Cov Tsev Kho Mob Nruab Nrab Nruab Nrab
The Designated Intermediate Care Facility (DICF) Quality Assurance Fee (QAF) program is governed by the California Health and Safety Code, Sections 1324 through 1324.14. These provisions require the California Department of Health Care Services (DHCS) to impose a QAF based on the gross receipts for each DICF, including Developmentally Disabled (DICF-DD), Developmentally Disabled Habilitative (DICF-DD-H), and Developmentally Disabled Nursing (DICF-DD-N). For the purposes of this program, the term “gross receipts” is defined as compensation for services provided to residents of a DICF, not including the following:
- Rov qab ntawm ib qho nyiaj rau tus neeg them nyiaj raws li qhov tshwm sim ntawm kev them nyiaj ntau dhau
- Cov nuj nqis phem
- Cov neeg muag khoom rov qab tau txais los ntawm qhov chaw
- Cov nyiaj pub dawb tau txais los ntawm qhov chaw
As a condition for a DICF to participate in the Medi-Cal program, payments to DHCS must be made on or before the last day of each calendar quarter, following the calendar quarter for which the fee is imposed. DHCS has the discretion to make retroactive adjustments as necessary to ensure that the fees collected do not exceed 6 percent. Please refer to the following link regarding important changes to DICF QAF requirements: DICF Bulletin 388
Thov nco ntsoov tias Ntu Kev Them Nqi Them Nqi Them Ib Hnub tau raug tshem tawm ntawm QAF daim ntawv them nqi peb lub hlis twg. Cov ntawv xa nyiaj sib cais yuav raug xa mus rau Kev Them Nqi Kho Mob Hnub.
QAF-DICF Daim Ntawv Qhia Txog Kev Them Nyiaj thiab Kev Qhia
Cov Ntawv Xa Hauv Online - Siv qhov txuas no los xa cov ntaub ntawv txais nyiaj tag nrho hauv hluav taws xob:
Printable Forms – Use these links to print the form and mail gross receipts data, along with the corresponding QAF payment:
- Daim Ntawv Them Nyiaj thiab Kev Tshaj Tawm ntawm DICF QAF - Sau Tau
- Daim Ntawv Them Nyiaj thiab Daim Ntawv Qhia Txog Kev Kho Mob Thaum Nruab Hnub QAF - Sau Tau
Thov nco ntsoov sau koj lub npe chaw nyob, chaw nyob, thiab National Provider Identification (NPI) tus lej, kom koj cov nyiaj them poob haujlwm yuav raug muab tso rau hauv tus account kom raug.
Provider bulletins and rates information is available on the Long Term Care Reimbursement webpage.
DHCS tam sim no txais Electronic Funds Transfer (EFT) mus rau DICF cov kev pab cuam. Yog xav paub ntxiv, thov mus saib ntawm TPLRD EFT Payments webpage.
Lus Cim: Yog tias koj tso tsis raug lossis tsis muaj tus lej xa ntawv, saib cov lus hauv qab no thiab siv tus lej xa ntawv uas koj twb siv lawm los them nqi.
| QAF Program | Invoice Number |
|---|---|
| Qhov Chaw Kho Mob Nruab Nrab (DICF) | ICF12345678 |
| Day Treatment – DICF | DAY12345678 |
Thaum them nyiaj los ntawm EFT siv tus lej Invoice nyob saum toj no, thov xa email rau QAF@dhcs.ca.gov thiab suav nrog cov ntsiab lus hauv qab no kom ntseeg tau tias EFT them nyiaj raug tshaj tawm thiab siv tau raug:
- Lub npe tus kws kho mob
- National Provider Identifier (NPI) Number
- Yog tias koj muab NPI rau lwm qhov chaw, thov muab koj tus lej Muag Khoom.
- Tus nqi ntawm EFT them nyiaj
- Hnub tim ntawm EFT them nyiaj
- Daim ntawv them nqi thiab/lossis cov ntaub ntawv suav pej xeem txheeb xyuas seb qhov EFT them nyiaj li cas rau (piv txwv li, peb lub hlis twg thiab tus nqi xyoo).
Cov lus nug?
Cov lus nug txog QAF cov nyiaj them yuav tsum raug xa mus rau:
Department of Health Care Services
Third Party Liability & Recovery Division
Quality Assurance Fee Program – MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
Xov tooj: (916) 650-0583
Fax: (916) 440-5671
Email: QAF@dhcs.ca.gov