Medi-Cal Retroactive Claim Submissions

Medi-Cal Retroactive Claim Submissions This training made possible by funding from the CMSP Governing Board Presented by Penni Wright, EDS/ Medi-Cal , Provider Training Introduction Some CMSP members may become retroactively eligible for Medi-Cal When Retroactive Medi-Cal eligibility is granted, previously-paid CMSP claims may be recouped CMSP recoupment process instructs providers to bill services to Medi-Cal Page 1. Objectives Medi-Cal recipient eligibility verification process, managed care recipients Completion and submission of Retroactive TARs SOC information and clearance Claim completion guidelines beyond six- month billing limit Page 2. Objectives Claim completion guidelines over-one-year claims UB-04 Claim completion tips Resources available to providers Page 2. Recipient Eligibility Recipient eligibility is determined by the County Eligibility Worker Benefits Identification Card (BIC). 14-character ID number Date of birth Date of issue Page 3. Recipient Eligibility Access eligibility information in the POS.

Medi-Cal Retroactive Claim Submissions This training made possible by funding from the CMSP Governing Board Presented by Penni Wright, EDS/Medi-Cal, Provider Training

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  Claim, Submissions, Medi, Retroactive, Medi cal retroactive claim submissions

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