Txheej txheem tso cai​​ 

All requests for CCS diagnostic and treatment services must be submitted using a Service Authorization Request (SAR) form except Orthodontic and Dental services (All necessary authorizations will be Medi-Cal Dental’s responsibility). Only active Medi-Cal Providers may receive authorization to provide CCS program services. Services may be authorized for varying lengths of time during the CCS client’s eligibility period.​​ 

Qee cov lus qhia muaj txiaj ntsig thaum xa SAR:​​ 

• Providers must request CCS services using a
  SAR form.
  Note: Providers should verify CCS eligibility before submitting a SAR.​​ 
• Providers are required to submit documentation to substantiate medical necessity at the time the SAR is submitted. Send the completed SAR form with supporting documentation to the appropriate CCS county or Regional Office via fax or mail. Examples of required supporting documentations include prescriptions, clinic visit reports, physical therapy evaluation reports, etc. A SAR without supporting documentation will be deferred back to the provider for additional information.​​ 
• Txhua SAR xa mus rau CCS raug tshuaj xyuas txog qhov tsim nyog kho mob.​​ 

Yuav Ua Li Cas Kom Zam Tsis Tau Txais Kev Pab CCS​​ 

Qhov kev pab cuam CCS yuav tsum tau tso cai ua ntej rau cov kev pab cuam. Qhov no txhais tau hais tias Daim Ntawv Thov Kev Tso Cai Pabcuam (SAR) yuav tsum raug xa mus rau CCS Lub Xeev Lub Chaw Haujlwm kom pom zoo rau txhua qhov kev kuaj mob thiab kev kho mob, tshwj tsis yog thaum muaj xwm txheej ceev. Daim ntawv thov kev tso cai rau cov kev pabcuam xwm txheej ceev yuav tsum raug xa mus rau CCS los ntawm qhov kawg ntawm hnub ua haujlwm tom ntej tom qab hnub ua haujlwm.​​ 

Kev thov kev thov​​ 

Kev thov rau cov kev pabcuam uas tau tso cai los ntawm CCS yuav tsum xa ncaj qha mus rau Gainwell Technologies tshwj tsis yog tus neeg siv khoom nyob hauv Napa, San Mateo, Santa Barbara, San Luis Obispo, Solano, Marin, lossis Yolo counties. Cov neeg siv khoom nyob hauv cov nroog no tau txais kev pabcuam los ntawm Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Hauv Lub Nroog (COHS) uas tau cog lus los ntawm lub tuam tsev kom ua haujlwm rau cov nroog no ua Medi-Cal Kev Pabcuam Nyiaj Txiag.​​  

Kaiser Permanente yuav yog lub luag haujlwm rau kev saib xyuas rau Medi-Cal uas tsim nyog CCS cov menyuam yaus thiab cov tub ntxhais hluas uas tau cuv npe nrog Kaiser Permanente thiab yuav siv WCM qhov kev pab cuam hauv cov nroog nram qab no uas WCM program muaj tam sim no: Marin, Napa, Orange, San Mateo, Santa Cruz, Solano, Sonoma, thiab Yolo.  CCS yog ib qho kev pabcuam tshwjxeeb rau cov tswvcuab tau txais kev pabcuam kev noj qab haus huv los ntawm Kaiser Permanente hauv cov nroog no, siv tau rau hnub ua haujlwm rau lossis tomqab Lub Ib Hlis 1, 2024.​​ 

• Xa cov ntawv thov rau cov kev pabcuam uas tau pom zoo lossis tso cai los ntawm CCS. Kev thov rau cov kev pabcuam yam tsis tau txais kev pom zoo CCS lossis kev tso cai ua ntej yuav raug tsis lees paub.​​ 
• Xa cov ntawv thov rau cov kev pabcuam uas muab rau tus neeg siv khoom lees paub tias tsim nyog tau txais cov txiaj ntsig CCS. Kev thov rau cov kev pabcuam uas muab rau cov neeg siv khoom uas tsis yog CCS lossis tsis tsim nyog tau txais cov txiaj ntsig CCS yuav raug tsis lees paub.​​ 
• Xa cov ntawv thov rau Xerox lossis COHS raws sijhawm.​​ 
• Xa cov ntawv thov rau cov kev pabcuam muab rau cov neeg siv khoom nrog rau lwm yam kev pov hwm kev noj qab haus huv nrog rau Kev Qhia Txog Kev Pabcuam (EOB) txuas nrog rau cov lus thov.​​ 
• Xa txhua daim ntawv thov rau cov kev pabcuam uas muab rau cov neeg siv khoom hauv cov nroog hauv qab no:​​ 
  • Napa, Solano, Marin or Yolo:
    Partnership Health Plan of California
    P.O. Box 1368
    Suisun, CA 94585​​ 
  • San Mateo:
    ALL CCS and HF CLAIMS STRAIGHT TO EDS
    ALL MEDI-CAL CLAIMS TO SAN MATEO COUNTY CCS
    California Children’s Services
    2000 Alameda de las Pulgas       
    Suite 230
    San Mateo, CA 94403​​ 
  • San Luis Obispo and Santa Barbara:
    CENCAL Health
    P.O. Box 948
    Goleta, CA 93116-0948​​ 
  • For Northern California Kaiser Permanente Counties: Marin, Napa, San Mateo, Santa Cruz, Solano, Sonoma, and Yolo:
    Continuum Claims Processing CenterPO Box 12923Oakland, CA 94604​​ 
  • For claims sent Certified mail only for Northern California Kaiser Permanente: Marin, Napa, San Mateo, Santa Cruz, Solano, Sonoma, and Yolo:Kaiser Foundation Health Plan, Inc. National Claims Administration 1800 Harrison St., 12th FloorOakland, CA 9461​​ 
  • For Southern California Permanente Counties: OrangeKaiser Permanente Claims Administration Department PO Box 7004 Downey, CA 90242-7004​​ 

Nqe Lus Nug​​ 

If you have billing questions, please contact Medi-Cal at (916) 636-1980 (outside of California, please call (800) 541-5555). You can also visit the Medi-Cal website for billing procedures and updates.​​