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Important Provider Information for Post-Mass Deactivation

February 17, 2015

The Department of Health Care Services (DHCS) conducts periodic deactivations of providers that have not billed Medi-Cal for 12 consecutive months. On February 7, 2015, DHCS conducted a mass deactivation/provider file conversion of provider locations that have not submitted a claim for Medi-Cal fee-for-service reimbursement for one year as authorized by Welfare and Institution Code (W&I Code), Section 14043.62(a). The last time DHCS conducted a mass deactivation was in September 2007.

In the January 2015 Medi-Cal Update bulletin, DHCS notified providers of the upcoming mass deactivation. In addition, DHCS sent written correspondence to notify affected providers of their deactivation or provider file conversion.

Providers Incorrectly Deactivated
DHCS has recognized a small subgroup of providers that were incorrectly deactivated due to a system error. If you participated and billed the Medi-Cal fee-for-service program within the last 12 months and feel you have been deactivated in error, please contact DHCS at DHCSMASSDEACT@dhcs.ca.gov.

Providers Unable to Determine Eligibility
Enrollment in the Medi-Cal fee-for-service program is a requisite for billing the Medi-Cal fee-for-service program and is not intended to be the method of accessing eligibility verification for providers that do not bill Medi-Cal fee-for-service. Providers who do not bill the Medi-Cal fee-for-service program, but require access to eligibility for other Medi-Cal programs, must use their second provider identification number (PIN) or other intermediary identification (OI) code for eligibility verification.

Managed care and substance use disorder treatment providers can obtain beneficiary eligibility verification by contacting Xerox State Healthcare, LLC at 1-800-541-5555 for a temporary PIN via the Automated Eligibility Verification System (AEVS).

Denti-Cal providers can obtain beneficiary eligibility verification by contacting the Denti-Cal Provider Customer Service center at 1-800-423-0507 via AEVS.