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)
- SNF Online Daim Ntawv Xa Cov Ntaub Ntawv
- SNF Nplooj ntawv rau Cov Ntaub Ntawv / Them Nyiaj Xa Daim Ntawv Thov
Qhov Chaw Kho Mob Nruab Nrab-Developmentally Disabled (DICF-DD)
- DICF Daim Ntawv Qhia Txog Cov Ntaub Ntawv Online
- DICF Nplooj ntawv rau cov ntaub ntawv xa tawm / Them nyiaj
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.
| QAF/MCO Tax Program | Invoice Number |
|---|---|
| Ground Emergency Medical Transport (GEMT) | GEM12345678 |
| Qhov Chaw Kho Mob Nruab Nrab (DICF) | ICF12345678 |
| Day Treatment – 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 |
When paying by EFT using the default Invoice Number above, please send an email to QAF@dhcs.ca.gov and include the details listed below to ensure the EFT payment is posted and applied correctly:
- 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
| QAF/MCO Tax Program | Chaw Nyob Xa Ntawv |
|---|---|
| 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 | Payments may be submitted by Overnight Mail with a tracking number for morning delivery via FedEx, Golden State, or United Parcel Service to: Department of Health Care Services ATTN: HQAF Accounting Section/Cashiers Unit, Mail Stop 1101 1501 Capitol Avenue P.O. Box 997415 Sacramento, CA 95899-7415 |
| MCO Tax | Payments may be submitted by Overnight Mail with a tracking number for morning delivery via FedEx, Golden State, or United Parcel Service to: Department of Health Care Services ATTN: MCO Tax Accounting Section/Cashiers Unit, Mail Stop 1101 1501 Capitol Avenue P.O. Box 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:
- Ground Emergency Medical Transport Program (GEMT)
- Hospital Quality Assurance Fee Program (HQAF)
- Skilled Nursing Facilities (SNF)
- Cov Chaw Kho Mob Nruab Nrab (DICF)
- Managed Care Organization (MCO) Tax
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.