Kev raug mob ntawm tus kheej cov lus nug uas nquag nug
Hauv qab no yog cov lus nug uas nquag nug txog qhov Kev Pab Cuam Rau Tus Kheej. Thov nyem rau ntawm nqe lus nug kom saib cov lus teb sib xws, lossis nqes hauv nplooj ntawv mus rau cov lus nug thiab lus teb.
- Kuv tuaj yeem tiv tauj Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) Txoj Haujlwm Pabcuam Rau Tus Kheej (PIP) li cas?
- PIP chaw nyob xa ntawv yog dab tsi?
- Kuv muaj lus nug txog kuv cov nyiaj pab Medi-Cal thiab kev tsim nyog.
- Kuv tau raug xwm txheej. Leej twg tuaj yeem pab kuv?
- Kuv raug mob, thiab kuv tabtom tawm tsam rau lub luag haujlwm. Kuv yuav ceeb toom rau Medi-Cal li cas thiab yuav tsum muaj ntaub ntawv dab tsi?
- Kuv tau koom nrog kev sib tsoo nrog ntau dua ib tus tswv cuab Medi-Cal. DHCS puas yuav tsum paub txog txhua tus tswv cuab koom nrog?
- Vim li cas kuv thiaj li yuav tsum tau ceeb toom rau Medi-Cal?
- Yuav ua li cas yog tias kuv tsis ceeb toom rau Medi-Cal?
- Kuv hais rau kuv tus neeg ua haujlwm hauv nroog txog kuv txoj kev koom tes hauv kev sib tsoo. Puas yog qhov kev ceeb toom txaus?
- Puas yog tus neeg tuav pov hwm yuav tsum tau ceeb toom rau Medi-Cal?
- Vim li cas kuv thiaj tau txais tsab ntawv los ntawm koj lub tuam tsev? CAS 1090D
- Cov kev cai lij choj twg tswj hwm Txoj Haujlwm Kev Txhaum Tus Kheej?
- Tom qab kuv xa ib rooj plaub, yuav siv sijhawm ntev npaum li cas rau Medi-Cal los teb?
- Kuv yuav tsum tau tham nrog ib tug neeg txog kuv tus kheej raug mob. Kuv yuav nrhiav tau leej twg ua hauj lwm kuv rooj plaub?
- Vim li cas nws thiaj siv sij hawm ntev los npaj ib daim ntawv pov thawj? Dab tsi yog txheej txheem kom tau txais daim ntawv lav npaj?
- Kuv yuav ua li cas thiaj li tau kuv rooj plaub kom nrawm dua?
- Dab tsi yog qhov yuav tsum tau ua kom tau txais cov khoom ua ntej?
- Kuv yog tus neeg foob lossis tus kws lij choj tiv thaiv thiab yuav tsum tau thov cov ntaub ntawv them nqi khomob lossis kev pom tus kheej. Kuv xa daim ntawv foob qhov twg?
- Vim li cas kuv thiaj tau txais daim nqi (CAS3025)?
- Why am I receiving bills from providers? I have Medi-Cal, why hasn’t Medi-Cal paid them?
- Qhov Kev Pab Cuam Rau Tus Kheej tau ua txhaum cai rau kuv qhov kev txiav txim. Kuv puas tuaj yeem tau txais kev txo qis?
- Kuv puas tuaj yeem tau txais daim ntawv cog lus them rov qab?
- Kuv tuaj yeem them nyiaj lien ntawm Electronic Fund Transfer (EFT)?
- Where do I send a check and to whom do I make the check payable to?
- What happens if the insurance company sends me a check made payable to both Medi-Cal and me?
- Kuv tuaj yeem tau txais tsab ntawv tso Medi-Cal li cas?
- Nws yuav siv sij hawm ntev npaum li cas thiaj tau txais cov nyiaj rov qab los ntawm kev them nyiaj ntau dhau?
- Kuv tuaj yeem thov kom sai li sai tau cov nyiaj rov qab?
Kuv tuaj yeem tiv tauj Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Kev Pabcuam Tus Kheej Tus Kheej li cas hauv xov tooj?
Thov hu rau peb Lub Chaw Pab Txhawb Xov Tooj ntawm (916) 445-9891.
Hours of operation: Monday through Friday, from 8:00 a.m. to 5:00 p.m., and closed from 12:00 p.m. to 1:00 p.m. Closed on weekends and state holidays.
PIP chaw nyob xa ntawv yog dab tsi?
Koj tuaj yeem xa cov ntawv sau mus rau:
Department of Health Care Services
Third Party Liability and Recovery Division
Personal Injury Branch – MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
Chaw nyob xa ntawv rau kev them nyiaj:
Department of Health Care Services
Third Party Liability and Recovery Division
Personal Injury Branch – MS 4720
P.O. Box 997421
Sacramento, CA 95899-7421
Chaw nyob xa ntawv rau xa ntawv xa tuaj (UPS, FedEx, thiab lwm yam):
Department of Health Care Services
Third Party Liability and Recovery Division
1501 Capitol Avenue, MS 4720
Sacramento, CA 95814-5005
Kuv muaj lus nug txog kuv cov nyiaj pab Medi-Cal thiab kev tsim nyog.
Thov hu rau California Medicaid Management Information Systems (CA-MMIS) Xov Tooj Chaw Pabcuam ntawm (800) 541-5555. Lawv tuaj yeem teb tau cov lus nug uas koj muaj ntawm kev tsim nyog, cov txiaj ntsig, thiab koj daim npav ID.
Kuv tau raug xwm txheej. Leej twg tuaj yeem pab kuv?
You can represent yourself, or you can hire an attorney to represent you. DHCS does not provide assistance in filing claims against other parties.
Kuv raug mob, thiab kuv tabtom tawm tsam rau lub luag haujlwm. Kuv yuav ceeb toom rau Medi-Cal li cas thiab yuav tsum muaj ntaub ntawv dab tsi?
For faster processing, please report the personal injury accident or claim by using our Online Forms webpage, “PI Step 1: Report a New Case (Personal Injury Notification Form).”
Koj tseem tuaj yeem tshaj tawm los ntawm kev xa ntawv:
Department of Health Care Services
Third Party Liability and Recovery Division
Personal Injury Branch – MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
Kuv tau koom nrog kev sib tsoo nrog ntau dua ib tus tswv cuab Medi-Cal. DHCS puas yuav tsum paub txog txhua tus tswv cuab koom nrog?
Yes, DHCS requires notification of each Medi-Cal member involved. You may submit a separate form for each Medi-Cal member online or by mail.
Vim li cas kuv thiaj li yuav tsum tau ceeb toom rau Medi-Cal?
T he Medi-Cal member or personal representative is required by law to report the third party tort action or claim in writing to the Department of Health Care Services (DHCS) pursuant to Welfare and Institutions Code section 14124.73 et seq. Notification must be submitted online or by mail within 30 days of filing a personal injury action or claim. Attorneys must submit a “Medical Authorization” form signed by their client.
Yuav ua li cas yog tias kuv tsis ceeb toom rau Medi-Cal?
Raws li ib qho xwm txheej ntawm kev tsim nyog Medi-Cal, koj tau pom zoo tias DHCS yuav tau txais cov nyiaj them rov qab rau cov kev siv nyiaj kho mob uas tshwm sim vim koj raug xwm txheej lossis raug mob thaum koj tau txais nyiaj los ntawm lwm yam kev pov hwm kev noj qab haus huv, kev them nyiaj raws cai, lossis lwm qhov chaw (tseem ceeb thib peb). Yog tias koj tsis ceeb toom rau DHCS ntawm koj qhov kev huam yuaj lossis raug mob, DHCS tuaj yeem ua raws cai rau koj los sau cov nqi kho mob uas koj tau txais.
Kuv hais rau kuv tus neeg ua haujlwm hauv nroog txog kuv txoj kev koom tes hauv kev sib tsoo. Puas yog qhov kev ceeb toom txaus?
Tsis muaj. Welfare and Institutions Code tshooj 14124.73 xav kom koj lossis koj tus neeg sawv cev sau ntawv ceeb toom rau DHCS hauv 30 hnub tom qab ua ntawv foob rau tus neeg thib peb lub luag haujlwm.
Puas yog tus neeg tuav pov hwm yuav tsum tau ceeb toom rau Medi-Cal?
Yes. Welfare and Institutions Code section 14124.79 requires insurance carriers that have liability for a Medi-Cal member’s claim to notify DHCS. Liable third party insurance carriers are legally obligated to reimburse Medi-Cal.
Vim li cas kuv thiaj tau txais tsab ntawv los ntawm koj lub tuam tsev? CAS 1090D
DHCS tau txais tsab ntawv ceeb toom tias koj tau koom nrog qhov xwm txheej raug mob ntawm tus kheej thiab muaj feem cuam tshuam nrog lwm tus. Tsab ntawv ceeb toom rau koj tias DHCS muaj txoj cai lees paub qhov kev tsis txaus siab rau txhua qhov kev txiav txim, kev txiav txim, lossis khoom plig sau los ntawm tus neeg thib peb lub luag haujlwm.
(Kev Noj Qab Haus Huv thiab Cov Tsev Kawm Ntawv Txoj Cai Tshooj 14124.70 txog 14124.795.)
Cov kev cai lij choj twg tswj hwm Txoj Haujlwm Kev Txhaum Tus Kheej?
Welfare and Institutions Code sections 14124.70 – 14124.795
Tom qab kuv xa ib rooj plaub, nws yuav siv sij hawm ntev npaum li cas rau Medi-Cal los teb?
If the injured party is Medi-Cal eligible, DHCS will send a “Notice of Lien” within 30 days of the referral to assert its recovery rights. If the injured party is not currently Medi-Cal eligible, DHCS may send notification stating the Medi-Cal eligibility status will be rechecked for retroactive eligibility in 90 days.
Tom qab tus tswv cuab ntawm Medi-Cal tau ua tiav kev kho mob lossis tau txais kev pom zoo, DHCS yuav tsum tau txais hnub kawg ntawm kev kho mob (FDOT) lossis tsab ntawv ceeb toom hais txog kev sib hais kom ua tiav qhov teeb meem thiab tsim kom muaj kev lav phib xaub, yog tias tsim nyog. Tom qab ntawd DHCS yuav xa tsab ntawv lav nrog cov npe ntawm cov kev pabcuam raug mob rau tus tswvcuab Medi-Cal lossis lawv tus kheej tus neeg sawv cev thiab tus neeg thib peb lub luag haujlwm.
Kuv yuav tsum tham nrog ib tug neeg txog kuv tus kheej raug mob. Kuv yuav nrhiav tau leej twg ua hauj lwm kuv rooj plaub?
To request information about your case or to speak with a live representative, please call our Phone Support Unit at (916) 445-9891. The operating hours are 8 a.m. to 12 p.m. and 1 p.m. to 5 p.m. Monday through Friday. The Phone Support Unit is closed on weekends and state holidays.
You can also use our online form, “Request the Status of an Open Case” at the bottom of the page.
Vim li cas nws thiaj siv sij hawm ntev los npaj ib daim ntawv pov thawj? Dab tsi yog txheej txheem kom tau txais daim ntawv lav npaj?
Thov xa mus rau Qhov Kev Pab Cuam Tus Kheej lub vev xaib lossis xa mus rau Tus Txheej Txheem Kev Raug Mob Tus Kheej kom paub meej.
Kuv yuav ua li cas thiaj li tau kuv rooj plaub kom nrawm dua?
Muaj ntau ntau yam uas koj tuaj yeem ua kom txo tau lub sijhawm nws yuav siv los ua cov ntaub ntawv:
- Notify us within 30 days of taking an action or filing a claim using the online form, under Step 1 “Report a New Case (Personal Injury Notification Form).“
- If you are an attorney, include with the notification the letter of representation and a signed medical authorization using the online form. This will allow our office to speak with you regarding this case.
- If you have an upcoming court or mediation date and need a Medi-Cal lien amount, alert us as soon as you get the date. We will need time to obtain and review the claims payment data to determine the lien.
- Once your case settles, submit a copy of the signed settlement release using the online form, under Step 2 “Provide a Case Update or Documentation (All Other Notifications)” so we can apply the appropriate statutory reduction. If you’re an attorney, include information about your fees and itemization of litigation expenses.
- Provide the final date of treatment, using the online form, as soon as possible once the Medi-Cal member has completed treatment.
- For more information about our lien process, please go to Personal Injury Lien Process webpage.
Dab tsi yog qhov yuav tsum tau ua kom tau txais cov khoom ua ntej?
A preliminary itemization may be requested online, under Step 2 “Provide a Case Update or Documentation (All Other Notifications)“. The request must include proof of hearing, settlement conference, mediation, or similar event and received at least 30 days in advance.
Kuv yog tus neeg foob lossis tus kws lij choj tiv thaiv thiab yuav tsum tau thov cov ntaub ntawv them nqi khomob lossis kev pom tus kheej. Kuv xa daim ntawv foob qhov twg?
Please refer to DHCS’ webpage, Service of Process, for all the options available for sending a subpoena.
Vim li cas kuv thiaj tau txais daim nqi (CAS3025)?
Qhov kev pab cuam Medi-Cal them rau cov kev pab cuam cuam tshuam txog koj tus kheej raug mob. DHCS tuav txoj cai los sau tawm tsam txhua qhov kev txiav txim, kev txiav txim, lossis khoom plig uas tshwm sim los ntawm koj tus kheej raug mob. Tus nqi them uas tau teev tseg hauv tsab ntawv yuav tsum tau them thaum koj tau txais nyiaj los ntawm lwm yam kev pov hwm kev noj qab haus huv, kev them nyiaj raws cai, lossis lwm qhov chaw (tseem ceeb thib peb).
Why am I receiving bills from providers? I have Medi-Cal, why hasn’t Medi-Cal paid them?
Thov hu rau tus kws kho mob thiab muab koj daim Medi-Cal Benefits Identification Card (BIC) cov ntaub ntawv kom lawv thiaj li them tau Medi-Cal. Cov kws kho mob muaj txog li 1 xyoos los sau Medi-Cal.
Qhov Kev Pab Cuam Rau Tus Kheej tau ua txhaum cai rau kuv qhov kev txiav txim. Kuv puas tuaj yeem tau txais kev txo qis?
The DHCS’ recovery is limited to the amount derived from applying Welfare and Institutions Code section 14124.785. To request a reduction, submit a copy of the settlement release documents along with the attorney’s fees and itemized litigation costs using the online form, under Step 2 “Provide a Case Update or Documentation (All Other Notifications)“.
Kuv puas tuaj yeem tau txais daim ntawv cog lus them rov qab?
Tsis muaj. Tus nqi ntawm Medi-Cal lien yuav tsum tau them thaum qhov teeb meem daws teeb meem.
Peb puas tuaj yeem them tus nqi qiv nyiaj ntawm Electronic Fund Transfer (EFT)?
Yes, we prefer electronic payments over checks and other forms of payment. Please use our Electronic Funds Transfer payment system. Please have your DHCS Account number available to ensure payment is applied to the correct case.
Kuv yuav xa daim tshev mus rau qhov twg thiab kuv yuav ua kom tau daim tshev them rau leej twg?
Daim tshev yuav tsum them rau Department of Health Care Services. Thov sau koj tus lej DHCS tus lej nyiaj ntawm qhov kev them nyiaj kom paub meej tias daim ntawv thov raug raws sijhawm.
Thov xa cov nyiaj them tuaj rau:
Department of Health Care Services
Third Party Liability and Recovery Division
Personal Injury Branch – MS 4720
P.O. Box 997421
Sacramento, CA 95899-7421
If you’re using courier mail (FedEx, UPS, etc.), please mail to:
Department of Health Care Services
Third Party Liability and Recovery Division
1501 Capitol Avenue, MS 4720
Sacramento, CA 95814-5005
Yuav ua li cas yog lub tuam txhab tuav pov hwm xa kuv daim tshev them rau Medi-Cal thiab kuv?
Yog lub tuam txhab tuav pov hwm muab daim tshev them rau Medi-Cal lossis DHCS thiab koj:
- Pib txij Lub Xya Hli 1, 2025, California Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) yuav tsis lees txais daim ntawv DHCS 4204 thiab tsis lees paub cov tshev / cov cuab yeej ua tus neeg them nyiaj rau cov tshev / cov cuab yeej nrog ntau tus neeg them nyiaj. Yog li ntawd, cov tshev / cov cuab yeej tau txais tom qab Lub Xya Hli 1, 2025, yuav raug xa rov qab yam tsis muaj kev pom zoo.
- Qhia rau tus neeg them nyiaj / tus tshaj tawm txog qhov kev txiav tawm ntawm cov txheej txheem no thiab thov kom tus neeg them nyiaj / tus tshaj tawm muab cov tshev cais rau Medi-Cal Tus Tswv Cuab thiab DHCS raws li.
Thov nco ntsoov: DHCS tsis pom zoo rau kev txheeb xyuas nyiaj txiag ntxiv lawm. Yog tias DHCS tsis muaj kev txaus siab rau qhov kev txiav txim, thov ua haujlwm nrog lub tuam txhab pov hwm kom tau txais daim tshev tshiab uas them rau koj. Yog tias DHCS muaj cov paj laum rov qab tau, thov qhia rau lub tuam txhab tuav pov hwm kom muab cov tshev cais tawm—ib qho them rau DHCS thiab ib qho them rau koj.
Kuv tuaj yeem tau txais tsab ntawv tso Medi-Cal li cas?
Upon request, DHCS will issue a release letter after the lien amount has been paid in full. If the Medi-Cal lien was paid by check, DHCS will wait 30 days for the check payment to clear the bank before issuing a lien release letter. If you would like a release letter prior to 30 days, you can send a confirmation of the cleared check payment. You also need to provide the settlement information that includes the settlement amount, attorney fees, and litigation costs before DHCS can issue a lien release letter.
Nws yuav siv sij hawm ntev npaum li cas thiaj tau txais cov nyiaj rov qab los ntawm kev them nyiaj ntau dhau?
Thaum tau txais cov nyiaj them ntau dhau lawm, lub sijhawm tos 30 hnub yuav tsum tau ua kom ntseeg tau tias cov nyiaj them poob haujlwm tsis raug cuam tshuam lossis xa rov qab los ntawm lub txhab nyiaj. Tom qab lub sijhawm tos no, cov txheej txheem nyiaj rov qab feem ntau yuav siv sijhawm txog 60 hnub ua haujlwm ua ntej daim tshev nyiaj rov qab tau txais los ntawm pawg neeg tsim nyog. Thov nco ntsoov tias lub sijhawm lub sijhawm tseem nyob ntawm USPS xa ntawv hauv koj cheeb tsam.
Kuv tuaj yeem thov kom sai li sai tau cov nyiaj rov qab?
Tam sim no tus nqi nrawm nrawm yog raws li hauv qab no:
- Tib Hnub Teeb Meem & Tso Tawm: $ 75 / tus neeg them nyiaj
- Hnub Nyoog Tshaj Tawm: $ 50 / tus neeg them nyiaj
- Hnub Ob Tso Tawm: $ 25 / tus neeg them nyiaj
- Hnub Peb Tso Tawm: $ 15 / tus neeg them nyiaj
- Tshwj xeeb Hnub Tso Tawm: $ 10 / tus neeg them nyiaj
Thov tso cai rau kwv yees li 2-3 lub lis piam ua ntej koj yuav tau txais daim tshev nyiaj rov qab sai. Lub sijhawm ua haujlwm tseem nyob ntawm USPS xa ntawv hauv koj cheeb tsam.
Kev them nqi ceev ceev tuaj yeem xa tuaj los ntawm peb lub Electronic Funds Transfer (EFT) kev them nyiaj. Kev them nyiaj xa los ntawm daim tshev yuav raug lees txais tab sis yuav ncua cov txheej txheem vim tias kev npaj nyiaj rov qab tsis pib kom txog thaum tau txais tus nqi nrawm. Cov ntaub ntawv hauv qab no yuav tsum suav nrog kev them nqi sai sai:
- Case lub npe thiab/los yog tus lej xov tooj.
- Yog vim li cas rau kev them nyiaj, piv txwv li, refund expedite nqi.
- Sijhawm rau kev nrawm, piv txwv li, tib hnub, hnub tom ntej, thiab lwm yam.
- Xa nyiaj rov qab daim tshev them nyiaj (Npe kom them rov qab daim tshev them rau). *
- Xa qhov chaw nyob xa daim tshev nyiaj rov qab. *
* Cov ntaub ntawv no yog ib qho tseem ceeb los xyuas kom meej tias daim tshev nyiaj rov qab tau raug muab raug thiab kom tsis txhob rov qab daim tshev rov qab. Yog tias daim tshev them rov qab tau xa rov qab, tus nqi them rov qab yuav raug xa rov qab rau daim tshev.
Thov hu rau Lub Chaw Pab Txhawb Xov Tooj ntawm (916) 445-9891 yog xav paub ntxiv lossis ceeb toom rau PIP txog koj qhov kev thov. Sijhawm ua haujlwm: Hnub Monday txog Friday, thaum 8:00 teev sawv ntxov txog 5:00 teev tsaus ntuj, kaw thaum 12:00 teev tsaus ntuj - 1:00 teev tsaus ntuj Kaw rau hnub so thiab hnub so hauv xeev.