Medi-Cal recipients (patients) receive health care services from medical, pharmacy, or dental providers enrolled in the Medi-Cal Program. Providers must receive authorization from Medi-Cal in order to provide and/or be paid for some of these services. The form a provider uses to request authorization is called a Treatment Authorization Request (TAR). Your Medi-Cal provider will know how and when to complete and submit a TAR.
TARs are used by Medi-Cal to help ensure that necessary medical, pharmacy, or dental services are provided to Medi-Cal recipients and that providers are reimbursed appropriately. TARs are confidential documents and the information included on them is protected by state and federal privacy laws.
After your medical, pharmacy, or dental provider has submitted a TAR to Medi-Cal, he or she can check its status by phone or on the internet. Your provider will inform you if the TAR was approved. If it was approved, no further action is required. If the TAR was not approved, and you disagree with the decision, you may be able to request a fair hearing to determine if the decision should be changed. Information on your fair hearing rights is available online at: http://www.DHCS.ca.gov/services/medi-cal/Pages/Medi-CalFairHearing.aspx