人身傷害常見問題
Below are Frequently Asked Questions pertaining to the Personal Injury Program. Please click on the question to view the corresponding answer, or scroll down the page to the listed question and answer.
- 我如何透過電話聯絡Department of Health Care Services (DHCS) ) 人身傷害專案 (PIP)？
- 什麼是 PIP 郵寄地址？
- 我對我的加州醫療補助健康保健計劃福利和資格有疑問。
- 我遇到了意外。 誰可以幫助我？
- I have been injured, and I am taking action against the responsible party. How do I notify Medi-Cal and what information is required?
- 我捲入了一起涉及多名加州醫療補助健康保健計劃成員的事故。 DHCS 是否需要了解每位相關成員的資訊？
- 為什麼我需要通知加州醫療補助健康保健計劃？
- 如果我不通知加州醫療補助健康保健計劃會怎樣？
- 我告訴我的縣工人我參與意外。 這是否被認為是足夠的通知？
- 保險公司是否需要通知加州醫療補助健康保健計劃？
- 為什麼我收到你部門的信？ (卡斯 1090 二)
- 人身傷害專案受哪些法律管轄？
- 我轉介案例後，加州醫療補助健康保健計劃需要多長時間才會回覆？
- 我需要跟某人談談我的個人傷害案件 我如何找出誰正在處理我的案件？
- 為什麼準備押權需要這麼長時間？ 準備押權的過程是什麼？
- 我如何讓我的案件更快地進行？
- 獲得初步項目的要求是什麼？
- I am the plaintiff’s or defense attorney and need to request medical expense records or a personal appearance. Where do I send a subpoena?
- 為什麼我收到賬單（CAS3025）？
- Why am I receiving bills from providers? I have Medi-Cal, why hasn’t Medi-Cal paid them?
- 人身傷害專案對我的和解金施加了留置權。 我可以獲得折扣嗎？
- 請問可以給我一個 償還 協議？
- Can I pay a lien via Electronic Fund Transfer (EFT)?
- Where do I send a check and to whom do I make the check payable to?
- What happens if the insurance company sends me a check made payable to both Medi-Cal and me?
- 我如何獲得釋放加州醫療補助健康保健計劃留置權的信函？
- 因超額付款需要多長時間才能收到退款？
- 我該如何要求加快退款的付款？
我如何透過電話聯繫衛生保健服務部人身傷害專案？
Please call our Phone Support Unit at (916) 445-9891.
Hours of operation: Monday through Friday, from 8:00 a.m. to 5:00 p.m., and closed from 12:00 p.m. to 1:00 p.m. Closed on weekends and state holidays.
什麼是 PIP 郵寄地址？
您可以將書面通訊發送至：
Department of Health Care Services
Third Party Liability and Recovery Division
Personal Injury Branch – MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
付款的郵寄地址：
Department of Health Care Services
Third Party Liability and Recovery Division
Personal Injury Branch – MS 4720
P.O. Box 997421
Sacramento, CA 95899-7421
快遞郵件（UPS、聯邦快遞等）的郵寄地址：
Department of Health Care Services
Third Party Liability and Recovery Division
1501 Capitol Avenue, MS 4720
Sacramento, CA 95814-5005
我對我的加州醫療補助健康保健計劃福利和資格有疑問。
Please contact the California Medicaid Management Information Systems (CA-MMIS) Telephone Service Center at (800) 541-5555. They can answer any questions you may have on eligibility, benefits, and your identification card.
我遇到了意外。 誰可以幫助我？
You can represent yourself, or you can hire an attorney to represent you. DHCS does not provide assistance in filing claims against other parties.
I have been injured, and I am taking action against the responsible party. How do I notify Medi-Cal and what information is required?
For faster processing, please report the personal injury accident or claim by using our Online Forms webpage, “PI Step 1: Report a New Case (Personal Injury Notification Form).”
您也可以通過郵件報告：
Department of Health Care Services
Third Party Liability and Recovery Division
Personal Injury Branch – MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
我捲入了一起涉及多名加州醫療補助健康保健計劃成員的事故。 DHCS 是否需要了解每位相關成員的資訊？
Yes, DHCS requires notification of each Medi-Cal member involved. You may submit a separate form for each Medi-Cal member online or by mail.
為什麼我需要通知加州醫療補助健康保健計劃？
時間 he Medi-Cal member or personal representative is required by law to report the third party tort action or claim in writing to the Department of Health Care Services (DHCS) pursuant to Welfare and Institutions Code section 14124.73. Notification must be submitted online or by mail within 30 days of filing a personal injury action or claim. Attorneys must submit a “Medical Authorization” form signed by their client.
如果我不通知加州醫療補助健康保健計劃會怎樣？
As a condition of Medi-Cal eligibility, you agreed that DHCS would receive reimbursement for medical expenditures incurred due to your accident or injury when you receive money from settlement, judgment, or award from the liable third party, as well as first party insurance proceeds such as Uninsured Motorist, Underinsured Motorist, or Medical Payments. If you do not notify DHCS of your accident or injury, DHCS can take legal action against you to collect the cost of the medical services you received.
我告訴我的縣工人我參與意外。 這是否被認為是足夠的通知？
不 Welfare and Institutions Code section 14124.73 requires you or your representative to notify DHCS in writing within 30 days of filing an action against the liable third party.
保險公司是否需要通知加州醫療補助健康保健計劃？
Yes, Welfare and Institutions Code section 14124.79, requires insurance carriers to notify DHCS. Liable third party insurance carriers are legally obligated to reimburse Medi-Cal.
我為什麼會收到 DHCS 的信件？(CAS1090D)
DHCS 收到通知，表示您涉及人身傷害事件和潛在的第三方和解。信中通知您，DHCS 有權對從應負責任的第三方收取的任何和解金、判決或裁決提出留置權。
人身傷害專案受哪些法律管轄？
《福利與機構法》第14124.70-14124.795條
我轉介案例後，加州醫療補助健康保健計劃需要多長時間才會回覆？
If the injured party is Medi-Cal eligible, DHCS will send a “Notice of Medi-Cal Lien Rights” within 30 days of the referral to assert its recovery rights. If the injured party is not currently Medi-Cal eligible, DHCS may send notification stating the Medi-Cal eligibility status will be rechecked for retroactive eligibility in 90 days.
After the Medi-Cal member has completed treatment or reached a settlement, DHCS needs to receive the final date of treatment (FDOT) or the settlement notification to finalize the case and establish a lien, if applicable. DHCS will then send the lien letter with an itemized list of injury-related services to the Medi-Cal member or their personal representative and the liable third party.
我需要跟某人談談我的個人傷害案件 我如何找出誰正在處理我的案件？
To request information about your case or to speak with a live representative, please call our Phone Support Unit at (916) 445-9891. The operating hours are 8 a.m. to 12 p.m. and 1 p.m. to 5 p.m. Monday through Friday. The Phone Support Unit is closed on weekends and state holidays.
You can also use our online form, “Request the Status of an Open Case” at the bottom of the page.
為什麼準備押權需要這麼長時間？ 準備押權的過程是什麼？
詳細資訊請參閱人身傷害專案網頁或參閱人身傷害留置權流程。
我如何讓我的案件更快地進行？
您可以採取幾項措施來減少處理案件所需的時間：
- 在採取行動或提出索賠的 30 天內，使用
線上表格，在步驟 1「報告新案件（個人損傷通知表）」下。 - If you are an attorney, include with the notification the letter of representation and a signed medical authorization using the
online form. This will allow our office to speak with you regarding this case. - 一旦您的案件和解，請使用步驟 2「提供案件更新或文件（所有其他通知）」中的
線上表格，在步驟 2「提供案件更新或文件（所有其他通知）」下提交一份已簽署的和解解除書副本，以便我們適用適當的法定扣減額。如果您是律師，請附上您的收費資訊以及訴訟費用的明細。 - 在 Medi-Cal 會員完成治療後，儘快使用
Medi-Cal 會員完成治療後，儘快使用線上表格提供最終治療日期。 - 有關留置權程序的詳細資訊，請前往
人身傷害留置權程序」網頁。
獲得初步項目的要求是什麼？
A preliminary itemization may be requested online, under Step 2 “Provide a Case Update or Documentation (All Other Notifications)“. The request must include proof of hearing, settlement conference, mediation, or similar event and received at least 30 days in advance.
I am the plaintiff’s or defense attorney and need to request medical expense records or a personal appearance. Where do I send a subpoena?
Please refer to DHCS’ webpage, Service of Process, for all the options available for sending a subpoena.
為什麼我收到賬單（CAS3025）？
Medi-Cal 計劃支付與您的人身傷害事件有關的服務費用。DHCS 保留向您的人身傷害事件所導致的任何和解、判決或裁決收款的權利。當您收到任何與您的傷害有關的款項時，必須支付應付金額，包括來自應負責任的第三方的和解金、判決賠償金或裁決賠償金，以及第一方保險理賠金，例如「無保險駕駛人」、「保險額不足駕駛人」或「醫療費用」等。
Why am I receiving bills from providers? I have Medi-Cal, why hasn’t Medi-Cal paid them?
請聯絡供應商並提供您的 Medi-Cal 福利身份證（BIC）信息，以便他們可以向 Medi-Cal 發票。 提供者最多有 1 年的時間才能計費 Medi-Cal。
人身傷害專案對我的和解金施加了留置權。 我可以獲得折扣嗎？
DHCS’ recovery is limited to the amount derived from applying Welfare and Institutions Code section 14124.785. To request a reduction, submit a copy of the settlement release documents along with the attorney’s fees and itemized litigation costs using the online form, under Step 2 “Provide a Case Update or Documentation (All Other Notifications)“.
我可以獲得還款協議嗎？
不 加州醫療補助健康保健計劃留置權的金額將於案件和解時到期。
我們可以通過電子轉賬（EFT）支付押權嗎？
Yes, we prefer electronic payments over checks and other forms of payment. Please use our Electronic Funds Transfer payment system. Please have your DHCS Account number available to ensure payment is applied to the correct case.
Where do I send a check and to whom do I make the check payable?
支票抬頭請寫「健康照護服務部」。請在付款上註明您的 DHCS 帳號，以確保能及時申請到正確的病例。
請將付款郵寄至：
Department of Health Care Services
Third Party Liability and Recovery Division
Personal Injury Branch – MS 4720
P.O. Box 997421
Sacramento, CA 95899-7421
If you’re using courier mail (FedEx, UPS, etc.), please mail to:
Department of Health Care Services
Third Party Liability and Recovery Division
1501 Capitol Avenue, MS 4720
Sacramento, CA 95814-5005
What happens if the insurance company sends me a check payable to Medi-Cal and me?
If the insurance company issues a check made payable to Medi-Cal or DHCS and you:
- 自 2019 年 7 月1 起，2025 ，DHCS 將不再受理 DHCS 4204 表格，亦不再作為多收款人支票或票據的共同收款人進行背書。因此，於 7 月1 及2025 之後收到的支票／票據，將在未經背書的情況下予以退還。
- 請通知付款方／發卡機構此流程已終止，並要求付款方／發卡機構分別為 Medi-Cal 會員及 DHCS 開立獨立支票。
Please note: DHCS no longer endorses settlement checks. If DHCS has no interest in a settlement, please work with the insurance company to obtain a new check made payable to you. If DHCS has a recoverable interest, please inform the insurance carrier to issue separate checks—one made payable to DHCS and one made payable to you.
我如何獲得釋放加州醫療補助健康保健計劃留置權的信函？
Upon request, DHCS will issue a release letter after the lien amount has been paid in full. If the Medi-Cal lien was paid by check, DHCS will wait 30 days for the check payment to clear the bank before issuing a lien release letter. If you would like a release letter prior to 30 days, you can send a confirmation of the cleared check payment. You also need to provide the settlement information that includes the settlement amount, attorney fees, and litigation costs before DHCS can issue a lien release letter.
因超額付款需要多長時間才能收到退款？
When an overpayment is received, a 30-day waiting period is required to ensure that the check payment is not dishonored or returned by the bank. After this waiting period, the refund process typically takes up to 60 business days before the refund check is received by the appropriate party. Please note that the time frame is also dependent on the USPS mail delivery in your area.
我該如何要求加快退款的付款？
現時加速費用費用如下：
- Same Day Issue & Release: $75/payee
- Next Day Release: $50/payee
- 第二天發行：25 美元/收款人
- 第三天發行：15 美元/收款人
- 特定日期發行：10 美元/收款人
請等待約 2-3 週之前，才能收到快速退款支票。 時間範圍也取決於您所在地區的 USPS 郵件發送。
Expedite fee payment can be sent through our Electronic Funds Transfer (EFT) payment system. Payment sent via check will be accepted but will delay the process as refund preparation does not begin until the expedite fee is received. The following information must be included with the expedite fee payment:
- 案例名稱及/或個案編號。
- 付款原因，即退款加速費。
- 加速時間範圍，例如，同一天，第二天等。
- 退款支票收款人（退款支票應付給的姓名）。*
- 發送退款支票的郵寄地址。 *
* 此信息對於確保退款支票正確發出並避免退還退款支票非常重要。 如果退還退款支票，可能需要另一筆快速費用才能重新發行支票。
Please contact the Phone Support Unit at (916) 445-9891 for more information or to notify PIP about your request. Hours of operation: Monday through Friday, from 8:00 a.m. to 5:00 p.m., closed from 12:00 p.m. – 1:00 p.m. Closed on weekends and state holidays.