Welcome to the Department of Health Care Services Welcome to Medi-Cal Welcome to the Department of Health Care Services

Part 2 – Long Term Care (LTC)

111,469 Bytes206,336 Bytes

Medi-Cal Program (00medi-cal)

3,922 Bytes22,016 Bytes

Medi-Cal Provider Manual Contents

7,265 Bytes49,152 Bytes

Manual Organization (0Amanorg)

24,928 Bytes90,112 Bytes

How to Use This Manual (0Bhwtouse)

18,979 Bytes98,304 Bytes

Getting Started: Where to Find the Answers D (0Cgetstart)

10,270 Bytes36,352 Bytes

Contents (Part 2 – Medi-Cal Billing and Policy): Long Term Care (LTC) (2toc ltc)

7,609 Bytes26,624 Bytes

Accommodation Codes for Long Term Care (accom cd ltc)

1,430,829 Bytes1,511,936 Bytes

Admissions and Discharges (admis)

110,212 Bytes162,304 Bytes

Appeal Form Completion (appeal form)

106,270 Bytes155,648 Bytes

Child Health and Disability Prevention (CHDP) Program (child)

125,697 Bytes212,992 Bytes

CIF Completion (cif co)

152,417 Bytes214,528 Bytes

CIF Special Billing Instructions for Long Term Care (cif sp ltc)

64,981 Bytes100,864 Bytes

CIF Submission and Timeliness Instructions (cif sub)

3,727 Bytes27,136 Bytes

Distinct-Part Long Term Care Facilities (distinct)

13,404 Bytes43,520 Bytes

Forms: Legibility and Completion Standards (forms leg)

9,769 Bytes32,768 Bytes

Forms Reorder Request: Guidelines (forms reo)

31,829 Bytes67,584 Bytes

Forms Reorder Request: Long Term Care (forms reo ltc)

27,989 Bytes130,048 Bytes

Incontinence Medical Supplies (incont)

75,314 Bytes122,880 Bytes

Leave of Absence and Bed Hold (leave)

14,320 Bytes53,248 Bytes

Licensing and Certification for Long Term Care (licens ltc)

4,166 Bytes30,208 Bytes

Form: SNF/ICF Physician Recertification For Medi-Cal

18,418 Bytes72,192 Bytes

Medicare/Medi-Cal Crossover Claims: Long Term Care (medi cr ltc)

464,873 Bytes592,896 Bytes

Medicare/Medi-Cal Crossover Claims: Long Term Care Billing Examples (medi cr ltc ex)

7,445 Bytes50,688 Bytes

Mental Disease Institutions Directory (mental)

31,860 Bytes134,144 Bytes

Optional Benefits Exclusion (opt ben exc)

18,336 Bytes64,000 Bytes

Other Health Coverage (OHC) (oth hlth)

9,388 Bytes38,912 Bytes

Patient Plans of Care for Long Term Care (patient ltc)

159,353 Bytes260,096 Bytes

Payment Request for Long Term Care (25-1) Completion (pay ltc comp)

19,160 Bytes80,384 Bytes

Payment Request for Long Term Care (25-1): Submission and Timeliness Instructions (pay ltc sub)

10,904 Bytes53,760 Bytes

Payment Request for Long Term Care (25-1): Tips for Billing (pay ltc tips)

448,316 Bytes614,400 Bytes

Preadmission Screening Resident Review (PASRR) (preadmis)

15,978 Bytes60,928 Bytes

Provider Billing after Beneficiary Reimbursement (Conlan v. Shewry) (prov bil)

14,330 Bytes50,688 Bytes

Rates: Facilities (rate facil)

30,414 Bytes210,432 Bytes

Rates: Facility Per Diem (rate facil diem)

10,211 Bytes52,736 Bytes

Rates: Facility Reimbursement - Miscellaneous Inclusive and Exclusive Items (rate facil misc)

10,070 Bytes52,224 Bytes

Remittance Advice Details (RAD) (remit adv)

27,718 Bytes183,808 Bytes

Remittance Advice Details (RAD) Examples: Long Term Care (remit ex ltc)

10,607 Bytes35,328 Bytes

Remittance Advice Details (RAD): Payments and Claim Status (remit pay)

700,066 Bytes809,984 Bytes

Resubmission Turnaround Document (RTD) Completion (resub comp)

5,662 Bytes34,816 Bytes

Rural Hospital Swing Bed Program (rural hosp)

85,414 Bytes146,432 Bytes

Share of Cost (SOC): 25-1 for Long Term Care (share ltc)

11,715 Bytes45,056 Bytes

Sign Language Interpretation (sign)

11,489 Bytes41,984 Bytes

Subacute Care Programs: Adult (subacut adu)

13,562 Bytes64,512 Bytes

Subacute Care Programs: Billing Codes (subacut code)

13,070 Bytes46,592 Bytes

Subacute Care Programs: Level of Care for Adults and Children (subacut lev)

14,250 Bytes59,392 Bytes

Form: Information for Authorization/Reauthorization of Subacute Care Services – Adult Subacute Program (DHS 6200 A)

16,111 Bytes63,488 Bytes

Subacute Care Programs: Pediatric (subacut ped)

205,071 Bytes260,608 Bytes

TAR Completion for Long Term Care (tar comp ltc)

207,574 Bytes258,560 Bytes

TAR Criteria for DP/NF Authorization (Hudman v. Kizer) (tar crit dp)

17,869 Bytes85,504 Bytes

Form: Family Certification

17,330 Bytes84,480 Bytes

Form: Medical Certification

15,949 Bytes102,400 Bytes

Form: Call List for NF Placement

19,946 Bytes89,600 Bytes

TAR Criteria for NF Authorization (Valdivia v. Coye) (tar crit nf)

294,934 Bytes543,232 Bytes

TAR Deferral/Denial Policy (Frank v. Kizer) (tar defer)

28,019 Bytes118,784 Bytes

TAR Field Office Addresses (tar field)

18,952 Bytes75,776 Bytes

TAR for Long Term Care: 20-1 Form (tar ltc)

1,707,779 Bytes1,774,592 Bytes

TAR for Long Term Care: MDS Form (tar ltc mds)

104,646 Bytes153,600 Bytes

TAR Submission: Transmittal Form (tar submis)

10,600 Bytes34,304 Bytes

TAR: Submitting Appeals (tar submit)

6,860 Bytes49,152 Bytes

Utilization Review: ICF/DD, ICF/DD-H and ICF/DD-N Facilities (util review)



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