Claim Submission

Claims for service may be submitted either hard copy or electronically through usual Medi-Cal channels. Claims must be submitted with the14-digit ID number that is received after the recipient has been enrolled via DETEC. All claims submitted without the 14-digit ID number will be denied. All other Medi-Cal criteria will apply (e.g., timeliness guidelines, modifier requirements, etc.). Claims must be submitted with a valid CDP: EWC ICD-9 diagnosis code to be eligible for payment.

Prior to submitting the claim for CM, providers must complete and submit via DETEC the necessary Breast and/or Cervical Cancer Screening Cycle Data forms for the recipient for the certification time period being billed. For more information regarding claims, call the TSC at 1-800-541-5555.

Data Submission

As a CDP: EWC enrolled provider, the PCP is required to submit demographic information, screening, diagnostic procedures, workup status, final diagnosis and treatment data using DETEC, the online data collection system. CDP: EWC program policy requires data submission within 10 days after receipt of results.