Batch Transactions
The 276 claim status request files are uploaded to the Medi-Cal Web site through a link on the Provider and Claim Submitter menus. (Click the “Transaction Login” link and enter your user ID and password to access these menus.) Submitters are only allowed to inquire on claims for providers for which they have signed and have on file with Medi-Cal the Medi-Cal Telecommunications Provider and Biller Application/Agreement (DHS 6153). Providers are only allowed to inquire on their own claims and must have a signed Medi-Cal Point of Service (POS) Network/Internet Agreement on file with Medi-Cal.

Medi-Cal will send 277 claim status responses regardless of whether the claim was submitted by paper or electronically. Twelve weeks of searchable claim data is available. Providers/submitters may search by Claim Control Number (CCN), Service Level or Claim Level.

Claims received and adjudicated within the same week are in pending status until the following Monday. Paid claims have a delay of an additional week due to a pre-checkwrite review of claims. The earliest paid response is two weekends after receipt of the claim. Responses are available for download for 14 calendar days, then purged.

For information about building the 276/277 batch transaction, view the 276/277 Companion Guides on the ASC X12N Version 4010A1 Companion Guides and NCPDP Technical Specifications page.

Additional Resources
For more information, in-state providers may call the Telephone Service Center (TSC) at 1-800-541-5555, 8 a.m. to 5 p.m., Monday through Friday. Border providers, software vendors and out-of-state billers who bill for in-state providers should call the Border Provider Line at (916) 636-1200, 8 a.m. to 12 p.m. and 1 p.m. to 5 p.m., Monday through Friday.

Providers may continue to obtain claim status information by calling the TSC or the Provider Telecommunications Network (PTN) at 1-800-786-4346 (in-state providers) or (916) 636-1950 (out-of-state, border and local providers).  A paper Claims Inquiry Form (CIF) may also be used to inquire about or trace a claim for which payment has not been received.