Tsev Cov Chaw Muab Kev Pabcuam & Cov Neeg Koom Tes Medi-Cal ORP Cov Lus Nug Feem Ntau ntawm Cov Kws Muab Kev Pabcuam​​ 

Cov Lus Nug Feem Ntau Txog Cov Kws Kho Mob thiab Cov Kws Muab Kev Them Nqi​​ 

Cov kws kho mob uas sau ntawv kom lawv muab tshuaj rau lawv, xaj kev kuaj mob, thiab/lossis xa cov tswv cuab Medi-Cal mus rau lwm yam kev pabcuam, yuav tsum tau sau npe nrog Medi-Cal. Yog tias tus kws kho mob tsis tau sau npe lossis lawv cov ntaub ntawv ploj lawm lossis tsis siv tau ntev lawm, tej zaum yuav muaj kev ncua sij hawm rau cov tswv cuab Medi-Cal tau txais lawv cov tshuaj thiab/lossis cov kev pabcuam. Yog tias cov kws kho mob uas xaj lossis xa mus rau lwm tus tsis tau sau npe lossis lawv cov ntaub ntawv ploj lawm lossis tsis siv lawm, tej zaum yuav muaj kev ncua sij hawm rau cov tswv cuab Medi-Cal tau txais lawv cov kev pabcuam. Cov lus nug thiab lus teb no muab cov ntaub ntawv ntxiv rau cov kws kho mob thiab cov neeg muab kev pab them nqi txog cov teeb meem uas yuav tshwm sim thiab cov kauj ruam uas yuav ua tau los daws.​​ 

Cov ntaub ntawv dav dav​​ 

Cov neeg muab kev pabcuam ORP yog leej twg?​​ 

A. Cov kws kho mob ORP yog cov kws kho mob uas tau txais daim ntawv tso cai uas xaj, xa mus, lossis sau cov kev pabcuam lossis cov khoom rau cov tswv cuab Medi-Cal.​​ 

  • Kev txib cov chaw muab kev pab ncaj qha xws li kev kuaj mob hauv chaw kuaj mob, DME, lossis kev noj qab haus huv hauv tsev.​​ 
  • Cov kws kho mob xa mus xa cov tswv cuab mus rau lwm tus kws kho mob kom lawv ntsuam xyuas lossis kho mob uas lawv muab tsis tau.​​ 
  • Cov kws kho mob sau cov ntawv sau tshuaj rau cov tshuaj lossis cov khoom muag hauv tsev muag tshuaj.​​ 

Rau kev noj qab haus huv tshwj xeeb, ntau tus Kws Kho Mob Uas Muaj Ntawv Tso Cai ntawm Healing Arts thiab Cov Kws Kho Mob Hlwb Uas Muaj Ntawv Tso Cai kuj ua haujlwm ua cov kws muab kev pab thiab yuav tsum rau npe. (Saib cov FAQ rau daim ntawv teev tag nrho.)​​ 

Vim li cas kuv daim ntawv thov thiaj raug ncua lossis tsis raug lees paub?​​ 

Cov kev thov tuaj yeem raug ncua lossis tsis lees paub thaum tus kws kho mob uas xaj, xa mus, lossis sau ntawv rau tus neeg mob tsis tau sau npe rau hauv Medi-Cal, lossis thaum tus kws kho mob hom 1 NPI ploj lawm, tsis raug cai, lossis tsis tau sau rau qhov twg xav tau ntawm daim ntawv thov.​​ 

Yog tias ib tug tswv cuab ntawm Medi-Cal xav tau tshuaj sai sai, kuv yuav ua li cas?​​ 

Cov khw muag tshuaj tuaj yeem tso cai rau kev sau tshuaj thaum muaj xwm txheej ceev thaum muag khoom. Kev ntim tshuaj thaum muaj xwm txheej ceev raug tso cai rau kev muab tshuaj rau 14 hnub ob zaug hauv lub sijhawm 30 hnub. Koj tuaj yeem nrhiav tau cov ntaub ntawv ntxiv hauv phau ntawv qhia txog tus neeg muab kev pabcuam uas siv 15.7.1 Kev Muab Khoom Siv Rau 14 Hnub Thaum Muaj Xwm Ceev. Koj tuaj yeem nrhiav tau cov ntaub ntawv ntxiv hauv Phau Ntawv Qhia Txog Kev Muab Tshuaj Medi-Cal Rx, Ntu 15.7.1 Kev Muab Tshuaj Rau Thaum Muaj Xwm Ceev rau 14 Hnub.​​ 

Qhov no puas yog qhov yuav tsum tau ua tshiab?​​ 

Txij li xyoo 2013 los, cov kev cai lij choj hauv tebchaws tau yuam kom cov neeg muab kev pabcuam yuav tsum tau sau npe kom raug thiab txheeb xyuas meej rau ntawm cov ntawv thov Medi-Cal, tab sis kev siv txoj cai tsis tau ib txwm sib xws thoob plaws hauv tsev muag tshuaj (Medi-Cal Rx), kev kho mob (CA-MMIS), thiab kev noj qab haus huv ntawm tus cwj pwm (Short Doyle). Kev sib phim cov kev cai no thoob plaws hauv cov txheej txheem ua rau muaj kev ncaj ncees ntawm cov kev pab cuam, ua kom paub tseeb tias cov neeg sau tshuaj raug, txo cov kev ua yuam kev ntawm kev them nqi, thiab txhawb nqa kev kho mob uas ua raws li txoj cai thiab tsis muaj kev cuam tshuam rau cov tswv cuab. Los ntawm kev siv cov cai no sib npaug zos, DHCS ua tau raws li tsoomfwv cov lus txib thaum txhim kho kev meej thiab kev lav ris rau cov neeg muab kev pabcuam thiab cov neeg koom tes.​​ 

Cov neeg muab kev pabcuam puas yuav tsum ua dab tsi?​​ 

Yog. Cov kws kho mob uas xaj, xa mus, lossis sau ntawv rau cov tswv cuab Medi-Cal yuav tsum tau sau npe rau hauv Medi-Cal siv lawv tus kheej Hom 1 NPI los ntawm kev thov siv lub portal sau npe online. Thov saib cov ntaub ntawv ntxiv txog cov txheej txheem sau npe. Kev sau npe sai li sai tau yuav pab tiv thaiv kev tsis lees paub qhov kev thov, teeb meem them nqi, thiab kev ncua sijhawm rau cov tswv cuab kom tau txais cov tshuaj lossis cov kev pabcuam. Cov neeg muab kev pab them nqi yuav tsum xyuas kom meej tias tus neeg muab kev pab uas xaj/xa mus/muab tshuaj rau ntawd tau sau npe thiab tias muaj Hom 1 NPI uas siv tau rau txhua daim ntawv thov ua ntej xa mus.​​ 

Vim li cas kuv daim ntawv thov thiaj raug tsis lees txais yog tias kuv tau sau npe rau hauv Medi-Cal?​​ 

Ib daim ntawv thov yuav raug tsis lees paub yog tias nws xav tau kev txiav txim, kev xa mus, lossis daim ntawv yuav tshuaj thiab tus neeg muab kev txiav txim, kev xa mus, lossis kev sau tshuaj tsis tau rau npe rau hauv Medi-Cal lossis tsis tau txheeb xyuas kom raug, txawm tias tus neeg muab kev them nqi tau rau npe lawm los xij. Yog xav paub ntxiv txog kev tsis kam lees txais daim ntawv pov thawj Medi-Cal, mus saib phau ntawv qhia txog kev pab cuam Medi-Cal Rx.​​ 

Cov kws kho mob yuav sau npe rau hauv Medi-Cal li cas?​​ 

Cov kws kho mob yuav tsum sau npe rau hauv Medi-Cal los ntawm daim ntawv thov rau npe online ntawm DHCS PED (lub kaw lus siv lawv tus kheej Hom 1 NPI).​​ 

Kev sau npe yuav siv sijhawm ntev npaum li cas?​​ 

Feem ntau cov ntawv thov los ntawm cov kws kho mob yuav raug tshuaj xyuas tsis pub dhau 90 hnub, thiab cov ntawv thov los ntawm txhua hom ntawv tso cai feem ntau yuav raug tshuaj xyuas tsis pub dhau 180 hnub. Tos ntev dhau los sau npe ua rau muaj kev pheej hmoo ntawm kev tsis lees paub qhov kev thov thaum cov kev hloov kho tshiab ntawm kev thov raug siv.​​ 

Qhov no yuav pib siv thaum twg?​​ 

Cov kev hloov kho cov ntawv thov yuav raug qhia ua pawg pib thaum lub quarter thib ib ntawm xyoo 2027 thoob plaws cov ntawv thov kev kho mob hauv tsev muag tshuaj, kev kho mob, thiab kev noj qab haus huv ntawm tus cwj pwm. Peb siv txoj kev siv ntau xyoo los sib npaug qhov xav tau kev ua raws li txoj cai nrog qhov xav tau kom txo qis kev cuam tshuam rau cov tswv cuab thiab cov neeg muab kev pabcuam. Nws tseem yog ib txoj hauv kev uas tsav los ntawm cov ntaub ntawv thiab kev sib txuas lus thaum ntxov thiab nquag nrog cov neeg koom nrog. Yog xav pom cov ntaub ntawv ntxaws ntxiv txog lub sijhawm ua raws li txoj cai, mus saib qhov kev nthuav qhia ntawm Lub Tsev Haujlwm Hauv Zos thaum Lub Cuaj Hli 2026.​​ 

Puas yuav cuam tshuam tag nrho cov kev thov ib zaug?​​ 

Tsis yog. Cov kev hloov kho cov ntawv thov yuav maj mam nthuav tawm thiab cuam tshuam rau cov neeg muab kev pabcuam ntawm ntau lub sijhawm sib txawv. Cov neeg muab kev pab yuav tsum thov sai li sai tau kom ntseeg tau tias cov txheej txheem rau npe ua tiav ua ntej hnub uas lawv siv txoj cai.​​ 

Yog tias kuv xav tau kev pab txog kev sau npe, kuv yuav tiv tauj leej twg tau?​​ 

Yog koj muaj lus nug txog kev sau npe lossis kev pab cuam, hu rau DHCS Provider Enrollment Division los ntawm daim ntawv nug Provider.​​ 

DHCS npaj cov neeg muab kev pab li cas rau cov kev hloov pauv txoj cai uas yuav los tom ntej? ​​  

DHCS tab tom tiv tauj cov neeg muab kev pabcuam uas tseem tsis tau rau npe, qhia cov lus qhia rau MCPs, thiab ua haujlwm nrog cov pawg thawj coj saib xyuas daim ntawv tso cai, cov pab pawg lag luam, thiab cov koom haum koom tes los tsa kev paub thiab pab cov neeg muab kev pabcuam rau npe. DHCS tau tuav cov Rooj Sib Tham Hauv Zos rau lub Xya Hli 30, 2026 thiab Cuaj Hlis 24, 2026, nrog rau cov rooj sib tham me me rau cov neeg koom nrog thaum Lub Yim Hli los sau cov lus taw qhia, txhawb kev npaj siv, thiab sib txuas lus cov sijhawm rau kev siv.​​ 

Thaum twg DHCS mam li tshaj tawm hnub uas yuav pib siv txoj cai? ​​  

DHCS tau tshaj tawm lub sijhawm siv txoj cai ntawm Lub Tsev Haujlwm Hauv Zos thib ob rau lub Cuaj Hlis 24, 2026. Qhov no suav nrog txoj kev npaj tso tawm rau kev muag tshuaj, kev noj qab haus huv tus cwj pwm, thiab kev hloov kho kev thov kho mob. Cov kws kho mob yuav tsum tsis txhob tos- sau npe tam sim no siv koj daim ntawv NPI Hom 1 kom tsis txhob muaj kev ncua lossis kev tsis lees paub thaum kev siv txoj cai pib. Cov kws kho mob uas tsis tau sau npe nrog lawv Hom 1 NPI, yuav tsum xa lawv daim ntawv thov sai li sai tau rau Lub Chaw Haujlwm los ntawm cov lus qhia uas tau muab rau ntawm DHCS' Ordering/Referring/Prescribing Only Enrollment Information webpage.​​ 

Kuv nkag siab tias yog tus neeg muab kev pab tsis rau npe yuav ua rau tsis lees txais daim ntawv thov thaum pib ua raws li txoj cai. Puas muaj lwm yam tshwm sim yog tias tsis sau npe?​​ 

Yog. Thaum pib siv txoj cai, cov kev thov kev tso cai ua ntej (PA) rau cov txiaj ntsig tshuaj yuav raug tsis lees paub yog tias tus kws sau ntawv uas tsis tau sau npe xa lawv. Tej zaum yuav muaj ib txhia neeg uas "txais" kev pab kho mob uas yuav pib txheeb xyuas cov neeg uas xa lawv mus rau lawv ua ntej teem caij lossis muab kev pab kho mob rau cov tswv cuab ntawm Medi-Cal. Piv txwv li, ib tus kws tshwj xeeb yuav tsis lees txais kev xa mus los ntawm ib tus kws kho mob uas tsis tau sau npe. Ib yam li ntawd, lub chaw kuaj mob uas tau txais daim ntawv xaj yuav tsis khiav cov kev kuaj mob uas xav tau yog tias lawv raug xa los ntawm tus kws kho mob uas tsis tau sau npe, vim tias NPI ntawm daim ntawv thov yuav tsis tsim nyog rau kev ua tiav.  ​​  

Cov Kev Cai Rau Kev Sau Npe ​​  

Kuv yuav nrhiav tau cov ntaub ntawv hais txog kev sau npe rau cov kws kho mob Medi-Cal qhov twg?​​ 

DHCS lub Chaw Sau Npe Rau Cov Neeg Muab Kev Pab (PED) yog lub luag haujlwm rau kev sau npe rau ORPs.​​   

Mus saib nplooj ntawv Sau Npe Ordering/Referring/Prescribing (ORP) ntawm DHCS thiab nplooj ntawv Cov Ntaub Ntawv Thov los ntawm Hom Kws Muab Kev Pab . Yog muaj lus nug, xa daim ntawv thov los ntawm Daim Ntawv Nug Txog Tus Muab Kev Pabcuam.​​   

Kuv yuav ua li cas thiaj paub tseeb tias kuv muaj npe kawm tiav? ​​  

Siv daim ntawv teev cov Chaw Muab Kev Pabcuam Medi-Cal Fee-for-Service (FFS) uas tau sau npe (MediCal Dental FFS Provider Listing - Dataset - California Health and Human Services Open Data Portal rau cov chaw muab kev pabcuam kho hniav) los xyuas seb koj puas tau sau npe ua tus neeg muab kev pabcuam Medi-Cal FFS. Thaum koj nyob rau ntawm nplooj ntawv lawm, scroll down mus rau hauv daim teb tshawb nrhiav sab xis thiab sau koj hom 1NPI los txheeb xyuas koj qhov xwm txheej rau npe nkag mus rau Medi-Cal FFS. ​​  

Yog tias koj tus NPI Hom 1 pom nyob rau hauv daim ntawv teev npe, ces koj qhov kev xav tau Medi-CalFFF tshwj xeeb rau kev txiav txim, xa mus thiab sau ntawv tau raug ua tiav thiab tsis tas yuav ua dab tsi ntxiv.  Yog tias koj tus NPI Hom 1 tsis pom nyob rau hauv daim ntawv teev npe, ces koj yuav tsum xa daim ntawv thov rau npe rau tus kws kho mob Medi-Cal FFS nrog DHCS PED sai li sai tau kom muaj sijhawm txaus rau kev ua tiav. ​​  

Kuv yuav nrhiav tau kuv hom National Provider Identifier (NPI) qhov twg? ​​  

Siv Lub Tebchaws Txoj Kev Npaj thiab Lub Tshuab Sau Npe Tus Muab Kev Pabcuam (NPPES) NPI Registry los txheeb xyuas koj li NPI.​​  

Puas yog kev cog lus nrog Medi-Cal MCP lossis rau npe rau hauv tsoomfwv txoj kev pab cuam Medicare ua tau raws li cov cai rau kev sau npe rau Medi-Cal tus kws kho mob rau kev txiav txim, xa mus, thiab sau ntawv rau tus neeg mob?​​  

Tsis yog. Kev cog lus nrog Medi-Cal MCP thiab/lossis rau npe ua tus kws kho mob nrog tsoomfwv qib siab Medicare tsis ua raws li cov cai rau California txoj kev rau npe rau tus kws kho mob Medi-Cal FFS kom xaj, xa mus, lossis sau ntawv yuav tshuaj. Koj yuav tsum tau thov cais thiab tau txais kev pom zoo los ntawm DHCS PED nrog koj hom NPI1.​​  

Cov kws kho mob sab nraud xeev uas pom cov tswv cuab Medi-Cal puas yuav tsum tau sau npe?  ​​  

Cov kws kho mob uas saib xyuas cov tswv cuab Medi-Cal tsis tu ncua (tsis yog kev kho mob thaum muaj xwm txheej ceev xwb) yuav tsum tau sau npe rau hauv Medi-Cal. PED tuaj yeem sau npe rau cov kws kho mob hauv cov zej zog ciam teb sab nraum California. ​​  

 Qhov kev cai no puas siv rau cov kws muag tshuaj?​​  

Yog, cov kws muag tshuaj uas sau ntawv rau lawv raws li lawv lub luag haujlwm yuav tsum tau sau npe ua tus kws muab kev pabcuam Medi-Cal nrog lawv hom NPI 1. ​​  

Cov neeg xyaum ua haujlwm thiab cov neeg nyob hauv cov kev kawm puas yuav tsum tau sau npe rau hauv Medi-Cal? ​​  

Yog, thaum lawv muaj daim ntawv tso cai kawm tiav qib siab (PTL) lossis daim ntawv tso cai puv ntoob. Cov neeg kawm uas tsis muaj daim ntawv tso cai yuav tsum siv NPI ntawm tus neeg muab kev pab uas tau sau npe saib xyuas.​​  

Cov Neeg Ua Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Hauv Zej Zog (CHWs) thiab Cov Neeg Ua Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Thaum Yug Me Nyuam Hauv Zej Zog (CPHWs) puas yuav tsum tau sau npe ua cov neeg muab kev pabcuam ORP? Peb tsis pom cov hom kev muab kev pab no muaj ua cov kev xaiv rau kev sau npe.​​  

Tsis yog. Kev sau npe ORP yog ib tus neeg thiab tsis khi rau ib tus tswv ntiav haujlwm twg.​​  

Peb muaj ib lub County Behavioral Health Network uas muab faib ua Mental Health and Drug Medi-Cal Organized Delivery System (DMC-ODS). Cov chaw muab kev pab DMC-ODS puas yuav tsum tau sau npe ua cov chaw muab kev pab ORP, lossis puas yuav koom tes los ntawm lawv cov chaw muab kev pab txaus?​​  

Txhua tus kws kho mob uas sau cov lus txib, cov lus xa mus, lossis cov ntawv yuav tshuaj yuav tsum tau sau npe rau hauv lawv Hom 1 NPI. Yog tias lawv twb tau sau npe nrog lawv hom NPI 1 los ntawm lawv txoj kev koom tes nrog lub chaw, lawv tsis tas yuav ua tiav kev sau npe ORP sib cais.​​  

Cov Kws Pab Tswv Yim Txog Kev Haus Cawv thiab Lwm Yam Tshuaj uas tau ntawv pov thawj los ntawm California puas yuav tsum sau npe ua cov kws kho mob ORP?​​  

Tsis yog. Tus NPI ntawm tus kws kho mob uas tau sau npe thiab sau daim ntawv xaj, daim ntawv xa mus, lossis daim ntawv yuav siv rau ntawm daim ntawv thov.​​  

Cov kws saib mob hauv tsev kawm ntawv lossis cov kws kho mob hlwb uas tau txais daim ntawv tso cai puas yuav tsum sau npe ua ORP yog tias ua haujlwm los ntawm Lub Chaw Haujlwm Saib Xyuas Kev Kawm Hauv Zos (LEA)?​​  

Tsis yog, cov kws saib mob hauv tsev kawm ntawv thiab cov kws kho mob hlwb uas muaj ntawv tso cai tsis tsim nyog rau npe.​​  

Cov kws tu mob uas tau sau npe puas tuaj yeem sau npe ua tus kws muab kev pabcuam ORP?​​  

Cov kws saib mob uas tau sau npe tsis tsim nyog rau npe.​​  

Kuv tau raug hais kom sau npe ua tus kws kho mob ORP los ntawm kuv lub tsev kho mob, tab sis daim ntawv thov tsis tau nug txog kuv lub koom haum hauv tsev kho mob, tsuas yog kuv lub tsev kho mob sab nraud xwb. Qhov no puas yuav txuas nrog tsev kho mob los ntawm kuv tus NPI rau lawv cov nyiaj them rov qab?​​  

Hom kev sau npe no tsis koom nrog lwm lub koom haum, suav nrog cov tsev kho mob, thiab tsis muaj txheej txheem los txuas koj qhov kev sau npe rau NPI ntawm tsev kho mob.​​ 

Yog tias kuv tau sau npe ua tus neeg muab kev pabcuam, kuv puas yuav tsum tau sau npe ua tus neeg muab kev pabcuam ORP thiab?​​  

Tsis yog. Yog tias koj tam sim no tau sau npe nrog koj hom NPI 1, suav nrog kev sau npe ua tus muab kev pabcuam, koj tsis tas yuav sau npe siv hom kev sau npe ORP. ​​  

Kuv puas yuav tsum tau sau npe ua tus kws kho mob lossis tus kws pab tswv yim?​​  

Yog tias koj tau sau npe nrog Medi-Cal ua tus kws kho mob ORP nrog koj hom NPI 1, koj raug lees paub tias yog tus kws kho mob uas tau sau npe rau Medi-Cal. Tus neeg muab kev pabcuam ORP yog ib hom FFSenrollment. ​​  

Puas yog txhua tus kws kho mob sau npe ua ORPproviders lossis puas muaj lwm pawg neeg muab kev pabcuam lossis pawg uas cov kws kho mob tuaj yeem sau npe?​​  

Txhua tus kws muab tshuaj yuav tsum ua kom tiav kev sau npe siv lawv hom 1 NPI. Cov neeg sau ntawv yuav raug sau npe ua tus kws kho mob hloov chaw, tus kws kho mob uas tsis yog kws kho mob (NMP), tus kws kho mob them nqi rau tus tswv ib leeg, lossis tus kws kho mob ORP xwb. ​​  

Yog tias kuv rau npe nrog Medi-Cal, kuv puas yuav tsum muab kev saib xyuas rau cov tswv cuab ntawm Medi-Cal? Qhov kev cai no puas muaj lwm lub luag haujlwm xws li kev kho mob tsawg kawg nkaus ntawm cov tswv cuab Medi-Cal?​​  

Tsis yog. Kev sau npe nrog Medi-Cal los ntawm kev txiav txim, xa mus rau lossis sau ntawv rau koj, tsis khi koj rau lwm lub luag haujlwm ntxiv txog kev saib xyuas ib lossis ntau tus tswv cuab Medi-Cal.​​  

Kuv twb tau sau npe nrog Medi-Cal Rx lawm thiab tsis muaj teeb meem dab tsi txog kev tau txais tshuaj rau kuv cov neeg mob Medi-Cal. Qhov ntawd puas txaus lawm?​​  

Kev sau npe nrog Medi-Cal Rx muab kev nkag mus rau Medi-Cal Rx ProviderPortal, tab sis nws tsis txaus los ua kom tau raws li cov cai ntawm kev sau npe rau Medi-Cal cov kws kho mob. Nrog kev siv txoj cai lij choj hauv tebchaws, cov tswv cuab Medi-Cal yuav tsis tuaj yeem tau txais lawv cov ntawv sau tshuaj uas sau los ntawm cov kws kho mob uas tsis tau sau npe. ​​  

Kuv ua haujlwm hauv ntau lub nroog. Puas yuav tsum tau ua daim ntawv thov rau txhua lub nroog?​​  

Yog koj xa daim ntawv thov rau npe ORP, koj tsuas yog xa ib daim ntawv thov xwb.​​  

Yog tias tus neeg muab kev pab tshiab uas raug ntiav twb tau sau npe nrog lawv tus tswv haujlwm yav dhau los lawm, puas yog lawv yuav tsum rov sau npe dua?  ​​  

Yog tias koj tau sau npe ua tus neeg muab kev pab ORP, koj tsis tas yuav tsum tshaj tawm thaum koj hloov cov tswv haujlwm. Kev sau npe rau tus neeg muab kev pabcuam ORP yog kev sau npe rau tus kheej uas tsis txuas/koom nrog rau tus tswv haujlwm lossis chaw nyob tshwj xeeb.  ​​  

Cov chaw muab kev pab uas tau sau npe lawm puas yuav tsum tau rov xyuas dua thiab yog tias muaj, yuav tsum tau ua ntau zaus npaum li cas?  ​​  

Yog. Cov cai lij choj hauv tebchaws yuav tsum tau rov ua dua tsawg kawg txhua tsib xyoos. Cov neeg muab kev pab yuav raug ceeb toom thaum lawv yuav tsum tau rov ua dua. ​​  

Cov Txheej Txheem Sau Npe​​ 

Lub sijhawm ua tiav rau daim ntawv thov rau Medi-Cal FFS uas xa mus rau DHCS' PED yog dab tsi? ​​  

Cov ntawv thov rau kws kho mob feem ntau yuav tau txais cov lus teb tsis pub dhau 90 hnub. Txhua hom ntawv tso cai lwm yam (xws li tus kws saib xyuas neeg mob lossis tus pab kws kho mob) feem ntau yuav tau txais cov lus teb hauv 180 hnub.  Cov ntawv thov raug ua tiav sai li sai tau raws li qhov kev txiav txim uas tau txais. Nco ntsoov tias qee daim ntawv thov yuav xav tau cov ntaub ntawv ntxiv kom thiaj li ua tiav, uas tuaj yeem ua rau kev ua tiav qeeb.​​  

Puas yog DHCS yuav siv hnub tim rov qab mus rau hnub uas daim ntawv thov raug xa mus?​​ 

Feem ntau, hnub siv tau rau kev sau npe yog hnub uas tau txais daim ntawv thov tiav, tshwj tsis yog teev tseg lwm yam hauv txoj cai. Rau hom kev pabcuam ORP, hnub siv tau yog ib xyoos ua ntej hnub uas daim ntawv thov tau txais. Txawm li cas los xij, yog tias tus neeg muab kev pabcuam tsis muaj daim ntawv tso cai ua haujlwm raug cai thaum lub sijhawm ntawd, hnub sau npe siv tau yuav yog hnub uas daim ntawv tso cai tau muab. ​​  

Cov neeg ua haujlwm hauv kev tswj hwm (xws li tus thawj tswj hwm chaw ua haujlwm) puas tuaj yeem xa daim ntawv thov rau kev sau npe rau tus kws kho mob Medi-Cal FFS rau ib lossis ntau tus kws kho mob lossis txhua tus kws kho mob yuav tsum xa lawv daim ntawv thov rau kev sau npe rau tus kws kho mob Medi-Cal FFS?​​  

Cov neeg ua haujlwm hauv kev tswj hwm, xws li tus thawj tswj hwm chaw ua haujlwm, tuaj yeem npaj daim ntawv thov rau tus neeg muab kev pabcuam, tab sis tus neeg muab kev pabcuam yuav tsum tsim lawv tus kheej lub npe siv thiab tus password tshwj xeeb kom nkag mus rau daim ntawv thov rau npe rau tus neeg muab kev pabcuam Medi-Cal FFS kom tshuaj xyuas cov ntaub ntawv thiab ua kom tiav daim ntawv cog lus thiab kos npe rau tus neeg muab kev pabcuam. Cov kos npe tsis tuaj yeem muab rau lwm tus neeg.​​  

Puas yog txhua tus neeg muab kev pab kho mob yuav raug them tus nqi thov $750.00 kom thiaj li tau sau npe nrog Medi-Cal? ​​  

Tsis muaj tus nqi cuam tshuam nrog daim ntawv thov ORPprovider. Cov tib neeg tsis raug them tus nqi thov. ​​  

Kev Them Nqi Rau Cov Kws Muag Tshuaj/Medi-Cal Rx​​ 

Cov khw muag tshuaj yuav tsum npaj li cas rau kev siv txoj cai? ​​  

Cov khw muag tshuaj twb tau txais cov lus ceeb toom thaum tus kws sau ntawv tsis tau sau npe. Lawv yuav tsum ceeb toom rau cov neeg sau tshuaj thiab txhawb kom lawv sau npe ua ntej pib siv tshuaj rau xyoo 2027.​​  

Yog tias muaj xwm txheej ceev, puas tuaj yeem them rov qab rau qhov kev thov nyiaj pab thaum muaj xwm txheej ceev yog tias tus kws sau ntawv tsis tau sau npe? ​​  

Muaj—txog li 14 hnub muab, ob zaug hauv 30 hnub, siv Qib Kev Pabcuam "Tub Ceev Xwm" thaum muag khoom.​​  

Ib tug tswv cuab ntawm Medi-Cal puas tuaj yeem them tus kheej rau daim ntawv yuav tshuaj uas raug ncua lossis raug tsis kam vim tus neeg sau npe tsis sau npe? Yog tias muaj, puas yuav them rov qab cov nuj nqis nrog Conlan claim? ​​  

Tsis yog. Cov kev thov uas tsis raug lees paub vim tus kws sau ntawv tsis tau sau npe yuav tsis tsim nyog tau txais nyiaj rov qab.​​  

Yog tias daim ntawv thov nkag mus rau Medi-Cal ntawm tus kws kho mob Ordering/Referring/Prescribing (ORP) tau txais kev pom zoo nrog hnub uas siv tau yav dhau los, cov lus thov tshuaj puas suav tias siv tau thaum lawv tau them ua ntej tus kws kho mob xa daim ntawv thov ORP tab sis tom qab hnub uas siv tau rau kev nkag mus rau Medi-Cal? ​​  

Yog, yog tias hnub ua haujlwm yog rau lossis tom qab hnub uas siv tau rov qab. Cov kev thov tseem yuav raug tshuaj xyuas rau lwm yam kev cai.​​  

Medical/CA-MMIS Billing​​ 

Cov NPI twg yuav tsum suav nrog rau hauv cov ntawv thov Medi-Cal rau cov khoom thiab/lossis cov kev pabcuam uas Medi-Cal them uas tau xaj thiab/lossis xa mus los ntawm lwm tus kws kho mob? ​​  
  • Cov kws kho mob uas them nqi rau cov kev pabcuam uas Medi-Cal them rau ntawm daim ntawv thov CMS 1500, saib CMS1500 comp hauv phau ntawv qhia Medi-Cal.  Kev Ua Tiav CMS-1500 (cms comp) ​​  
  • Cov kws kho mob uas them nqi rau cov kev pabcuam uas Medi-Cal them rau ntawm daim ntawv thov UB04 rau cov kev pabcuam sab nraud, saib cov ntu UB04op comp hauv phau ntawv qhia Medi-Cal.  UB-04 Ua tiav: Kev Pabcuam Sab Nraud (ub comp op) ​​  

Cov chaw muab kev them nqi yuav tsum suav nrog Hom Kev Xaj thiab/lossis Kev Xa Mus Rau Hom 1 NPI 1, nyob ntawm hom chaw muab kev pabcuam thiab txoj cai xav tau, thaum ua daim ntawv thov. ​​  

Yog tias kuv yog ib feem ntawm lub koom haum loj dua, kuv puas yuav tsum xa daim ntawv xaj thiab/lossis daim ntawv xa mus rau NPI ntawm daim ntawv thov?​​  

Yog tias lub koom haum yog tus them nqi, NPIType1 (tus kheej) Kev Txiav Txim thiab/lossis Kev Xa Mus yuav tsum muaj nyob rau ntawm daim ntawv thov.​​  

Yuav ua li cas thiaj siv tau qhov kev cai rau npe ORP thaum muaj ntau tus neeg muab kev pab cuam koom nrog rau kev xa mus rau DME? ​​  

Yog, txhua tus neeg muab kev pab uas ua haujlwm txiav txim, xa mus, lossis sau ntawv yuav tsum tswj hwm Medi-Cal kev sau npe nrog lawv hom 1 NPI kom tsis txhob raug tsis lees paub qhov kev thov. ​​  

Puas siv tau tus lej daim ntawv tso cai lossis EITN rau ntawm daim ntawv thov Medi-Cal ua lwm yam rau Daim Ntawv Xaj thiab/lossis Daim Ntawv Xa Mus Rau NPI?​​  

Tsis yog, ib daim NPI uas siv tau, uas tau sau npe rau Medi-Calparticipating10-digit rau hnub uas tau them nqi rau kev pabcuam yuav tsum muaj nyob rau ntawm daim ntawv thov.​​