September 21, 2005

Beginning October 24, 2005, Medi-Cal will receive crossover claims directly from approved providers/submitters who bill electronically using the ASC X12N 837 v.4010A1 Professional and Institutional transactions. Hard copy claim submission to Medi-Cal will remain an option but will no longer be required for most inpatient, outpatient, skilled nursing facility, medical and vision claim types.

As a result of this upcoming system enhancement, the 837 Companion Guides have been updated. For information about building the 837 transaction, view the 837 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.