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\u2039\u2039Note: Providers must bill Medicare or the Other Health Coverage within one year of the month of service to meet Medi-Cal timeliness requirements.\u203a\u203a
The CMS-1500 form is the standard claim form used by a non-institutional provider or supplier to bill Medicare carriers and durable medical equipment regional carriers (DMERCs) when a provider qualifies for a waiver from the Administrative Simplification Compliance Act (ASCA) requirement for electronic submission of ...
The process for verifying your Medi-Cal eligibility, from the time your completed application is received to when you receive your Benefits Identification Card (BIC), normally takes 45 days.
The two most common claim forms are the CMS-1500 and the UB-04.
You must file claims within 180 days from the date services were performed, unless there's a contractual exception. For inpatient claims, the date of service refers to the member's discharge date.
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Like other bills, medical-legal evaluation and service bills must be submitted within 12 months from the date of service. The Labor Code states that \u201cbills for medical-legal charges are barred unless timely submitted.\u201d There are no exceptions to this rule.
Paper Claims All submitted forms must be on standard paper claim forms. Standard claim forms can be purchased from authorized vendors. Accuracy, completeness and clarity of the form are necessary to ensure that the information is scanned correctly into the system.
\u200bYes, you may be reimbursed for Retro Active Medi-Cal expenses up to three months from the date you applied for Medi-Cal. For further information, please contact your local County office.
Like other bills, medical-legal evaluation and service bills must be submitted within 12 months from the date of service. The Labor Code states that \u201cbills for medical-legal charges are barred unless timely submitted.\u201d There are no exceptions to this rule.
What Triggers a Post-Payment Audit? The most common trigger for a post-payment audit is provider profiling and data mining to identify aberrant billing practices and outliers. In addition, post-payment audits can also be triggered by complaints made by patients or employees about the practice.

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