指定中間護理設施
The Designated Intermediate Care Facility (DICF) Quality Assurance Fee (QAF) program is governed by the California Health and Safety Code, Sections 1324 through 1324.14. These provisions require the California Department of Health Care Services (DHCS) to impose a QAF based on the gross receipts for each DICF, including Developmentally Disabled (DICF-DD), Developmentally Disabled Habilitative (DICF-DD-H), and Developmentally Disabled Nursing (DICF-DD-N). For the purposes of this program, the term “gross receipts” is defined as compensation for services provided to residents of a DICF, not including the following:
- 因超額付款而將任何金額退還給付款人
- 欠債
- 設施收到的供應商回贈
- 該設施收到的慈善捐款
As a condition for a DICF to participate in the Medi-Cal program, payments to DHCS must be made on or before the last day of each calendar quarter, following the calendar quarter for which the fee is imposed. DHCS has the discretion to make retroactive adjustments as necessary to ensure that the fees collected do not exceed 6 percent. Please refer to the following link regarding important changes to DICF QAF requirements: DICF Bulletin 388
請注意，「日間治療費用付款」部分已從 QAF 季度付款發票中刪除。 將郵寄單獨的發票以供日間治療費用支付。
QAF-DICF 付款及報告表格
線上提交表格 - 使用此連結以電子方式提交總收入資料：
Printable Forms – Use these links to print the form and mail gross receipts data, along with the corresponding QAF payment:
請務必輸入您的設施名稱、地址和國家提供者識別號碼，以便您的付款將存入正確的帳戶。
Provider bulletins and rates information is available on the Long Term Care Reimbursement webpage.
DHCS現在接受電子資金轉帳 (EFT) 至 DICF 專案。 有關更多信息，請訪問 TPLRD EFT 付款網頁。
注意：如果您放錯或沒有發票號碼，請參閱下表，並使用預設的發票號碼付款。
| QAF專案 | 發票編號 |
|---|---|
| 指定中間護理設施 (DICF) | ICF12345678 |
| Day Treatment – DICF | DAY12345678 |
使用上述預設發票編號以 EFT 付款時，請發送電子郵件至 QAF@dhcs.ca.gov 並附上以下詳細信息，以確保存款項已正確登入和應用：
- 提供者名稱
- 國家提供者識別碼 (NPI) 號碼
- 如果您與其他設施共用 NPI，請提供您的供應商號碼。
- 電子貨幣付款金額
- 電子匯款支付日期
- 支付發票和/或人口普查數據，識別 EFT 付款的用途（即季度和費率年）。
有問題？
關於 QAF 付款的任何疑問，請向：
Department of Health Care Services
Third Party Liability & Recovery Division
Quality Assurance Fee Program – MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
電話: (916) 650-0583
傳真：(916) 440-5671
電子郵件 QAF@dhcs.ca.gov