CHDP Gateway to Health Coverage

September 2019 | Bulletin 179

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1. New Aid Code 2C: County Children's Health Initiative Program

Effective for dates of service on or after October 1, 2019, aid code 2C (County Children's Health Initiative Program [CCHIP]) provides county-specific, full-scope, no Share of Cost (SOC) medical, dental, mental health and vision benefits to CCHIP children. CCHIP children must be 18 years of age or younger with a modified adjusted gross income above 266 percent and up to and including 322 percent of the U.S. Department of Health & Human Services (HHS) poverty guidelines.

This aid code is not eligible for Local Educational Agency (LEA) services, Child Health and Disability Prevention (CHDP) services or for an infant using the mother's ID.

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

Provider Manual(s) Page(s) Updated
CHDP
Part 1
aid codes (21)
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2. CHDP Gateway Aid Code Update

Effective for dates of service on or after July 1, 2019, Child Health and Disability Prevention (CHDP) Gateway applicants with unsatisfactory immigration status who would have been enrolled in aid code 8Y, for CHDP services only, will now be enrolled in aid code 8W or 8X, for full-scope Medi-Cal benefits. Pursuant to Welfare and Institutions Code (W&I Code), Section 14007.8, individuals under age 19 who do not have satisfactory immigration status or are unable to establish satisfactory immigration status may receive full-scope Medi-Cal benefits, including temporary full-scope Presumptive Eligibility (PE).

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

Provider Manual(s) Page(s) Updated
CHDP
Part 1
aid codes (32)
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3. Updates to CHDP Gateway Internet Step-by-Step User Guide

The Child Health and Disability Prevention (CHDP) Gateway Internet Step-by-Step User Guide has been updated to include new screenshots, revised field specifications and updated response messages.

The word “NONE” and the characters 0 – 9 and period (.) are not valid for the First Name and Last Name fields. The period (.) character is not valid for the Residence City and Mailing City fields. Providers should enter the pound sign (#) in First Name fields to indicate the absence of a first name.

Response messages regarding infant pre-enrollment in full-scope, share of cost coverage have been removed.

Providers may access and download the user guide on the CHDP Provider Manual and Bulletins page of the Medi-Cal website.

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4. 2020 ICD-10-CM/PCS Codes Annual Update

Effective for dates of service on or after October 1, 2019, the Centers for Medicare & Medicaid Services (CMS) has updated ICD-10-CM and ICD-10-PCS codes for the 2020 annual ICD-10 update.

Information and downloads for these codes can be found at the ICD-10 page of the CMS website. Specific billing policy related to this update will be published in a future Medi-Cal Update and Family PACT Update.

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5. CHDP Gateway Access Issue Notification

Provider access to the Child Health and Disability Prevention (CHDP) Gateway may be impacted as a result of the multi-year, multi-phase project to transition CHDP providers from billing local codes on the PM 160 claim to billing national codes on the CMS-1500 or UB-04 claim form. It is anticipated most providers will not be impacted by the administrative updates; however, providers who are unable to access the Gateway should 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 Gateway access issues to CHDPTransition@conduent.com.

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6. October 2019 Medi-Cal Provider Seminar

The October Medi-Cal provider seminar is scheduled for October 29 – 30, 2019, at the Pasadena Convention Center in Pasadena, 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 October 15, 2019, to receive a hard copy of the Medi-Cal provider training workbooks on the date(s) of training. After October 15, 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 regional representative.

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

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7. 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 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.

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8. Provider Manual Revisions

Pages updated due to ongoing provider manual revisions:

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