In order to accommodate the size and complexity of the transaction and code set projects, Medi-Cal has been implementing the federally mandated Health Insurance Portability and Accountability Act (HIPAA) standards in multiple phases.

On December 1, 2004, Medi-Cal began accepting the new ASC X12N 270/271 v.4010A1 transaction for eligibility inquiry and response transactions via dial-up and leased-line transmissions. As part of the continuing effort to comply with HIPAA, Medi-Cal will discontinue the acceptance of non-HIPAA standard electronic formats for dial-up and leased-line eligibility inquiry and response transactions.

It has come to our attention that some providers/submitters are not yet in a position to submit compliant transactions; therefore, the June 30, 2005 deadline has been extended by three months. September 30, 2005 is the last day that the old, non-HIPAA standard (v.3040) eligibility inquiry and response transactions will be accepted. Medi-Cal will no longer accept non-compliant 270 transactions from ANY provider/submitter on October 1, 2005. If, for whatever reason, you are not able to meet this extended submission deadline, we suggest that you contact a vendor who is capable of compliant 270 submissions and contract with them to handle these submissions on your behalf.

Effective October 1, 2005, those who have not converted to the new ASC X12N 270/271 v.4010A1 format may also use the telephone Automated Eligibility Verification System (AEVS), the Point of Service (POS) device or the Real-Time Internet Eligibility (RTIE) transaction to verify eligibility.

The Companion Guide for the new 270/271 transaction can be viewed by going to the ASC X12N Version 4010A1 Companion Guides and NCPDP Technical Specifications page.

Mandatory testing is required to use the new 270/271 transaction. Information about testing requirements for the dial-up and leased-line transmissions is also available on the Web page indicated above.

Eligibility Resources
Instructions for using AEVS are available in the AEVS User Guide.

Those who do not have access to a Provider Identification Number (PIN), may call the following telephone numbers from 2:30 a.m. – 12 a.m., 7 days a week, for access to the Supplemental AEVS (SAEVS) system:

In-state, non-Medi-Cal providers and intermediaries	1-800-541-5555
Out-of-state, border and local providers	1-916-636-1200

Instructions for using the POS device are available on the Point of Service (POS) Device User Guides page, at the “Eligibility Transaction Procedures” link.

RTIE transactions can be accessed through Transaction Services.