Txoj Kev Txhaum Tus Kheej Lien
Kauj Ruam 1
Muab kev ceeb toom txog kev raug mob kom paub tseeb tias muaj rooj plaub tshiab. Tus tswv cuab Medi-Cal lossis tus neeg sawv cev raug cai lij choj yuav tsum tshaj tawm ib qho kev nqis tes ua lossis kev thov ua ntawv sau rau Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) raws li Welfare and Institutions (W&I) Code ntu 14124.70 et seq. Tsim cov ntaub ntawv tshiab hauv online lossis xa ntawv ceeb toom hauv xa ntawv tsis pub dhau 30 hnub tom qab ua ntaub 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 muaj cov hauv qab no raws li W&I Code ntu 14124.73 (c):
- Date of the Medi-Cal member’s injury.
- Member’s Medi-Cal Benefits Identification Card number.
- Contact information of the liable third party or insurer.
- Cov ntaub ntawv tiv tauj ntawm tus thawj coj kev thov nyiaj pov hwm, suav nrog lawv tus lej thov.
- Cov ntaub ntawv tiv tauj ntawm ib tus kws lij choj tiv thaiv uas sawv cev rau tus neeg thib peb lossis tus neeg pov hwm uas muaj lub luag haujlwm.
Kauj ruam 2
Qhia rau DHCS thaum tus tswv cuab tau kho mob tiav nrog tus kws kho mob Medi-Cal lossis tom qab kev sib hais haum tau tshwm sim. Thaum txhua qhov kev sib hais haum, tus tswv cuab lossis tus neeg sawv cev yuav tsum ceeb toom rau DHCS raws li W&I Code ntu 14124.785 thiab 14124.79. Thaum tus tswv cuab tau kho tiav lawm lossis muaj kev sib hais haum, DHCS yuav xaj thiab tshuaj xyuas cov ntaub ntawv them nqi kom tsim tau "lien," uas yog daim ntawv teev cov kev pabcuam cuam tshuam nrog kev raug mob uas yuav tsum tau sau. Siv qhov txuas Muab Kev Hloov Kho Tshiab lossis Cov Ntaub Ntawv Qhia Txog Cov Ntaub Ntawv los qhia rau DHCS txog kev sib hais haum, kev kho mob tiav, lossis yog tias koj muaj lwm cov ntaub ntawv txog cov ntaub ntawv los qhia lossis cov ntaub ntawv los muab rau cov ntaub ntawv uas twb muaj lawm.
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 los ua kom tiav. Raws li W&I Code ntu 14124.76, tsis muaj kev sib hais haum, kev txiav txim, lossis kev muab khoom plig uas yog qhov kawg kom txog rau thaum Medi-Cal muaj lub sijhawm tsim nyog los ua kom tiav qhov 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 Code ntu 14115, cov kws kho mob muaj sijhawm txog ib xyoos txij li hnub muab kev pabcuam los them nqi rau Medi-Cal. Feem ntau cov kws kho mob yuav xa daim nqi rau Medi-Cal tsis pub dhau plaub lub hlis txij li hnub uas tau txais kev pab. Los ntawm kev thov cov ntaub ntawv them nqi tsis pub dhau 120 hnub tom qab hnub them nyiaj, DHCS tso cai rau lub sijhawm txaus rau cov kws kho mob los them nqi rau 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.
Kauj Ruam 3
Them qhov Medi-Cal lien. Muab tus lej nyiaj ntawm tus tswv cuab DHCS rau hauv kom paub tseeb tias qhov kev them nyiaj tau siv rau qhov teeb meem raug. Koj tuaj yeem them nyiaj los ntawm daim tshev lossis Kev Hloov Nyiaj Hluav Taws Xob (EFT).
Yog xav paub ntxiv txog cov txheej txheem lien thiab lub sijhawm, mus saib peb nplooj ntawv Cov Lus Nug Nquag Nug . Yuav tsum tau them qhov Medi-Cal lien ua ntej muab nyiaj rau tus account special needs trust (SNT), raws li Probate Code 3604(d). Yog xav paub ntxiv txog SNT, thov mus saib lub vev xaib Special Needs Trust .