Does Medi-Cal cover past bills?

How do I check my Medi-Cal coverage?

How Do I Check My Medicaid Status? Contact your local county social services office to learn about your Medi-Cal status and eligibility. The California Department of Health Care Services has a full directory of each county's agency.

What is the timely filing limit for Medi-Cal?

Original (or initial) Medi-Cal claims must be received by the FI within six months following the month in which services were rendered. This requirement is referred to as the six-month billing limit.

Does Medi-Cal cover observation?

Observation is not a status that Medi-Cal recognizes and, therefore, Medi-Cal does not honor InterQual/MCG observation criteria. If referred for Secondary Review, the reviewer must approve as acute inpatient status and not for observation only.

How do I fight a balance bill in California?

Your health insurer will review your complaint and should tell the provider to stop billing you. If you do not agree with your health insurer's response or would like help from the California Department of Insurance to fix the problem, you can file a complaint with us online or by calling 1-800-927-4357.

What is code P in Medi-Cal?

OHC code “N” identifies Medi-Cal recipients who do not have OHC reflected. Providers can bill Medi-Cal directly if the response from the Medi-0Cal eligibility verification system is “N.”›› ‹‹OHC code “P” identifies Medi-Cal recipients who have OHC through a PPO/PHP/HMO/EPO not otherwise specified.

Does Medi-Cal expire every year?

Local Medi-Cal offices review each member's eligibility once a year or when they report changes to their household. Everyone's renewal date is different.

Do you have to pay back Medi-Cal in California?

Do you have to pay back California Medicaid? The Medi-Cal program is required to seek repayment from the estates of certain deceased Medi-Cal members. The rules state that repayment only applies to the benefits received by members on or after their 55th birthday and who owned assets at the time of death.

What are full benefits under Medi-Cal?

​​​​What are the Medi-Cal Benefits? ​​Medi-Cal currently provides a core set of health benefits, including doctor visits, hospital care, immunization, pregnancy-related services and nursing home care. The Affordable Care Act ensures all Medi-Cal health plans offer what are known as Essential Health Benefits (EHB).

How far back does Medi Cal pay?

How long before applying for Medi-Cal can a person transfer assets? The Medi-Cal "Look-Back" period in California is 30 months.

How do I claim Medi Assist reimbursement?

Is Medi Cal government funded?

Medi‑Cal provides health care coverage to over 14 million Californians with low incomes. As a joint state‑federal program, costs are shared between the federal and state as well as local governments.

Is there a time limit for medical billing in California?

Q: Is there a time limit to submit a medical bill? A: Yes. There are different time requirements for submitting a bill (12 months, 180 days, or 30 days) depending on the type of service and other factors as set forth in the California Labor Code.

Is balance billing illegal in California?

Medicare providers (like doctors and hospitals) cannot bill dual eligible beneficiaries for Medicare cost sharing. This is known as balance billing, or “improper billing,” and is illegal under both federal and state law.

What states is balance billing illegal?

What is Medi-Cal budget?

The Governor's budget includes $38.7 billion General Fund spending on Medi‑Cal, the state's Medicaid program, in 2023‑24. This amount reflects a $6.4 billion (20 percent) net increase over the revised 2022‑23 level.

Does Medi-Cal cover outpatient services?

Physician services • Hospital outpatient & outpatient clinic services • Outpatient surgery (includes anesthesiologist services.) Podiatry • Chiropractic • Allergy care • Treatment therapies (chemotherapy, radiation therapy, etc.) Dialysis/hemodialysis • Coverage is at least the greater of one drug in each U.S.

What medical equipment does Medi-Cal cover?

Durable Medical Equipment (DME) under the Medi-Cal program includes equipment such as basic and custom wheelchairs, canes, crutches, walkers, grab bars, hospital beds, water or gel pressure mattresses, oxygen therapy equipment, augmentative communication devices and other devices.

What are the time and distance standards for Medi Cal?

1. What are the time and distance standards for medical care? Primary care providers (pediatric and adult) must be located within ten (10) miles or thirty (30) minutes of your home. Hospitals must be located within fifteen (15) miles or thirty (30) minutes of your home.

What is Blue Shield of California timely filing limit?

Initial disputes must be submitted within 365 days, or the time specified in the provider's contract, whichever is greater, of Blue Shield's date of contest, denial, notice, or payment.