Contact Us

Medi-Cal Provider telephone and correspondence support options. Use the drop-downs below to learn more about what is available and how Medi-Cal can help.

Telephone

The Telephone Service Center (TSC) 1-800-541-5555

Providers may call the Telephone Service Center (TSC) from 8 a.m. to 5 p.m., Monday through Friday, except holidays. Border providers and out-of-state billers billing for in-state providers, call 1-916-636-1200.

The TSC is staffed by knowledgeable Medi-Cal telephone service agents who can assist providers with the following:

  • Medi-Cal billing policies and procedures

  • Provider manual information

  • Correct completion of claims, Claims Inquiry Forms (CIFs) and Appeal forms

  • Ordering forms and provider manuals

  • Assist providers interested in automating their Medi-Cal billing processes

  • Billing support for specialty programs Family Planning, Access, Care and Treatment (Family PACT), Every Woman Counts (EWC), Breast and Cervical Cancer Treatment Program (BCCTP), California Children's Services/Genetically Handicapped Persons Program (CCS/GHPP), CHDP/EPSDT and obstetrical services

  • Arrange an on-site Regional Representative visit to answer your questions and offer technical assistance

  • Technical support using the:

    • Point of Service (POS) network, including the telephone Automated Eligibility Verification System (AEVS)

    • Medi-Cal Provider website

    • Lab Service Reservation System (LSRS)

    • eTAR and

    • Computer Media Claims (CMC)

  • Pharmacy provider assistance with:

    • Online pharmacy claims submission adjudication and denial messages

    • Treatment Authorization Requests (TARs) and

    • Drug Utilization Review (DUR) alerts

For faster access to TSC resources, please refer to the following help guides:

Automated Phone Center: 1-800-786-4346

The automated phone center is available 7 a.m. to 8 p.m., seven days a week. The Provider Telecommunications Network (PTN) is an automated voice response service that allows providers to obtain Checkwrite information, claim status or Treatment Authorization Request (TAR) status, continuing care, procedure, National Drug Code (NDC) or medical supply codes, general mailing information or form ordering information.

Each active Medi-Cal provider has been assigned a unique Personal Identification Number (PIN) that may be entered using a touch-tone telephone to access the PTN. Refer to the Provider Telecommunications Network (PTN) section in your provider manual for PTN instructions.

Out-of-State Provider Support: 1-916-636-1960

Out-of-State Provider Support addresses the billing needs of non-California providers. California Code of Regulations (CCR), Title 22, Chapter 3, Article 1.3, Section 51006 allows reimbursement for medically necessary emergency services provided by an Out-of-State provider to California MMIS (Medi-Cal) recipients who are temporarily in another state.

Out-of-State providers must be enrolled in the Medi-Cal program before they can receive reimbursement. To enroll as an Out-of-State provider, you must complete the one-page Out-of-State Provider Express Enrollment form. This is the only form required for basic enrollment.

To learn more about the Out-of-State Provider Support Program or to access links to other Out-of-State provider forms and agreements, review the Out-of-State Providers Frequently Asked Questions (FAQs).

Out-of-State providers can access the other forms and agreements directly by clicking the following links. These are the same forms and agreements referenced in the FAQs.

Contact the Out-of-State Provider Unit at 1-916-636-1960 from 8 a.m. to 5 p.m., Monday through Friday, except holidays.

Small Provider Billing Assistance: 1-916-636-1275

Small Provider Billing Assistance is a free, full-service billing assistance and training program provided to providers submitting fewer than 100 Medi-Cal claim lines per month and not be conducting business with an outside billing service or agency. Claim Specialists and Regional Onsite Field Representatives work directly with providers in a 12 month structured program to assist in completing and submitting Medi-Cal claims.

The Small Provider Billing Assistance program is designed to support Medical Services, Individual Nurse Provider (INP) and Adult Day Health Care providers.

Providers can bill by hard copy claims or submit claims electronically.

For more information, contact the Small Provider Billing Unit at 1-916-636-1275 or 1-800-541-5555, ext. 1275 from 8 a.m. to 5 p.m., Monday through Friday, except holidays.

Correspondence

California MMIS Fiscal Intermediary
Attn: CSU
P.O. Box 13029
Sacramento, CA 95813-4029

The Correspondence Specialist Unit (CSU) resolves complex billing issues. TSC agents may refer providers to the CSU for inquiries that require additional research.

Providers may write directly to the CSU for clarification about recurring billing issues that have not been resolved through either the Claims Inquiry Form (CIF) or appeal process and have resulted in claim denials or potential unsatisfactory payments.

When writing to the CSU for assistance, providers should enclose up to three examples of Claim Control Numbers (CCNs) for the billing issue and include as much of the following documentation as possible with the letter of inquiry:

  • Legible claim form

  • Proof of eligibility, if date of service is beyond one year

  • Necessary documentation, operative report, invoice, etc.

  • Copies of all Remittance Advice Details (RADs)

  • Copies of all CIF acknowledgements, response letters

  • Copies of all Appeals acknowledgements, response letters

  • Copies of all dated correspondence from the California MMIS Fiscal Intermediary
Note:

A lack of necessary records may delay research.

Cash Control assists providers with questions regarding missing, lost or returned warrants, Remittance Advice Details (RADs), accounts receivable transactions, 1099s and provider refund checks. Cash Control also enrolls providers in electronic fund transfers (EFTs) and processes requests for Paid Claim Summary and Claims Detail reports.

Providers may send written requests to Cash Control via mail at the address down below for:

  • Missing, lost or returned warrants that have been more than ten days from the date the warrant was issued.
  • If a provider did not receive a RAD and the RAD date is older than three years, or the provider is unable to obtain a PDF copy of a RAD via Transaction Services.

All written requests to the FCCU must include the National Provider Identifier (NPI), Warrant Number and Warrant date.

Letters to the Cash Control Unit should be addressed as follows:

California MMIS Fiscal Intermediary
Attn: Cash Control
P.O. Box 13029
Sacramento, CA 95813-4029

Medi-Cal Beneficiaries

The Medi-Cal Contacts page of the Department of Health Care Services (DHCS) website offers important contact information and Medi-Cal resources and health information for individuals, families, children with special medical conditions and seniors needing personal care.

This location does not accept claim forms or other hard copy information from beneficiaries.

Shipping and receiving hours of operation are 8 a.m. to 5 p.m., Monday through Friday except holidays. All hand-delivered Medi-Cal claims and correspondence are to be delivered and addressed to California MMIS Fiscal Intermediary at the following location:

California MMIS Fiscal Intermediary
820 Stillwater Road
West Sacramento, CA 95605-1630

Place claims and correspondence in the mail bin located inside the doorway of the warehouse double doors, located at the ground level by the loading area. There is a sign-off sheet next to the bin for couriers to fill-in their name, company, number of envelopes being delivered as well as the date and time.

The security desk in the lobby of the 820 building does not accept hand delivered claims and correspondence.

Map of Walk-Up Claims Delivery Address: 820 Stillwater Road West Sacramento, CA 95605-1630

Medi-Cal Provider Website and Systems Maintenance Window

The normal maintenance window for the Medi-Cal Provider website and systems is midnight to 2 a.m. This timeframe is used to apply system changes and updates. Transaction Services on the Medi-Cal Provider website may not be available for providers to perform transactions during this time. For further information related to the maintenance window, contact the TSC at 1-800-541-5555.

Extended mainframe maintenance occurs on the second Sunday of every month from 2 a.m. to 6 a.m., at the latest. The System Status page will be updated when the maintenance is completed. During the extended window, the Medi-Cal Point of Service (POS), Automated Eligibility Verification System (AEVS), Provider Telecommunications Network (PTN) and certain Transactions Services on the Medi-Cal Provider website may not be available.