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
To serve Medi-Cal members, providers must first submit a provider enrollment application with the Department of Health Care Services’ (DHCS’) Provider Enrollment Division (PED).
DHCS/PED is responsible for the enrollment and re‑enrollment of Medi-Cal fee-for-service (FFS) providers who can then directly serve Medi-Cal FFS members and bill DHCS as well as subsequently contract with individual Medi-Cal managed care plans (MCPs) to become network providers to serve Medi-Cal managed care members. For more information about Medi-Cal managed care and contracting with Medi-Cal MCPs to become network providers, please see DHCS’ website.
DHCS/PED tseem yog lub luag haujlwm rau tsim txoj cai rau npe kawm, thiab hloov kho thiab tswj cov ntaub ntawv tus kws kho mob hauv Cov Ntaub Ntawv Tus Thawj Saib Xyuas Cov Ntaub Ntawv uas siv rau hauv cov txheej txheem them nyiaj.
Medi-Cal providers can learn more about DHCS/PED, or contact them directly.
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.
Medi-Cal providers are also strongly encouraged to sign up for DHCS’ Medi-Cal Subscription Service (MCSS), which is a free service that keeps Medi-Cal providers up-to-date on the latest Medi-Cal news. Medi-Cal providers who subscribe will receive subject-specific emails for urgent announcements and other updates shortly after they post to the Medi-Cal website.
Medi-Cal Kev Pab Them Nqi thiab Kev Pabcuam Thov
Medi-Cal providers have access to billing and claims assistance through DHCS’ California Medicaid Management Information System (CA-MMIS) and its contracted Fiscal Intermediary (FI). CA-MMIS and FI staff can assist providers with questions about paper claim submissions, electronic claim submission, and Treatment Authorization Requests (TARs and electronic-TARs, or eTARs).
Cov kws kho mob Medi-Cal tuaj yeem tiv tauj Lub Chaw Pabcuam Xov Tooj (TSC) hauv xov tooj ntawm (800) 541-5555 (sab nraum California, (916) 636-1980), Hnub Monday txog Friday, tshwj tsis yog hnub so, thaum 8:00 teev sawv ntxov txog 5:00 teev tsaus ntuj Txhawm rau nkag mus rau TSC cov peev txheej sai dua, Medi-Cal cov kws kho mob tuaj yeem xa mus rau 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
DHCS’ Outreach and Education (O&E) team offers billing-specific education and support services to Medi-Cal providers and billers, to help providers navigate Medi-Cal and receive timely reimbursement for services.
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.
In addition to trainings offered through the Medi-Cal Learning Portal, the DHCS/O&E team also facilitates live, virtual and in-person trainings throughout each year. Information on these trainings can be found on DHCS’ website and Medi-Cal providers interested in attending these trainings must register through the Medi Cal Provider Learning Portal Event Calendar.
Medi-Cal providers can also review the information in the Medi-Cal Provider Training workbooks and PowerPoint presentations, which are available for download and can be used at the Medi-Cal provider seminars and other training events.
Reproductive Health Hotline (Tsis yog DHCS)
The Reproductive Health Hotline (ReproHH) is a free, confidential, on-demand phone service staffed by University of California San Francisco’s (UCSF) clinicians who specialize in sexual and reproductive health. It will provide evidence-based clinical information for health care providers with questions about sexual and reproductive health. Funded by the State of California and operated by UCSF’s Department of Family and Community Medicine.
Cov Nyiaj Pab Medi-Cal
Medi-Cal providers help ensure that Medi-Cal members have access to a core set of health benefits (known as Essential Health Benefits (EHBs)), including doctor visits, hospital care, immunization, pregnancy-related services, prescription drugs, mental health and substance use disorder services, dental, laboratory services, nursing home care, and more. Medi-Cal providers can learn more about specific EHB categories and the services that fall within each on the Department’s website.[HE1]