- How long will payments to providers be withheld?
A: Payments will be withheld until the State budget has been approved and EDS receives notification from the Department of Health Care Services (DHCS) to release the payments held during the budget impasse.
- Can I refuse service to a recipient if my reimbursements are being withheld?
A: DHCS appreciates providers seeing patients that receive State-covered health care services during this time. Please continue rendering services and billing for those services. Medi-Cal will continue to process claims. When the State budget passes, providers will be reimbursed for services rendered.
- Has the State budget passed?
A: No. It has not been passed. Please keep reviewing Medi-Cal Update bulletins and the Medi-Cal Web site for any updates.
- Are my claims going to continue being processed?
A: Yes. As Medi-Cal receives claims, they will be processed and after the budget is passed providers will start receiving payments.
- Should I keep sending my claims in?
A: Yes. Continue to send claims in for processing. The usual claims processing will continue. This will keep claims timely and after the budget is passed providers will start receiving payments.
- What do I tell my creditors and my staff if I cannot meet my payroll?
A: All Medi-Cal providers whose held payments equal or exceed $5,000 will be automatically sent the Value of Claims (VOC) letter on a weekly basis. This letter will be based on each Monday’s “in process amount”, which will be cumulative each week. The letter will also inform providers about which programs he/she is owed payments and how much is owed for each program (Healthy Families, Medi-Cal, etc.). This letter will be sent to the “Pay-To” Address on file. Providers who have not updated their “Pay-To” Address with Provider Enrollment (supplemental application) may not receive this letter. Providers who need to update their “Pay-To” Address, must do so with a cover memo to Provider Enrollment stating they are submitting the supplemental application for a VOC letter. Providers who want this letter, have not received it and have a valid “Pay-To” Address on file can contact the Telephone Service Center (TSC) after mid-July (or when the MPIP fund is exhausted) at 1-800-541-5555 and choose option 15, then option 13. Once the budget passes, providers can expect to receive payment for their claims held during the budget impasse, and not due to the August payment hold, within five to thirteen days of enactment of the 2008-09 State budget.
- Can I get an interim advance?
A: DHCS appreciates providers delivering service to recipients receiving State-covered health care services during period. At this time, the State does not have the legal authority to disburse any funds for withheld reimbursements.
- When the budget is passed will I be paid for all of my claims in a lump sum, or will it be divided into payments?
A: DHCS anticipates reimbursements in one payment. However extended delays in passing the budget may divide payments into two warrants. Once the budget is passed, payments will be processed as soon as possible.
- How can I get a letter for my bank in order to apply for a line of credit?
A: A Value of Claims (VOC) letter will be sent weekly to providers who have more than $5,000 in suppressed claims. The VOC letter will be sent to your "Pay-To" Address. If providers do not receive a VOC letter, call TSC at 1-800-541-5555 for assistance.
- Will I continue to receive RADs during hold or no-budget periods?
A: You will receive RADs which contain any claims paid on that warrant or EFT along with denied and suspended claims. Claims held as a result of no-budget/hold periods will not be reported on the RAD.