“Crossover Only” providers, by definition, must meet two required conditions. The first condition is that they are enrolled in Medicare and they are not enrolled in Medi-Cal. The second condition is that they have provided a service to a dual-eligible member and are seeking approval for reimbursement of that service.​​ 

Ob tus tswvcuab tsim nyog yog cov tswvcuab uas tsim nyog tau txais kev pabcuam los ntawm Medicare (txawm tias Medicare Part A, Part B lossis ob qho tib si) thiab Medi-Cal. Feem ntau, kev thov rau cov kev pabcuam uas tau muab rau cov tswvcuab dual-tsim nyog yog thawj zaug ua tiav los ntawm Medicare thiab tom qab ntawd raug xa mus rau hauv hluav taws xob rau Medi-Cal Fee-for-Service (FFS). Medi-Cal txoj kev them nyiaj FFS tom qab ntawd them rov qab cov nqi sib faib cov nqi ntawm cov nyiaj seem tshuav.​​ 

Rau Medi-Cal tus nqi-rau-kev pabcuam cov tswvcuab (tsis tau tso npe rau hauv txoj kev npaj khomob), cov kws khomob tuaj yeem thov kom tau txais cov nyiaj them rov qab raws li "Crossover nkaus xwb" tus kws kho mob los ntawm DHCS PAVE Provider Portal.​​ 

Thov nco ntsoov tias Medi-Cal cov kev pab them nqi kho mob muaj lawv tus kheej cov txheej txheem kom tau txais cov ntaub ntawv kho mob rau cov nqi sib faib. Cov neeg muab kev pabcuam uas muaj kev tswj xyuas cov tswvcuab yuav tsum tsis txhob xa daim ntawv "Crossover nkaus xwb" tus kws kho mob los ntawm DHCS PAVE Provider Portal. Hloov chaw, hu rau cov phiaj xwm kev saib xyuas uas raug tswj kom tau txais kev pab cuam nrog kev them nyiaj rau tus kws kho mob nkaus xwb.​​