ໜ້ານີ້ສະໜອງຂໍ້ມູນ ແລະຊັບພະຍາກອນກ່ຽວກັບວິທີລົງທະບຽນເພື່ອກາຍເປັນຜູ້ໃຫ້ບໍລິການ Medi-Cal, ການເອີ້ນເກັບເງິນຂອງຜູ້ໃຫ້ບໍລິການ ແລະ ການຮ້ອງຂໍການຊ່ວຍເຫຼືອ, ແລະຜົນປະໂຫຍດທີ່ໄດ້ຮັບການຄຸ້ມຄອງຈາກ Medi-Cal, ລວມທັງນະໂຍບາຍການຄຸ້ມຄອງ.​​ 

ການລົງທະບຽນຜູ້ໃຫ້ບໍລິການ Medi-Cal​​ 

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 ຍັງຮັບຜິດຊອບໃນການພັດທະນານະໂຍບາຍການລົງທະບຽນ, ແລະການປັບປຸງ ແລະຮັກສາຂໍ້ມູນຜູ້ໃຫ້ບໍລິການຢູ່ໃນຖານຂໍ້ມູນ Provider Master File ທີ່ຖືກນໍາໃຊ້ໃນຂະບວນການຊໍາລະການຮຽກຮ້ອງ.​​  

Medi-Cal providers can learn more about DHCS/PED, or contact them directly.​​ 

ຄູ່ມືຜູ້ໃຫ້ບໍລິການ Medi-Cal ແລະຂ່າວຂອງຜູ້ໃຫ້​​ 

ຜູ້ໃຫ້ບໍລິການ Medi-Cal ມີການເຂົ້າເຖິງ ຄູ່ມືຜູ້ໃຫ້ບໍລິການ Medi-Cal ແລະ Bulletins ຂອງຜູ້ໃຫ້ບໍລິການ, ເຊິ່ງອະທິບາຍເຖິງນະໂຍບາຍການຄຸ້ມຄອງ ແລະ ການຈ່າຍເງິນຄືນຂອງ Medi-Cal.​​ 

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.​​ 

ການເອີ້ນເກັບເງິນຂອງຜູ້ໃຫ້ບໍລິການ Medi-Cal ແລະຂໍຄວາມຊ່ວຍເຫຼືອ​​ 

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).​​ 

ຜູ້ໃຫ້ບໍລິການ Medi-Cal ສາມາດຕິດຕໍ່ສູນບໍລິການໂທລະສັບ (TSC) ທາງໂທລະສັບທີ່ເບີ (800) 541-5555 (ນອກລັດຄາລິຟໍເນຍ, (916) 636-1980), ວັນຈັນເຖິງວັນສຸກ, ຍົກເວັ້ນວັນພັກ, ເວລາ 8:00 ໂມງເຊົ້າ ຫາ 17:00 ໂມງແລງ ສໍາລັບການເຂົ້າເຖິງຊັບພະຍາກອນ TSC ໄດ້ໄວຂຶ້ນ, ຜູ້ໃຫ້ບໍລິການ Medi-Cal ສາມາດອ້າງອີງເຖິງ TSC Main Menu Prompt Options Guide.​​ 

ໂດຍຜ່ານໜ່ວຍບໍລິການໃບບິນຂອງຜູ້ໃຫ້ບໍລິການຂະໜາດນ້ອຍ, DHCS ຍັງສະເໜີໃຫ້ການຊ່ວຍເຫຼືອດ້ານການຮຽກເກັບເງິນເຕັມຮູບແບບ ແລະໂຄງການຝຶກອົບຮົມໃຫ້ກັບຜູ້ໃຫ້ບໍລິການ Medi-Cal ທີ່ຍື່ນຄໍາຮ້ອງຂໍ Medi-Cal ສູງສຸດ 100 ສະບັບຕໍ່ເດືອນ ແລະ ບໍ່ໄດ້ໃຊ້ບໍລິການ ຫຼື ໜ່ວຍງານອອກໃບບິນ. ຜູ້ໃຫ້ບໍລິການ Medi-Cal ສາມາດຕິດຕໍ່ໜ່ວຍເກັບເງິນຂອງຜູ້ໃຫ້ບໍລິການຂະໜາດນ້ອຍໄດ້ທາງໂທລະສັບ 916) 636-1275, ວັນຈັນເຖິງວັນສຸກ, ຍົກເວັ້ນວັນພັກ, ເວລາ 8:00 ໂມງເຊົ້າ ຫາ 12:00 ໂມງແລງ ແລະ ເວລາ 13:00 ໂມງ ຫາ 17:00 ໂມງແລງ​​ 

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.​​ 

ການຝຶກອົບຮົມຜູ້ໃຫ້ບໍລິການ 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.​​ 

ນອກຈາກນັ້ນ, Medi-Cal Learning Portal ສະເໜີໃຫ້ຜູ້ໃຫ້ບໍລິການ Medi-Cal ແລະຜູ້ອອກໃບບິນໄດ້ຝຶກອົບຮົມອອນໄລນ໌ດ້ວຍຕົນເອງກ່ຽວກັບພື້ນຖານການຮຽກເກັບເງິນ, ນະໂຍບາຍ, ຂັ້ນຕອນ, ການລິເລີ່ມໃໝ່ ແລະການປ່ຽນແປງທີ່ຈະມາເຖິງຕໍ່ກັບໂຄງການ Medi-Cal.​​ 

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.​​ 

ສາຍດ່ວນສຸຂະພາບຈະເລີນພັນ (ບໍ່ແມ່ນ 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.​​ 

ຜົນປະໂຫຍດ 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]​​