Txoj Kev Txhaum Tus Kheej Lien
Kauj Ruam 1: Muab kev ceeb toom ntawm kev raug mob los tsim rooj plaub tshiab. Tus tswv cuab Medi-Cal lossis tus neeg sawv cev ntawm tus kheej yuav tsum tau hais los ntawm txoj cai lij choj kom tshaj tawm qhov kev txiav txim lossis thov sau ntawv mus rau Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) raws li Welfare and Institutions (W&I) Code tshooj 14124.70 thiab lwm yam. Tsim rooj plaub tshiab hauv online lossis muab kev ceeb toom los ntawm kev xa ntawv tsis pub dhau 30 hnub ntawm kev ua ntawv foob lossis thov. DHCS yuav xa ib tsab ntawv lees paub tias tau txais koj daim ntawv ceeb toom tsis pub dhau 30 hnub.
Daim ntawv ceeb toom yuav tsum suav nrog cov hauv qab no raws li W&I Code tshooj 14124.73(c):
1. Hnub tim uas tus tswv cuab Medi-Cal raug mob.
2. Tus lej ntawm daim npav Medi-Cal Benefits Identification Card rau tus tswv cuab.
3. Tiv tauj cov ntaub ntawv ntawm lub luag haujlwm thib peb lossis tus neeg tuav pov hwm.
4. Cov ntaub ntawv tiv tauj ntawm tus thawj tswj hwm, suav nrog lawv tus lej thov.
5. Cov ntaub ntawv tiv tauj ntawm ib tus kws lij choj tiv thaiv sawv cev rau tus neeg thib peb lossis tus neeg tuav pov hwm lub luag haujlwm.
Step 2: Inform DHCS when the member has completed treatment with a Medi-Cal provider or after the settlement has occurred. Upon each settlement, the member or personal representative is required to notify DHCS pursuant to W&I Code section 14124.785 and 14124.79. When the member has completed treatment or a settlement has occurred, DHCS will order and review the payment records to create a “lien,” which is a list of injury-related services subject to collection. Use the Provide a Case Update or Documentation link to inform DHCS of a settlement, completion of treatment, or if you have other case information to report or documentation to provide for an existing case.
Yog tias koj muaj lus nug lossis xav tau kev pab, koj tuaj yeem tiv tauj Qhov Kev Pabcuam Tus Kheej ntawm (916) 445-9891 los tham nrog ib tus neeg sawv cev nyob lossis xa Kev Tshawb Fawb Online txhawm rau thov kom muaj xwm txheej ntawm rooj plaub.
DHCS Lien Txheej txheem cej luam: Tus kheej raug mob
- Kev raug mob raug qhia rau DHCS
Yuav kom ua tiav cov txheej txheem lien, hnub raug mob, qhov raug mob thawj zaug, hnub them rov qab, thiab tus nqi khoom plig yuav tsum tau muab online (Kauj Ruam 1) lossis xa los ntawm kev xa ntawv los tsim kom muaj rooj plaub tshiab. - DHCS kuaj xyuas Medi-Cal kev tsim nyog
Kev txheeb xyuas qhov tsim nyog yuav siv sijhawm 30 hnub kom tiav. Raws Li Kev Noj Qab Haus Huv thiab Lub Tsev Haujlwm (WI) Code tshooj 14124.76, tsis muaj kev txiav txim siab, kev txiav txim, lossis khoom plig yog qhov kawg kom txog thaum Medi-Cal muaj lub sijhawm tsim nyog los tsim Medi-Cal lien. - Yog tias tsim nyog, tsim ib rooj plaub ntawm tus kheej raug mob
Yog tias tsis tsim nyog, DHCS yuav ceeb toom rau pawg neeg xa khoom. - Ua ntej xaj cov ntaub ntawv them nqi, DHCS yuav tso cai 120 hnub dhau los ntawm hnub sib tham lossis hnub kawg ntawm kev kho mob, qhov twg tshwm sim thawj zaug.
Raws li (W&I) Txoj Cai Tshooj 14115, cov chaw muab kev pab muaj txog li ib xyoos txij li hnub tau txais kev pab them nqi Medi-Cal. Cov kws kho mob feem ntau them Medi-Cal li ntawm plaub lub hlis txij li hnub tau txais kev pab. Los ntawm kev thov cov ntaub ntawv them nqi tsis pub dhau 120 hnub tom qab hnub txiav txim, DHCS tso cai sijhawm txaus rau cov neeg muab kev pab them nqi Medi-Cal. - DHCS tuaj yeem xaj cov ntaub ntawv them nyiaj los ntawm Managed Care Plan (MCP)
Data may be ordered from multiple MCPs if the member is enrolled in multiple plans during the treatment period. MCPs usually respond to DHCS’ request for records within 30 days. However, additional time may be needed. - Thaum cov ntaub ntawv them nyiaj tuaj txog, DHCS yuav tshuaj xyuas thiab tsim daim ntawv lav, yog tias muaj.
Kev tshuaj xyuas cov ntaub ntawv them nyiaj feem ntau yuav siv li ntawm 30 hnub thiab 60 hnub. Txawm li cas los xij, yuav xav tau sijhawm ntxiv. - DHCS will send a “lien” or “no lien” letter to the appropriate parties.
Step 3: Pay the Medi-Cal lien. Include the member’s DHCS account number to ensure payment is applied to the correct case. You can make a payment by check or Electronic Funds Transfer (EFT).
Yog xav paub ntxiv txog cov txheej txheem lien thiab lub sijhawm, mus saib peb nplooj ntawv Cov Lus Nug Nug . Yog tias cov nyiaj yuav raug muab tso rau hauv ib tus account tshwj xeeb xav tau kev ntseeg siab, thov mus rau lub vev xaib tshwj xeeb xav tau kev ntseeg siab rau cov lus qhia ntxiv txog kev ceeb toom DHCS.