Effective July 2007, the Department of Health Care Services (DHCS) implemented the Adjudication Response (AR) in order to reduce the volume of documents containing Protected Health Information (PHI).

DHCS has received numerous requests to have ARs sent to different locations, other than the address on record with DHCS Provider Enrollment Division (PED). In response to these requests, DHCS has added the option of faxing the ARs to providers using the 50-1 and 18-1 TAR forms.

Effective immediately, providers now have the option of entering their fax number in the Verbal Control field on the TAR 50-1 form (Box 1B) or the Request for Extension of Hospital Stay form 18-1 (Box 10B). The AR will not be mailed to providers if a fax number is entered in this field.

ARs will continue to be mailed to the provider’s address on file with the DHCS PED if the provider does not enter in a fax number. The DHCS Medi-Cal field offices have been providing a courtesy service of forwarding undelivered ARs to providers after determining the reason for its return. Effective March 1, 2008, this service is discontinued.

Providers have three options for checking the status of a TAR and any related notes that might affect its adjudication prior to the mailing of an AR:

• Select the “Transactions” tab on the Medi-Cal Web site to check TAR status online. Using the provider number and the Personal Identification Number (PIN), providers can review the status of electronic and paper TARs any time, except from 12:00 a.m. to 2:00 a.m.
• Call the Telephone Service Center (TSC) at 1-800-541-5555. Providers should follow the prompts to check the status of electronic and paper TARs Monday through Friday from 8:00 a.m. to 5:00 p.m.
• Call the Provider Telecommunications Network (PTN) at 1-800-786-4346 and enter the provider number and PIN. Providers can review the status of paper TARs through the PTN any time, except from 12:00 a.m. to 2:00 a.m.

Providers that are not receiving ARs, or find issues with the status of their TAR because of incorrect information, are encouraged to update their records with PED. Instructions for changing or updating an address in the Provider Reminders area of the PED Web page. Providers can review the "General Reminders" area to find out more about the correct forms and related information required to change or update PED records.

The following manual replacement pages will be updated with this information and published in the March Medi-Cal Update: tar comp 5 (Part 2) and tar req ext 5 (Part 2).