Tus Nqi Kev Pov Hwm Zoo
Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) Lub Chaw Haujlwm Saib Xyuas Kev Lav Peev thiab Kev Rov Qab Tau Nyiaj Los Ntawm Sab Nraud (TPLRD) muaj lub luag haujlwm sau Cov Nqi Xyuas Kev Zoo (QAF) los ntawm cov chaw muab kev pabcuam tshwj xeeb. TPLRD kuj tseem muaj lub luag haujlwm sau se ntawm Lub Koom Haum Tswj Xyuas Kev Kho Mob (MCO) rau cov phiaj xwm kho mob. Cov chaw muab kev pab thiab cov MCOs siv tau nplooj ntawv no los qhia cov ntaub ntawv xav tau, them nyiaj hauv hluav taws xob, thiab xa cov lus nug rau cov neeg ua haujlwm hauv qhov kev pab cuam.
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 |
| Kev Kho Mob Thaum Nruab Hnub - 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 |
Thaum them nyiaj los ntawm EFT siv tus lej Invoice uas tau teev tseg saum toj no, thov xa email rau QAF@dhcs.ca.gov thiab muab cov ntaub ntawv teev hauv qab no kom ntseeg tau tias kev them nyiaj EFT tau xa thiab siv kom raug:
- 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 | Cov nyiaj them tuaj yeem xa los ntawm Overnight Mail nrog tus lej taug qab rau kev xa khoom thaum sawv ntxov ntawm FedEx, Golden State, lossis United Parcel Service mus rau: Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv ATTN: HQAF Chav Nyiaj Txiag/Chaivers Unit, Mail Stop 1101 1501 Capitol Avenue PO Thawv 997415 Sacramento, CA 95899-7415 |
| MCO Tax | Cov nyiaj them tuaj yeem xa los ntawm Overnight Mail nrog tus lej taug qab rau kev xa khoom thaum sawv ntxov ntawm FedEx, Golden State, lossis United Parcel Service mus rau: Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv ATTN: MCO Tax Chav Nyiaj Txiag/Cashiers Unit, Mail Stop 1101 1501 Capitol Avenue PO Thawv 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.
Rov qab mus rau Third Party Liability and Recovery Division