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Medi-Cal Rx Provider Manual

Proprietary & Confidential 2022 California Department of Health Care Services. All rights reserved. Medi-Cal Rx Provider Manual Version January 1, 2022 DHCS Medi-Cal Rx Provider Manual 2 01/01/2022 Revision History Document Version Date Name Comments 10/05/2020 Ashley Sipes Initial Creation Bridgette Devine/ Melissa Ferrante Document Review 11/05/2020 Ashley Sipes Updated according to DHCS feedback Melissa Ferrante Document Review 11/30/2020 Ashley Sipes Updated according to DHCS feedback Melissa Ferrante Document Review 12/16/2020 Ashley Sipes Updated according to DHCS feedback Melissa Ferrante Document Review 12/29/2020 Ashley Sipes

DHCS – Medi-Cal Rx Provider Manual 2 02/01/2022 Revision History Document Version Date Name Comments 0.1 10/05/2020 Ashley Sipes Initial Creation

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Medi-Cal Rx Billing Tips for Claims on or after January 1 ...

medi-calrx.dhcs.ca.gov

Nov 02, 2021 · DHCS – Medi-Cal Rx Billing Tips for Claims on or after January 1, 2022 4 11/02/2021 1.0 Introduction On January 1, 2022, the California Department of Health Care Services (DHCS) will transition all Medi-Cal pharmacy services from Managed Care Plan (MCP) to Fee-for-Service (FFS). The following information is to be used by pharmacy

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Medi-Cal Rx Training Information

medi-calrx.dhcs.ca.gov

information and high-level changes affecting pharmacy providers and the POS systems used. Session 3: Claim Submission & Finance Information – Includes background information and high-level changes to web claim submissions affecting pharmacy providers, along with an overview of the Finance Portal.

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Medi-Cal Rx Prior Authorization (PA) Job Aid

medi-calrx.dhcs.ca.gov

5. Once the required fields are filled out on the Provider page, the . Next. button turns blue. You can now click the . Next. button to proceed. See . Figure 3.0-5. Figure 3.0-5: Provider Page with Required Fields Met . 6. The PA page for Submitter information will load. Fill out the required fields and click the . Next button. See Figure 3.0-6.

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Medi-Cal Rx NCPDP Payer Specification Sheet

medi-calrx.dhcs.ca.gov

Payer Specification Sheet 5 10/01/2021 . General Information. The information within this section is NEW! and applies to all transactions in the document. Refer to the information in the chart below for successful transmission of transactions as well as contact and support numbers that have changed with the transition. Payer Name: Magellan Medicaid

  Name, Payer, Payer name

Medi-Cal Rx Contract Drugs List

medi-calrx.dhcs.ca.gov

Capsules 250 mg 500 mg ea ea Chewable Tablets Tablets 125 mg 250 mg 500 mg 875 mg ea ea ea ea Ampicillin Powder for injection 125 mg/vial 250 mg/vial 500 mg/vial . Medi-Cal Rx Contract Drugs List ...

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User Administration Console (UAC) Quick Start Guide

medi-calrx.dhcs.ca.gov

Oct 21, 2020 · DHCS – UAC Quick Start Guide 3 12/20/2021 2.0 Sending PIN to an Alternate Address To receive PIN(s) at a different address than the one displayed, you must submit a request to send the PIN(s) to the preferred address. • If you previously requested a PIN(s) and now require it to be sent to an alternate address, you need to

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medi-calrx.dhcs.ca.gov

1. Changes to the Contract Drugs List (CDL), Effective December 1, 2021 2. Changes to the Contract Drugs List (CDL) – Over the Counter Drugs, Effective December 1, ... reimburse a …

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Medi-Cal Rx Contract Drugs List - Therapeutic Classifications

medi-calrx.dhcs.ca.gov

Estramustine Phosphate Sunitinib Malate Etoposide Talazoparib Etoposide Phosphate Tamoxifen Citrate Everolimus Tazemetostat Exemestane Temozolomide Fam-Trastuzumab Deruxtecan-Nxki Temsirolimus Floxuridine Teniposide Fulvestrant Tepotinib Gefitinib Testosterone Gemcitabine HCl Thioguanine (Gemtuzumab Ozogamicin) Thiotepa

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Medi-Cal Rx Prior Authorization Request Form

medi-calrx.dhcs.ca.gov

Medi-Cal Rx Prior Authorization Request Form Instructions: Fill out all applicable sections on all pages completely and legibly. Attach any additional documentation that is important for the review (e.g., chart notes or lab data, to support the prior authorization). Information contained in this form is Protected Health Information under HIPAA.

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Medi-Cal Rx Contract Drugs List – Over the Counter Drugs

medi-calrx.dhcs.ca.gov

Liquid * 160 mg/5 ml 60 ml 120 ml 240 ml 480 ml ml ml ml ml ml * Restricted to individuals younger than 21 years of age for the liquid and drops only. ... CALCIUM SUPPLEMENTS AND VITAMIN D ANALOGS Calcium Carbonate Tablets or capsules 650 mg 1250 mg ea ea Calcium Gluconate Tablets or wafers 325 mg 500 mg 650 mg 1 gm ea ea ea

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