CHDP Gateway to Health Coverage

April 2017 | Bulletin 150

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1. Get the Latest Medi-Cal News: Subscribe to MCSS Today

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The Medi-Cal Subscription Service (MCSS) is a free service that keeps you up-to-date on the latest Medi-Cal news. Subscribers receive subject-specific emails for urgent announcements and other updates shortly, after posting on the Medi-Cal website.

Subscribing is simple and free!

  1. Go to the MCSS Subscriber Form
  2. Enter your email address and ZIP code
  3. Customize your subscription by selecting subject areas for NewsFlash announcements, Medi-Cal Update bulletins and/or System Status Alerts

After submitting the form, a welcome email will be sent to the provided email address. If you are unable to locate the welcome email in your inbox, check your junk email folder.

For more information about MCSS, please visit the MCSS Help page.

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2. Update: DHCS Fiscal Intermediary Name Change

Effective immediately, providers may notice that the Department of Health Care Services (DHCS) Fiscal Intermediary (FI) for the Medi-Cal program, formerly Xerox State Healthcare, LLC (Xerox), is operating under a new company name, “Conduent.” Providers may also see the Conduent logo on some items.

Operations and interactions with providers are not impacted by this FI name change.

Providers may see this name change in items such as:

  • NewsFlash articles and Medi-Cal Update bulletins
  • Medi-Cal website (www.medi-cal.ca.gov)
  • Forms and User Guides
  • Provider Manuals
  • Medi-Cal Learning Portal (MLP)
  • Presentations at Provider Training Seminars
  • Provider Letters, such as Erroneous Payment Corrections (EPCs)
  • Additional hard copy correspondence
  • Emails with an “@conduent.com” address rather than an “@xerox.com” address
  • References to the Conduent name when researching mailing addresses or published telephone numbers
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There are no changes in the telephone numbers used by providers, including the Telephone Service Center (TSC) number (1-800-541-5555), as a result of this name change. The mailing addresses used by providers to conduct business with DHCS and the FI will remain the same.

Medi-Cal providers are strongly encouraged to subscribe to the Medi-Cal Subscription Service (MCSS) to receive notifications related to Medi-Cal Update bulletins, NewsFlash articles, and System Status Alerts. Providers may sign up for MCSS by visiting http://www.medi-cal.ca.gov and completing the MCSS Subscriber Form. For more information about Conduent, visit https://www.conduent.com.

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3. CHDP Phase 2: HIPAA Code Conversion and Claim Form Transition

Effective for dates of service on or after July 1, 2017, the two-digit local procedure codes currently used for Child Health and Disability Prevention (CHDP) program claims are discontinued. The codes will be replaced with national HCPCS procedure codes and modifiers that comply with HIPAA requirements.

The CHDP Confidential Screening and Billing Report (PM 160) claim form will no longer be used to bill for CHDP Early and Periodic Screening, Diagnosis and Treatment (EPSDT) health assessments, immunizations and ancillary services for dates of service on or after July 1, 2017. For these dates of service, qualified Medi-Cal providers enrolled in the CHDP program must bill CHDP/EPSDT services on a CMS-1500, UB-04 claim form or electronic equivalent. Providers should note the national codes cannot be submitted on the PM 160.

Code Conversion Table: To view the full code conversion and additional instructions, providers may refer to the CHDP Code Conversion Table. Updated manual sections will be released in future CHDP Update and Medi-Cal Update bulletins.

This is Phase 2 of the CHDP transition to national codes and claim submission methods. Phase 1, which was effective February 1, 2017, was for CHDP providers submitting claims for laboratory-only services. To see what was published for Phase 1, providers may refer to the article CHDP HIPAA Code Conversion for Clinical Laboratory Service Providers Coming Soon.

Facts about both Phase 1 and Phase 2 are available on the CHDP Frequently Asked Questions page of the Medi-Cal website.

Providers are encouraged to watch for CHDP updates in the NewsFlash area on the Medi-Cal website, and subscribe to the Medi-Cal Subscription Service (MCSS) to receive timely notifications related to CHDP by completing the MCSS Subscriber Form. Providers with questions or concerns may call the Telephone Service Center (TSC) at 1-800-541-5555 from 8 a.m. to 5 p.m., Monday through Friday, except holidays.

Email Address for Questions/Concerns
Providers may submit questions or concerns regarding the CHDP code conversion and claim form transition to CHDPTransition@conduent.com.

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4. SSN Removal Initiative to Replace HIC Number on Medicare Cards

The Medicare Access and CHIP Reauthorization Act of 2015 requires Centers for Medicare & Medicaid Services (CMS) to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim (HIC) number on new Medicare cards and will be used for transactions such as billing, eligibility status and claim status.

A transition period will allow providers to use either the HIC number or the MBI. The transition will begin no earlier than April 1, 2018, and run through December 31, 2019.

CMS currently uses SSN-based HIC numbers to identify Medicare recipients and have used HIC numbers with state Medicaid agencies, health care providers and health plans. Under the new system, CMS will assign a new MBI and send a new Medicare card for each recipient enrolled in Medicare. The MBI should be protected as Personally Identifiable Information (PII).

Additional resources can be found on the Providers and Health & drug plans Web pages of the CMS website.

Additional information regarding this transition will be announced in a future Medi-Cal Update.

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5. Resolved: Non-Home Health Claims Erroneously Denied with RAD Code 0076

A claim processing issue that caused non-Home Health claims to be erroneously denied with Remittance Advice Details (RAD) code 0076: The submitted documentation was not adequate has been resolved.

As a reminder, providers who are not required to record a revenue code on their claims should always leave blank the Revenue Code field (Box 42).

Affected claims will be re-processed by an Erroneous Payment Correction (EPC). No action is required of providers. Providers are encouraged to check the Medi-Cal website regularly for updates regarding this issue.

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6. May 2017 Medi-Cal Provider Seminar

The next Medi-Cal seminar is scheduled for May 23 – 24, 2017, at the Visalia Convention Center in Visalia, California. Providers can access a class schedule for the seminar by visiting the Provider Training Web page of the Medi-Cal Learning Portal (MLP) and clicking the seminar date(s) they would like to attend. Providers may RSVP by logging in to the MLP.

Throughout the year, the Department of Health Care Services (DHCS) and Conduent, the Fiscal Intermediary for Medi-Cal, conduct Medi-Cal training seminars. These seminars, which target both novice and experienced providers and billing staff, cover the following topics:

Providers must register by May 9, 2017, to receive a hard copy of the Medi-Cal provider training workbooks on the date(s) of training. After May 9, 2017, the workbooks will be available only by download on the Medi-Cal Provider Training Workbooks Web page of the Medi-Cal website.

Note:  Wi-Fi will not be provided at the seminar, please plan accordingly.

Providers that require more in-depth claim and billing information have the option to receive one-on-one claims assistance, which is available at all seminars, in the Claims Assistance Room.

Providers may also schedule a custom billing workshop. On the Lookup Regional Representative page, enter the ZIP code for the area you wish to search and click the “Enter ZIP Code” button. The name of the designated field representative for your area will appear on the map. To contact a regional representative, providers must first contact the Telephone Service Center (TSC) at 1-800-541-5555 and request to be contacted by a representative.

Providers are encouraged to bookmark the Provider Training Web page and refer to it often for current seminar information.

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