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Dhcs 834 companion guide

California Medicaid (Medi-Cal) Standard Companion Guide - files medi-cal ca 2025

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The Medi-Cal Companion Guide provides detailed instructions for electronic transactions related to California's Medicaid program, adhering to ASC X12 Implementation Guides. It includes guidelines for communication and transaction submissions, compliance with HIPAA regulations, and specific transaction types such as health care eligibility inquiries, claims status requests, and payment advice. The document serves as a resource for ensuring proper electronic data interchange between healthcare providers and the Medi-Cal system.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the 3 month rule for Medi-Cal?

Retroactive Medi-Cal covers unpaid medical expenses from the three months prior to the month you apply for Medi-Cal. If you have unpaid bills from the three previous months, enter that information during the application process. If you qualify for Medi-Cal, you will also be evaluated for retroactive coverage.

How do I submit a claim to Medi-Cal?

To file a claim, you must submit a Medi-Cal Claim Form for Beneficiary Reimbursement. The claim form must be filled out in blue or black ink; The claim form must have an original signature (no copies will be accepted); The Claim Form must include: A photo copy of your Medi-Cal Beneficiary Identification Card (BIC).

What disqualifies you from Medi-Cal in California?

The Medi-Cal program determines eligibility for benefits on a means tested basis. If a Medi-Cal applicants property/assets are over the Medi-Cal property limit, the applicant will not be eligible for Medi-Cal unless they lower their property/assets ing to the program rules.

What is the deadline for Medi-Cal claims?

Original (or initial) Medi-Cal claims must be received by the California MMIS FI within six months following the month in which services were rendered.

What is the claim submission process?

The claim submission is defined as the process of determining the amount of reimbursement that the healthcare provider will receive after the insurance firm clears all the dues. If you submit clean claims, it means the claim spends minimum time in accounts receivable on the payers side, resulting in faster payments.

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