Family PACT Update

December 2017 | Bulletin 123

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1. Cefixime Capsules Now an Allowable Dosage for Gonorrhea Treatment

Effective for dates of service on or after September 1, 2017, cefixime capsules are reimbursable under the Family Planning, Access, Care and Treatment (Family PACT) Program for clinic and pharmacy dispensing for gonorrhea treatment.

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

Provider Manual(s) Page(s) Updated
Family PACT ben grid (21); clinic (2); drug onsite (3); pharmacy (2)
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2. Phase 1: RTD Generation to Be Discontinued

The Department of Health Care Services (DHCS) is phasing out the generation of Resubmission Turnaround Documents (RTDs) (Form 65-1). The discontinuation of RTDs will both increase claims processing efficiency and reduce costs.

RTDs will be discontinued in multiple phases. The first phase was implemented in November 2017 and the second phase will implement in the first quarter of 2018. The third phase is expected to implement in the second quarter of 2018. The new process will deny claims submitted with questionable or missing information instead of generating an RTD. As DHCS transitions from the use of RTDs to claim denials, providers can expect to receive fewer RTDs. When the project is completed, the use of RTDs will be completely discontinued.

The implementation of each RTD phase-out period will be announced in a future monthly bulletin. Providers are encouraged to routinely check the Medi-Cal website for more information.

In addition, the following Remittance Advice Details (RAD) codes are added to help reconcile provider accounts:

Addition Code Message
9282 Patient sex code missing or invalid.
9283 Attending, referring, or prescribing provider number missing or invalid.
9284 Patient liability information missing or invalid.
9285 Accommodation code missing or invalid.
9286 Cost center code missing/invalid.
9287 Admission date or hour missing or invalid.
9288 Admission date chronologically out of sequence with discharge date.
9289 Discharge date or hour missing or invalid.
9290 Medicare EOMB date billed missing or invalid.
9291 Total charges billed invalid.
9292 Medicare disallowed amount invalid.

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

Provider Manual(s) Page(s) Updated
Part 1 remit cd 9000 (25); remit elect corr 9200 (12–14); remit elect corr rarc (1–4)
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3. VeriFone VX 520 POS Device to Decommission in July 2018

In July 2018, the VeriFone VX 520 Point of Service (POS) device will be decommissioned. Providers may contact the POS Help Desk at 1-800-541-5555 (option 5, followed by option 6) for information about the decommission and for options.

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4. 2018 Medi-Cal Provider Training Schedule

The 2018 Medi-Cal provider training schedule is now available. Providers can access Medi-Cal training information and registration details by clicking on the Outreach & Education slideshow area of the Medi-Cal website homepage or by visiting the Training Calendar web page of the Medi-Cal Learning Portal (MLP).

Training Date Webinar or Seminar Location Address
January 2 – 31 Webinar Information posted on the Medi-Cal website
February 13 – 14 Seminar Ontario
Ontario Airport Hotel & Conference Center
700 North Haven Ave.
Ontario, CA  91764
March 13 Seminar Redding
Red Lion Hotel Redding
1830 Hilltop Drive
Redding, CA  96002
April 18 – 19 Seminar Escondido
California Center For The Arts
340 N. Escondido Blvd.
Escondido, CA  92025
May 15 – 16 Seminar Fresno
Double Tree Hilton
2233 Ventura Street
Fresno, CA  93721
June 5 – 28 Webinar Information to be posted on the Medi-Cal website
July 17 – 18 Seminar Alhambra
Almansor Court
700 S. Almansor Court St.
Alhambra, CA  91801
August 14 – 15 Seminar Sacramento
Sacramento Marriott
11211 Point East Drive
Rancho Cordova, CA  95742
September 18 – 19 Seminar Long Beach
Long Beach Marriott
4700 Airport Plaza Drive
Long Beach, CA  90815
October 16 – 17 Seminar Concord
Crown Plaza
45 John Glen Drive
Concord, CA  94520
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5. January 2018 Medi-Cal Provider Training Webinars

Beginning January 2, 2018, and continuing throughout the month of January, Medi-Cal providers may participate in provider training webinars:

Providers will be able to print class materials and ask questions during the training sessions. Recorded webinars will be archived and available for on-demand viewing from the MLP.

To view the webinars, providers must have internet access and a user profile in the MLP. Detailed instructions about the registration process and how to access webinar classes are available on the Outreach & Education web page of the Medi-Cal website.

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6. Provider Orientation

Medi-Cal providers applying to become a Family Planning, Access, Care and Treatment (Family PACT) provider are required to attend a Provider Orientation per Welfare and Institutions Code (W&I Code), Section (§) 24005(k). The Family PACT Provider Orientation provides an overview of the Family PACT Program, provider enrollment process, program standards and benefits and client eligibility and enrollment.

Solo or group providers or primary care clinics are eligible to apply for enrollment in the Family PACT Program if they currently have a National Provider Identifier (NPI) and are enrolled in Medi-Cal in good standing.

The medical director, physician, nurse practitioner or certified nurse midwife responsible for overseeing the family planning services to be rendered at the site to be enrolled is eligible to certify the site. Site certifiers shall sign a statement affirming responsibility.

The Family PACT Provider Orientation is delivered in two parts. Part one consists of an online orientation that must be completed prior to attending a part two in-person orientation. Medi-Cal providers who wish to enroll in the Family PACT Program will be required to complete both the online orientation and attend the in-person orientation. The Family PACT Provider Orientation is open to all site staff.

Complete the orientation process by following three simple steps:

  1. Visit: http://www.ofpregistration.org/ to register and create a profile in the Office of Family Planning Learning Management System (LMS). Once your profile has been set up, you are ready to proceed with the orientation.

  2. Complete part one of the orientation. Part one must be completed in order to register for the (part two) in-person orientation. Print the Certification of Completion when you have completed the online orientation.

  3. Complete part two by attending the in-person orientation. Register through the LMS and select an in-person orientation session. Site certifiers must attend the in-person orientation and are required to present photo identification during registration.

Upcoming In-Person Orientation

Oakland
February 15, 2018
10:00 a.m. – 2:00 p.m.
California Endowment
2000 Franklin Street
Oakland, CA  94612
Sacramento
March 13, 2018
9:00 a.m. – 1:00 p.m.
Sierra Health
1321 Garden Highway
Sacramento, CA  95833

Please contact the Office of Family Planning by phone (916) 650-0414 or email us at ProviderServices@dhcs.ca.gov if you have any questions regarding the orientation process.

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7. Billing Assistance

Providers may call the Telephone Service Center (TSC) at 1-800-541-5555, 8 a.m. to 5 p.m., Monday through Friday, except holidays.

What items are needed when calling in for billing assistance?
Providers should call the TSC with a brief description of the billing issue or training request. Details should include the Claim Control Number (CCN), ID, name and Date of Service (DOS) for the issue about which the provider is inquiring.

Where can you find more help?
The Provider Relations Organization (PRO) is the primary liaison between the provider community and the Medi-Cal program. PRO provides billing and training assistance to providers.

Correspondence Specialist Unit (CSU)
Providers may write directly to the CSU for clarification about recurring or complex billing issues that have not been resolved through either the Claims Inquiry Form (CIF) or appeal process.

Regional Representatives
Provider inquiries that cannot be handled by the TSC or CSU are referred to a regional representative. Regional representatives provide education services that are outlined on the Outreach & Education page of the Medi-Cal website and are geared toward assisting providers on how to efficiently submit their Medi-Cal claims for payment. Regional representatives are located throughout the state and are available to visit providers in their office or facility for one-on-one billing assistance and tailored workshops free of charge. To request a referral for a regional representative in your area, call the TSC at 1-800-541-5555.

For more information regarding the PRO, providers may refer to the Provider Relations Directory section of the Part 1 manual.

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8. 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!

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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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