Billing Tips: Managed Care Plans
Remittance Advice Details (RAD) Claim Denials
RAD code 0037: Health Care Plan enrollee, capitated service not billable to Medi-Cal.
- Verify Recipient’s 14-character ID number with a valid BIC prior to rendering service, except in an emergency.
- Verify the recipient's ID number on the RAD.
- Determine the Health Care Plan (HCP) to be billed and bill the appropriate HCP.
If you cannot view the MS Word or PDF (Portable Document Format) documents correctly, please visit the Web Tool Box
to link to a download site for the appropriate reader.