Cov Kev Xav Tau ntawm Tus Muab Kev Pab Cuam Rau Medi-Cal Tus Nqi-rau-Kev Pabcuam
Txij li Lub Xya Hli 1, 2025, cov chaw muab kev pabcuam Medi-Cal Fee-for-Service (FFS) yuav tsum muab cov ntaub ntawv ntxiv teev hauv qab no (ntxiv rau cov ntaub ntawv uas twb tau sau los ntawm daim ntawv thov rau npe Medi-Cal). Raws li Lub Chaw rau Medicare thiab Medicaid Services (CMS), Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tab tom siv cov lus qhia txog cov kev cai ntawm Cov Npe Kws Muab Kev Pabcuam rau cov kws muab kev pabcuam FFS raws li Division H, Title V, Seem 5123 ntawm Consolidated Appropriations Act, 2023 (CAA, 2023), thiab State Health Official 24-003 Letter, Seem Cov Kev Cai ntawm Cov Npe Kws Muab Kev Pabcuam, Nplooj Ntawv 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
Tus Muab Nyiaj Txiag
Cov kws kho mob uas tau txais kev pab cuam Fee-For-Service (FFS) uas tau them nqi rau cov kev pab cuam uas lawv muab siv lawv tus kheej tus kws kho mob (NPI) tus lej yuav tsum xa cov ntaub ntawv qhia chaw kho mob hauv Medi-Cal Provider Portal.
Cov kws kho mob tsis them nqi
Cov neeg muab kev pabcuam Fee-For-Service (FFS) uas tau sau npe ua haujlwm thiab muab kev pabcuam kho mob ncaj qha rau cov tswv cuab Medi-Cal thiab tsis xa cov ntawv thov ncaj qha rau Medi-Cal rau cov kev pabcuam uas tau muab yuav tsum xa cov ntaub ntawv los ntawm kev ua kom tiav Daim Ntawv Soj Ntsuam Cov Npe Kws Muab Kev Pabcuam. Cov chaw muab kev pab uas tsis them nqi suav nrog kev muab kev pab, kev txiav txim, kev xa mus, thiab kev muab kev pab (ORP) thiab cov chaw muab kev pab uas tsis yog kws kho mob (NMP).
Keeb kwm
CAA, 2023 yuam kom Medicaid, thiab Children's Health Insurance Program (CHIP) FFS cov kev pab cuam thiab cov Managed Care Plans uas tau cog lus tshaj tawm cov npe ntawm cov kws kho mob uas tuaj yeem tshawb nrhiav thiab hloov kho tsis tu ncua ntawm lub vev xaib pej xeem thaum Lub Xya Hli 1, 2025. CAA, 2023 tau qhia txog cov kev cai tshiab rau daim ntawv teev cov neeg muab kev pabcuam FFS raws li Division H, Title V, Seem 5123, hu ua "Yuav tsum muaj cov ntawv teev cov neeg muab kev pabcuam raug, hloov kho tshiab, thiab tshawb nrhiav tau." Cov kev cai no ntxiv rau cov ntaub ntawv tsawg kawg nkaus uas xav tau hauv daim ntawv teev cov chaw muab kev pabcuam FFS, uas yuav tsum tau hloov kho tsawg kawg yog txhua peb lub hlis. Cov ntaub ntawv "Cov Neeg Muab Kev Pabcuam Medi-Cal FFS" uas muaj nyob rau ntawm California Health & Human Services Open Data Portal yog suav tias yog daim ntawv teev cov neeg muab kev pabcuam FFS.
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 txawj hais lus thiab kab lis kev cai suav nrog cov lus (suav nrog Lus Kos Npe Amelikas) uas Tus Muab Kev Pabcuam muab lossis los ntawm tus kws txhais lus kho mob uas muaj peev xwm muab kev pabcuam txhais lus ntawm chaw ua haujlwm ntawm Tus Muab Kev Pabcuam
- Cov chaw nyob twg uas tus neeg muab kev pabcuam lub chaw ua haujlwm lossis chaw nyob tau muab rau cov tib neeg uas muaj kev tsis taus lub cev, suav nrog cov chaw ua haujlwm, chav kuaj mob, thiab cov khoom siv
- Seb tus kws kho mob puas muab Kev Pabcuam Covered ntawm telehealth
Hloov tshiab Peb Hlis
Yuav kom paub tseeb tias daim ntawv teev cov neeg muab kev pab muaj tseeb, cov neeg muab kev pab uas tau sau npe yuav tsum tshuaj xyuas thiab hloov kho cov ntaub ntawv no tsawg kawg yog peb lub hlis twg hauv txhua lub hlis ntawm lub Ib Hlis, Plaub Hlis, Xya Hlis, thiab Kaum Hli.
Cov kev hloov kho tshiab rau cov ntaub ntawv teev npe cov chaw muab kev pabcuam uas twb muaj lawm tuaj yeem ua tau txhua lub sijhawm.
Cov lus nug nquag
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 cov Managed Care Plans uas tau cog lus yuav tsum tshaj tawm cov npe ntawm cov kws kho mob uas tuaj yeem tshawb nrhiav tau, hloov kho tsis tu ncua ntawm lub vev xaib pej xeem thaum Lub Xya Hli 1, 2025.
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 uas tau sau npe yuav tsum xa cov ntaub ntawv hauv qab no, uas yuav siv los hloov kho Daim Ntawv Qhia Txog Tus Muab Kev Pabcuam Medi-Cal uas twb muaj lawm: tus xov tooj ntawm chaw ua haujlwm ntawm tus kws kho mob, lub vev xaib ntawm tus kws kho mob (yog tias muaj), seb tus kws kho mob puas lees 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 muab cov kev pabcuam uas them los ntawm kev kho mob hauv xov tooj, kev coj noj coj ua thiab kev hais lus, thiab cov chaw nyob uas chaw ua haujlwm lossis chaw kho mob ntawm tus kws kho mob tau muab rau cov tib neeg uas muaj kev tsis taus.
Tus Nqi-For-Service Directory yog dab tsi?
Medi-Cal Fee-For-Service Directory yog cov ntaub ntawv siv tau rau pej xeem muaj nyob hauv CalHHS Open Data Portal.
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?
Yuav kom paub tseeb tias daim ntawv teev cov neeg muab kev pab muaj tseeb, cov neeg muab kev pab uas tau sau npe yuav tsum tshuaj xyuas thiab hloov kho cov ntaub ntawv no tsawg kawg yog peb lub hlis twg hauv txhua lub hlis ntawm lub Ib Hlis, Plaub Hlis, Xya Hlis, thiab Kaum Hli. Cov kev hloov kho tshiab rau cov ntaub ntawv teev cov chaw muab kev pabcuam uas twb muaj lawm tuaj yeem ua tau txhua lub sijhawm.
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.
Cov chaw muab kev pab uas tsis them nqi yuav tsum xa cov ntaub ntawv los ntawm kev ua kom tiav Daim Ntawv Soj Ntsuam Cov Npe Chaw Muab Kev Pab , uas muaj nyob rau sab saum toj ntawm nplooj ntawv no.
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 koj nkag mus rau hauv lawm, mus rau "Tswj Lub Koom Haum" thiab xaiv "Public Fee-For-Service Provider Directory."
Kuv nkag tsis tau kuv tus account ntawm Provider Portal. Kuv yuav tiv tauj leej twg?
Lub Chaw Pabcuam Xov Tooj (1-800-541-5555) muaj sijhawm 8 teev sawv ntxov txog 5 teev tsaus ntuj PT, hnub Monday txog hnub Friday, tshwj tsis yog hnub so hauv tebchaws.
Who is authorized to make updates in the Provider Portal?
Only Organization Administrators and NPI Administrators can update provider directory information. To update user permissions, an Organization Administrator must add the user and assign permission levels. Refer to the Provider Portal User Guide: Provider Organization for a description of each available role.
Yog xav paub ntxiv txog Provider Portal, mus saib Provider 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 soj ntsuam tsis khaws cov lus teb tsis tiav. Peb xav kom koj sau cov lus teb rau hauv ib daim ntawv cais ua ntej koj muab sau rau hauv daim ntawv soj ntsuam.
How can I edit my previous submission?
Yog xav hloov, thov xa ib lo lus teb tshiab los ntawm kev siv Daim Ntawv Soj Ntsuam Cov Npe Kws Muab Kev Pab. Cov lus teb tshiab tshaj plaws yuav hloov cov lus xa ua ntej. Thov tso cai ib lub lim tiam tom qab xa tawm kom cov kev hloov tshiab pom hauv daim ntawv teev npe.
Kuv yuav saib kuv daim ntawv xa mus ua ntej li cas?
Yog xav tau daim qauv ntawm koj cov lus teb, thov ua kom tiav Daim Ntawv Nug Txog Tus Muab Kev Pabcuam.
Yog tias koj muaj lus nug ntxiv txog daim ntawv teev cov chaw muab kev pab FFS, cov chaw muab kev pab tuaj yeem tiv tauj Lub Chaw Sau Npe Rau Cov Chaw Muab Kev Pab los ntawm Daim Ntawv Nug Txog Tus Muab Kev Pabcuam.