ncaj qha rau cov tswvcuab Medi-Cal thiab tsis xa daim ntawv thov ncaj qha mus rau Medi-Cal rau cov kev pab cuam yuav tsum xa cov ntaub ntawv los ntawm kev ua tiav Daim Ntawv Tshawb Fawb Cov Ntawv Teev Npe. Cov kws kho mob uas tsis them nqi suav nrog kev xa tawm, Kev Txiav Txim, Kev xa mus, thiab Kev Pab (ORP) thiab Cov Kws Kho Mob Tsis Muaj Kws Kho Mob (NMP) cov kws kho mob.
Daim ntawv ntsuam xyuas tus kws kho mob(feature)
Keeb kwm
CAA, 2023 mandates Medicaid, thiab Children's Health Insurance Program (CHIP) FFS cov kev pab cuam thiab tau cog lus Managed Care Plans luam tawm cov ntaub ntawv tshawb nrhiav thiab hloov kho tshiab nyob rau hauv lub vev xaib pej xeem los ntawm Lub Xya Hli 1, 2025. Lub CAA, 2023 tau qhia txog cov kev cai tshiab rau FFS cov chaw muab kev qhia npe nyob rau hauv Division H, Title V, Tshooj 5123, hu ua "Yuav tsum Muaj Qhov Tseeb, Hloov Kho, thiab Tshawb Nrhiav Cov Chaw Pabcuam." Cov kev cai no ntxiv rau cov ntaub ntawv xav tau yam tsawg kawg nkaus hauv FFS cov chaw muab kev pabcuam, uas yuav tsum tau hloov kho yam tsawg kawg peb lub hlis twg. Cov ntaub ntawv "Sau npe Medi-Cal FFS Cov Chaw Kho Mob" cov ntaub ntawv nyob hauv California Health & Human Services Open Data Portal yog suav tias yog FFS cov chaw muab kev pabcuam.
Txoj Cai Tshiab
Pib txij Lub Xya Hli 1, 2025, FFS cov chaw muab kev pabcuam yuav tsum muab cov ntaub ntawv hauv qab no uas yuav suav nrog hauv FFS cov chaw muab kev pabcuam (ntxiv rau cov ntaub ntawv uas twb tau sau los ntawm Medi-Cal daim ntawv thov nkag):
- Tus xovtooj ntawm chaw ua haujlwm
- Tus kws kho mob lub vev xaib (yog tias muaj)
- Seb tus kws kho mob puas kam txais cov neeg mob Medicaid tshiab
- Seb tus kws kho mob puas kam txais cov neeg mob CHIP tshiab
- Kev coj noj coj ua thiab kev paub lus muaj peev xwm suav nrog cov lus (xws li Cov Lus Qhia Lus Asmesliskas) uas muab los ntawm Tus Kws Kho Mob lossis los ntawm tus kws txhais lus kho mob uas muaj peev xwm muab kev pab txhais lus ntawm Tus Kws Kho Mob lub chaw ua haujlwm
- Qhov kev pab twg uas tus kws kho mob lub chaw ua haujlwm lossis chaw ua haujlwm tau muab rau cov tib neeg uas muaj lub cev tsis taus, suav nrog chaw ua haujlwm, chav kuaj mob, thiab khoom siv.
- Seb tus kws kho mob puas muab Kev Pabcuam Covered ntawm telehealth
Hloov tshiab Peb Hlis
Txhawm rau kom ntseeg tau qhov tseeb ntawm cov chaw muab kev pabcuam, cov chaw muab kev pabcuam yuav tsum tshuaj xyuas thiab hloov kho cov ntaub ntawv no tsawg kawg peb lub hlis twg thiab thaum kawg ntawm txhua lub hlis ntawm Lub Ib Hlis, Plaub Hlis, Lub Xya Hli, thiab Lub Kaum Hli.
Kev hloov kho tshiab rau cov ntaub ntawv qhia chaw kho mob uas twb muaj lawm tuaj yeem ua tau txhua lub sijhawm. Yog tias tsis muaj kev hloov pauv rau cov ntaub ntawv qhia chaw kho mob hauv lub quarter tom ntej, tsis tas yuav tsum ua dab tsi.
Cov lus nug nquag
General
Cov kws kho mob twg yuav tsum tau hloov kho lawv cov ntaub ntawv teev npe?
Raws li Tshooj 5123 ntawm Consolidated Appropriations Act, 2023 (CAA, 2023), Medicaid, thiab Children's Health Insurance Program (CHIP) Fee-For-Service (FFS) cov kev pab cuam thiab lawv daim ntawv cog lus Managed Care Plans yuav tsum luam tawm cov ntaub ntawv tshawb nrhiav, tsis tu ncua hloov kho cov npe ntawm lub vev xaib pej xeem los ntawm Lub Xya 2025 1
Cov chaw muab ntawv teev npe suav nrog, tab sis tsis txwv rau cov kws kho mob, tsev kho mob, khw muag tshuaj, cov chaw muab kev pabcuam kev puas siab puas ntsws, cov neeg muab kev pabcuam kev siv tshuaj yeeb dawb, cov chaw muab kev pabcuam mus ntev, thiab tag nrho lwm cov chaw muab kev pabcuam uas teev nyob rau hauv
nplooj ntawv Kev Pabcuam Sau Npe.
Cov ntaub ntawv dab tsi kuv yuav tsum tau hloov kho?
Cov kws kho mob sau npe yuav tsum xa cov ntaub ntawv teev npe hauv qab no, uas yuav siv los hloov kho
Medi-Cal Fee-For-Service Provider Directory: tus xov tooj chaw ua haujlwm, tus kws kho mob lub vev xaib (yog tias muaj), seb tus kws kho mob puas txais cov neeg mob Medicaid tshiab, seb tus kws kho mob puas lees txais cov neeg mob CHIP tshiab, seb tus kws kho mob puas muaj kev pab them nqi kho mob ntawm telehealth, kab lis kev cai thiab kev hais lus rau ib tus neeg muaj peev xwm, kev pab cuam thiab kev hais lus. kev tsis taus.
Tus Nqi-For-Service Directory yog dab tsi?
Kuv tuaj yeem hloov kho cov ntaub ntawv no hauv PAVE?
Tsis yog, PAVE tsis sau cov ntaub ntawv qhia chaw kho mob ntxiv uas xav tau los ntawm Tshooj 5123 ntawm CAA, 2023.
Kuv yuav tsum hloov kho kuv cov ntaub ntawv ntau npaum li cas?
Txhawm rau kom ntseeg tau qhov tseeb ntawm cov ntaub ntawv muab kev pabcuam, cov chaw muab kev pabcuam yuav tsum tshuaj xyuas thiab hloov kho cov ntaub ntawv no tsawg kawg peb lub hlis twg thiab thaum kawg ntawm txhua hnub ntawm lub Ib Hlis, Plaub Hlis, Lub Xya Hli, thiab Lub Kaum Hli. Kev hloov kho tshiab rau cov ntaub ntawv qhia chaw kho mob uas twb muaj lawm tuaj yeem ua tau txhua lub sijhawm.
Yuav ua li cas yog tias kuv tsis muaj kev hloov pauv tom qab hloov tshiab thawj zaug?
Yog tias tsis muaj kev hloov kho tshiab rau koj cov ntaub ntawv qhia chaw muab kev pabcuam hauv peb lub hlis tom ntej tom qab xa thawj zaug, tsis tas yuav tsum tau ua ntxiv.
Kuv yuav hloov kho kuv cov ntaub ntawv kho mob qhov twg?
Cov chaw muab kev them nqi yuav tsum xa cov ntaub ntawv qhia chaw kho mob nyob rau hauv Medi-Cal
Provider Portal. Txhawm rau nkag mus rau lub portal, cov chaw muab kev pabcuam FFS uas tau sau npe yuav tsum xub tsim ib tus as-qhauj los ntawm kev tso npe rau ntawm
Medi-Cal Cov Chaw Pabcuam webpage.
Tus Muab Kev Pabcuam Portal rau Tus Muab Nyiaj Txiag
Kuv yuav hloov kho kuv cov ntaub ntawv nyob qhov twg ntawm Tus Kws Kho Mob Portal? Tom qab nkag mus, mus rau "NPI Daim Ntawv Pom Zoo thiab Chaw" thiab xaiv "Public Fee-For-Service Provider Directory."
Kuv tsis tuaj yeem nkag mus rau kuv tus as-qhauj ntawm Tus Pabcuam Portal. Kuv yuav hu rau leej twg?Lub Chaw Pabcuam Xovtooj (1-800-541-5555) muaj 8 teev sawv ntxov txog 5 teev tsaus ntuj PT, Monday txog Friday, tshwj tsis yog cov hnub so hauv tebchaws.
Leej twg tau tso cai los hloov kho tshiab hauv Chaw Kho Mob Portal?Tsuas yog Cov Thawj Coj Hauv Lub Koom Haum thiab NPI Cov Thawj Coj tuaj yeem hloov kho cov ntaub ntawv qhia chaw kho mob. Txhawm rau hloov kho cov neeg siv kev tso cai, Tus Thawj Coj Lub Koom Haum yuav tsum ntxiv tus neeg siv thiab muab cov qib tso cai. Xa mus rau
Tus Muab Kev Pabcuam Tus Neeg Siv Phau Ntawv Qhia: Lub Koom Haum Pabcuam rau cov lus piav qhia ntawm txhua lub luag haujlwm muaj.
Rau lwm cov lus nug txog Cov Chaw Pabcuam Portal, thov mus saib ntawm Chaw Pabcuam Portal FAQ.
Kev Tshawb Fawb Cov Ntawv Teev Npe rau Cov Kws Kho Mob Tsis-Billing
Kuv puas tuaj yeem khaws kuv qhov kev nce qib thaum ua tiav daim ntawv ntsuam xyuas? Tsis yog, daim ntawv ntsuam xyuas tsis txuag cov lus teb tsis tiav. Peb pom zoo kom sau cov lus teb rau hauv ib daim ntawv cais ua ntej nkag mus rau hauv daim ntawv ntsuam xyuas.
Kuv tuaj yeem kho kuv qhov kev xa mus dhau los li cas?Txhawm rau hloov pauv, thov xa cov lus teb tshiab uas siv
Daim Ntawv Teev Npe Muab Kev Tshawb Fawb. Cov lus teb tsis ntev los no yuav sau cov ntawv xa mus dhau los. Thov tso cai rau ib lub lim tiam tom qab xa cov ntaub ntawv tshiab kom muaj kev cuam tshuam hauv phau ntawv.
Kuv tuaj yeem saib kuv qhov kev xa mus dhau los li cas?Txhawm rau thov ib daim qauv ntawm koj cov lus teb, thov ua kom tiav
Daim Ntawv Thov Kev Pabcuam.
Rau lwm cov lus nug hais txog FFS tus neeg muab kev pabcuam cov npe, cov kws kho mob tuaj yeem hu rau Lub Chaw Pabcuam Npe Nkag Tebchaws los ntawm Daim Ntawv Qhia Txog Tus Muab Kev Pabcuam.
