CHDP Gateway to Health Coverage

August 2019 | Bulletin 178

Print Medi-Cal Update
 

1. CCHIP Transitions to MCP System with Administrative Vendor Change

Effective October 1, 2019, the delivery of benefits for the County Children’s Health Initiative Program (CCHIP), also known as Healthy Kids, will transition from their local plan to the Medi-Cal Managed Care Plan (MCP) system. MAXIMUS, the new administrative vendor, will be responsible for case management and premium billing/collection. The California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) will continue to identify eligible children in the three CCHIP counties (Santa Clara, San Mateo, and San Francisco). For further information, call the MAXIMUS dedicated phone line for CCHIP beneficiaries at 1-833-912-2447.

Print Article | Return to Top
 

2. PM 160 Information Only Discontinued for FQHCs, RHCs and IHS-MOA Clinics

Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs) and Indian Health Services – Memorandum of Agreement (IHS-MOA) 638, Clinics bill Early and Periodic Screening, Diagnostic and Treatment/Child Health and Disability Prevention (EPSDT/CHDP) services using the UB-04 claim. Effective September 1, 2019, FQHCs, RHCs and IHS-MOA clinics will no longer submit the Confidential Screening/Billing Report Information Only (PM 160 Information Only) with claims to fulfill reporting purposes. Instead, these providers will fulfill reporting requirements by including informational lines on their claims. Required reporting data will be extrapolated from the informational lines.

Providers submitting paper claims can refer to a sample UB-04 claim populated with informational lines in the Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) Billing Examples provider manual section. Instructions for submitting informational lines on electronic claims is available in the Medi-Cal Computer Media Claims (CMC) Billing and Technical Manual, “Special Billing Instructions: Federally Qualified Health Centers, Rural Health Clinics, and Indian Health Services-Memorandum of Agreement” section.

Additionally, beginning September 1, 2019, providers should no longer order PM 160 Information Only forms.

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 about the preceding to CHDPTransition@conduent.com.

This information is reflected in the following provider manual(s):

Provider Manual(s) Page(s) Updated
Adult Day Health Care Centers
Clinics and Hospitals
ind health (8); rural (9)
CHDP chdp trans (1)
Print Article | Return to Top
 

3. September 2019 Medi-Cal Provider Seminar

The September Medi-Cal Provider Seminar is scheduled for September 17 – 18, 2019, 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 the California Medicaid Management Information System (MMIS) Fiscal Intermediary (FI) 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 September 3, 2019, to receive a hard copy of the Medi-Cal provider training workbooks on the date(s) of training. After September 3, 2019, 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 web 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.

Print Article | Return to Top
 

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

MCSS Logo

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 shortly after urgent announcements and other updates post 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 and select a subscriber type

  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.

Print Article | Return to Top


Note:

If you cannot view the MS Word or PDF (Portable Document Format) documents correctly, please visit the Web Tool Box to link to a download site for the appropriate reader.