Tus Nqi Kev Pov Hwm Zoo
Lub Department of Health Care Services (DHCS) Third Party Liability and Recovery Division (TPLRD) yog lub luag hauj lwm rau kev sau cov nqi pov hwm zoo (QAF) los ntawm cov chaw muab kev pab. TPLRD tseem yog lub luag haujlwm los sau cov se ntawm Lub Koom Haum Saib Xyuas Kev Tswj Xyuas (MCO) ntawm cov phiaj xwm kho mob. Cov kws kho mob thiab MCOs tuaj yeem siv nplooj ntawv no los tshaj tawm cov ntaub ntawv xav tau, them nyiaj hluav taws xob, thiab xa cov lus nug rau cov neeg ua haujlwm.
Qhia txog cov ntaub ntawv xav tau
Cov neeg muab kev pabcuam cuam tshuam nrog cov kev pabcuam hauv qab no yuav tsum tshaj tawm cov ntaub ntawv rau DHCS txhawm rau txiav txim siab lawv QAF cov nyiaj them poob haujlwm. Cov kws kho mob yuav tsum siv cov kev sib txuas hauv qab no:
-
Ground Emergency Medical Transport Program (GEMT)
-
Skilled Nursing Facilities (SNF)
-
Qhov Chaw Kho Mob Nruab Nrab-Developmentally Disabled (DICF-DD)
Cov kev pabcuam hauv qab no tsis tas yuav xa cov ntaub ntawv ntxiv:
-
Hospital Quality Assurance Fee Program (HQAF)
-
Managed Care Organization (MCO)
Ua Kev Them Nyiaj Online
DHCS tam sim no lees txais Electronic Funds Transfer (EFT) rau QAF thiab MCO Tax programs. Yog xav paub ntxiv, thov mus saib ntawm TPLRD EFT Payments webpage.
Nco tseg: Yog tias koj muab tso rau qhov tsis raug lossis tsis muaj tus lej xa nyiaj, xa mus rau cov lus hauv qab no thiab siv tus lej them nqi tsis raug them nyiaj.
| Ground Emergency Medical Transport (GEMT) | GEM12345678 |
| Qhov Chaw Kho Mob Nruab Nrab (DICF) | ICF12345678 |
| Kev Kho Mob Hnub - DICF | DAY12345678 |
| Lub Chaw Saib Xyuas Neeg Mob (SNF) | SNF12345678 |
| Tsev Kho Mob Tus Nqi Them Nqi-Rau-Service | HQF12345678
|
| Tsev Kho Mob Tus Nqi Them Nqi Tswj Kev Kho Mob | HQM12345678 |
Managed Care Organization Tax
| MCO12345678
|
W hen them los ntawm EFT siv tus lej Invoice default, thov xa email rau
QAF@dhcs.ca.gov thiab suav nrog cov ntsiab lus hauv qab no kom paub meej tias EFT them nyiaj tau tshaj tawm thiab siv tau raug: - Lub Npe Chaw Pabcuam/Lub Koom Haum
- National Provider Identifier (NPI) Number (yog muaj)
- Kev Saib Xyuas Kev Noj Qab Haus Huv thiab Kev Txheeb Xyuas Cov Ntaub Ntawv (HCAI ID, yav tas los OSHPD) (yog tias tsim nyog).
- Tus nqi ntawm EFT them nyiaj
- Hnub tim ntawm EFT them nyiaj
- Cov ntaub ntawv them nqi thiab/lossis cov ntaub ntawv suav pej xeem txheeb xyuas seb EFT them nyiaj rau dab tsi (piv txwv li hli/quarter thiab tus nqi xyoo)
Chaw Nyob Them Nqi rau Daim tshev
| SNF |
Department of Health Care Services
ATTN: SNF QAF
Accounting Section/Cashiers Unit, Mail Stop 1101
1501 Capitol Avenue
PO Lub thawv 997415
Sacramento, CA 95899-7415
|
| DICF ua | Department of Health Care Services
ATTN: DICF QAF
Accounting Section/Cashiers Unit, Mail Stop 1101
1501 Capitol Avenue
PO Lub thawv 997415
Sacramento, CA 95899-7415 |
| GEMT | Department of Health Care Services
ATTN: GEMT QAF
Accounting Section/Cashiers Unit, Mail Stop 1101
1501 Capitol Avenue
PO Lub thawv 997415
Sacramento, CA 95899-7415 |
| HQAB | Cov nyiaj them tuaj yeem raug xa los ntawm Kev Xa Ntawv Hmo Hmo nrog tus lej taug qab rau kev xa khoom thaum sawv ntxov ntawm FedEx, Golden State, lossis United Parcel Service mus rau:
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv
ATTN: HQAF
Nqe Lus Qhia/ Cashiers Unit, Mail Stop 1101
1501 Capitol Avenue
PO Lub thawv 997415
Sacramento, CA 95899-7415 |
| MCO Tax | Cov nyiaj them tuaj yeem raug xa los ntawm Kev Xa Ntawv Hmo Hmo nrog tus lej taug qab rau kev xa khoom thaum sawv ntxov ntawm FedEx, Golden State, lossis United Parcel Service mus rau:
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv
ATTN: MCO Tax
Cov Nqe Nyiaj Txiag /Cashiers Unit, Mail Stop 1101
1501 Capitol Avenue
PO Lub thawv 997415
Sacramento, CA 95899-7415 |
Xav paub ntau ntxiv txog Cov Kev Pabcuam
Cov kev pab cuam no txhawb kev txhim kho kom zoo thiab txhim kho Tsoom Fwv Teb Chaws Kev Koom Tes Nyiaj Txiag rau Medi-Cal qhov kev pab cuam. Yog xav paub ntxiv txog QAF cov kev pab cuam, nyem rau ntawm nplooj ntawv program (s) hauv qab no:
Xa ib nqe lus nug rau Cov Neeg Ua Haujlwm Pabcuam
Xa cov lus nug txog QAF cov kev pab cuam lossis kev them nyiaj.
Rov qab mus rau Third Party Liability and Recovery Division
