Rau Medi-Cal Cov Chaw Kho Mob
Nplooj ntawv no muab cov ntaub ntawv thiab cov peev txheej hais txog yuav ua li cas rau npe los ua Medi-Cal tus kws kho mob, tus kws kho mob sau nqi thiab thov kev pab, thiab Medi-Cal cov kev pab cuam, suav nrog cov cai tswj hwm.
Medi-Cal Kev Pabcuam Rau Npe
Yuav kom pab tau cov tswv cuab Medi-Cal, cov kws kho mob yuav tsum xa daim ntawv thov rau npe rau cov kws kho mob nrog rau Department of Health Care Services (DHCS) Provider Enrollment Division (PED).
DHCS/PED yog lub luag haujlwm rau kev sau npe thiab rov sau npe cov neeg muab kev pabcuam Medi-Cal uas them tus nqi rau kev pabcuam (FFS) uas tom qab ntawd tuaj yeem pabcuam ncaj qha rau cov tswv cuab Medi-Cal FFS thiab xa daim ntawv them nqi rau DHCS thiab tom qab ntawd cog lus nrog cov phiaj xwm kev saib xyuas Medi-Cal (MCPs) ib tus zuj zus kom dhau los ua cov neeg muab kev pabcuam hauv network los pabcuam cov tswv cuab Medi-Cal. Yog xav paub ntxiv txog kev tswj hwm kev kho mob Medi-Cal thiab kev cog lus nrog Medi-Cal MCPs kom dhau los ua cov chaw muab kev pabcuam hauv network, thov mus saib DHCS lub vev xaib.
DHCS/PED kuj tseem muaj lub luag haujlwm los tsim txoj cai rau kev sau npe, thiab hloov kho thiab tswj cov ntaub ntawv ntawm tus kws kho mob hauv lub ntaub ntawv Provider Master File uas siv rau hauv cov txheej txheem them nqi.
Cov kws kho mob Medi-Cal tuaj yeem kawm paub ntxiv txog DHCS/PED, lossis tiv tauj lawv ncaj qha.
Medi-Cal Phau Ntawv Qhia Txog Tus Kws Kho Mob thiab Cov Ntawv Qhia Txog Tus Kws Kho Mob
Cov kws kho mob Medi-Cal muaj kev nkag tau mus rau Medi-Cal Tus Kws Kho Mob Phau Ntawv Qhia thiab Cov Ntawv Xov Xwm Muab Kev Pabcuam, uas qhia txog Medi-Cal kev pab them nqi thiab txoj cai them rov qab.
Cov kws kho mob Medi-Cal kuj raug txhawb kom sau npe rau DHCS' Medi-Cal Subscription Service (MCSS), uas yog ib qho kev pabcuam pub dawb uas ua rau cov kws kho mob Medi-Cal paub txog cov xov xwm tshiab kawg ntawm Medi-Cal. Cov kws kho mob Medi-Cal uas sau npe yuav tau txais email tshwj xeeb rau cov ncauj lus kom tau txais cov lus tshaj tawm ceev thiab lwm yam hloov tshiab sai tom qab lawv tshaj tawm rau hauv lub vev xaib Medi-Cal.
Medi-Cal Kev Pab Them Nqi thiab Kev Pabcuam Thov
Cov chaw muab kev pab Medi-Cal muaj cai nkag mus rau kev pab them nqi thiab kev thov nyiaj los ntawm DHCS' California Medicaid Management Information System (CA-MMIS) thiab nws tus neeg nruab nrab nyiaj txiag (FI) uas tau cog lus. Cov neeg ua haujlwm ntawm CA-MMIS thiab FI tuaj yeem pab cov chaw muab kev pabcuam nrog cov lus nug txog kev xa daim ntawv thov, kev xa daim ntawv thov hauv hluav taws xob, thiab Cov Lus Thov Kev Tso Cai Kho Mob (TARs thiab electronic-TARs, lossis eTARs).
Cov kws kho mob Medi-Cal tuaj yeem tiv tauj Chaw Pabcuam Xov Tooj (TSC) ntawm tus xov tooj (800) 541-5555 (sab nraum California, (916) 636-1980), hnub Monday txog hnub Friday, tshwj tsis yog hnub so, txij 8:00 sawv ntxov txog 5:00 tsaus ntuj. Yog xav tau kev pab cuam sai dua rau TSC, cov neeg muab kev pab cuam Medi-Cal tuaj yeem saib TSC Main Menu Prompt Options Guide.
Los ntawm Lub Chaw Pab Them Nqi Me Me, DHCS kuj tseem muaj kev pab them nqi kho mob tag nrho thiab kev cob qhia rau Medi-Cal cov kws kho mob uas xa mus txog 100 Medi-Cal thov ib hlis thiab tsis siv cov kev pab them nqi lossis lub koom haum. Cov kws kho mob Medi-Cal tuaj yeem tiv tauj Lub Chaw Pab Them Nqi Me Me hauv xov tooj ntawm 916) 636-1275, Monday txog Friday, tshwj tsis yog cov hnub so, thaum 8:00 teev sawv ntxov txog 12:00 teev tsaus ntuj thiab thaum 1:00 teev tsaus ntuj txog 5:00 teev tsaus ntuj
Medi-Cal providers can also refer to DHCS’ billing Frequently Asked Questions document for more information and refer to applicable sections of the Medi-Cal Provider Manual.
Kev cob qhia tus kws kho mob Medi-Cal
Pab neeg DHCS' Kev Tshaj Tawm thiab Kev Kawm (O&E) muab kev qhia tshwj xeeb thiab kev txhawb nqa rau cov kws kho mob Medi-Cal thiab cov neeg sau nqi, los pab cov kws kho mob nrhiav kev pab Medi-Cal thiab tau txais nyiaj rov qab raws sijhawm rau cov kev pabcuam.
Tsis tas li ntawd, Medi-Cal Learning Portal muaj Medi-Cal cov kws kho mob thiab cov neeg them nqi kho mob rau tus kheej-paced kev cob qhia online txog kev them nqi, cov cai, cov txheej txheem, cov kev pib tshiab thiab cov kev hloov pauv tshiab rau Medi-Cal qhov kev pab cuam.
Ntxiv rau cov kev cob qhia uas muab los ntawm Medi-Cal Learning Portal, pab pawg DHCS/O&E kuj tseem pab txhawb kev cob qhia nyob, virtual thiab tus kheej thoob plaws txhua xyoo. Cov ntaub ntawv hais txog cov kev cob qhia no tuaj yeem pom ntawm DHCS lub vev xaib thiab cov kws kho mob Medi-Cal uas xav koom nrog cov kev cob qhia no yuav tsum sau npe los ntawm Medi Cal Provider Learning Portal Event Calendar.
Cov kws kho mob Medi-Cal kuj tseem tuaj yeem tshuaj xyuas cov ntaub ntawv hauv phau ntawv ua haujlwm Medi-Cal Provider Training thiab PowerPoint presentations, uas muaj rau rub tawm thiab siv tau ntawm cov rooj sib tham Medi-Cal provider thiab lwm yam kev cob qhia.
Reproductive Health Hotline (Tsis yog DHCS)
Lub Chaw Pabcuam Kev Noj Qab Haus Huv Txog Kev Yug Me Nyuam (ReproHH) yog ib qho kev pabcuam xov tooj pub dawb, zais cia, thiab raws li qhov xav tau uas muaj cov kws kho mob ntawm University of California San Francisco (UCSF) uas tshwj xeeb hauv kev noj qab haus huv kev sib deev thiab kev yug me nyuam ua haujlwm. Nws yuav muab cov ntaub ntawv kho mob raws li pov thawj rau cov kws kho mob uas muaj lus nug txog kev noj qab haus huv ntawm kev sib deev thiab kev yug me nyuam. Tau txais nyiaj los ntawm Lub Xeev California thiab khiav lag luam los ntawm UCSF's Department of Family and Community Medicine.
Cov Nyiaj Pab Medi-Cal
Cov neeg muab kev pab Medi-Cal pab xyuas kom meej tias cov tswv cuab Medi-Cal muaj kev nkag mus rau cov txiaj ntsig kev noj qab haus huv tseem ceeb (hu ua Cov Txiaj Ntsig Kev Noj Qab Haus Huv Tseem Ceeb (EHBs)), suav nrog kev mus ntsib kws kho mob, kev kho mob hauv tsev kho mob, kev txhaj tshuaj tiv thaiv kab mob, kev pabcuam ntsig txog kev cev xeeb tub, tshuaj sau ntawv yuav tshuaj, kev pabcuam kev noj qab haus huv ntawm lub hlwb thiab kev siv tshuaj yeeb dej cawv, kev pabcuam kho hniav, kev kuaj mob hauv chaw kuaj mob, kev saib xyuas hauv tsev laus, thiab ntau ntxiv. Cov chaw muab kev pab Medi-Cal tuaj yeem kawm paub ntxiv txog cov pawg EHB tshwj xeeb thiab cov kev pabcuam uas poob rau hauv txhua pawg ntawm lub vev xaib ntawm Lub Chaw Haujlwm.
Cov Kev Pab Cuam Txog Kev Tsis Txaus Siab ntawm Tus Muab Kev Pabcuam Medi-Cal
Cov kws kho mob Medi-Cal tuaj yeem nkag mus rau cov peev txheej no siv Medi-Cal FFS thiab MCP Provider Compliant Pathways. Qhov no muab ib qho kev pom tseeb meej txog Medi-Cal's FFS thiab MCP txoj kev tsis txaus siab thiab kev sib cav rau cov kws kho mob. Nws piav qhia txog yuav xa cov lus nug li cas, tawm tsam qhov kev tsis lees paub lossis kev txiav txim siab rau kev sau npe, ua ntaub ntawv tsis txaus siab txog kev ntxub ntxaug, thiab taug qab cov txheej txheem kev tsis sib haum xeeb ntawm txoj kev npaj kho mob kom ntseeg tau tias muaj kev daws teeb meem raws sijhawm thiab ncaj ncees. Daim ntawv no tsis hloov pauv txhua tsab ntawv All Plan Letters (APLs), cov ntu ntawm Phau Ntawv Qhia Txog Tus Muab Kev Pabcuam, Daim Ntawv Cog Lus MCP, thiab/lossis lwm cov ntawv tshaj tawm ntawm DHCS.