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Medi-Cal ICD-10 End-to-End Testing Registration Due June 5, 2015

May 5, 2015

Medi-Cal will conduct ICD-10 end-to-end testing with Medi-Cal stakeholders in July 2015. Selection of test partners will be limited. Medi-Cal will select volunteers from a representative, broad cross-section of provider types, claim types and submitter types.

Registration will close at 11:59 p.m. (PDT) on June 5, 2015. Late registration will not be accepted. Medi-Cal will notify registered organizations no later than June 22, 2015, regarding participation in the testing program.

Testers/staff must

  • Currently submit claims as an 837I or 837P transaction.
  • Currently receive an 835 Health Care Claim Payment/Advice transaction.
  • Be ready to test ICD-10-CM/PCS, meaning all vendor and practice management software needed for testing is updated and internally tested prior to conducting end-to-end testing with Medi-Cal.
  • Be able to generate test claims with test beneficiaries.
  • Be able to generate test claims containing ICD-10-CM/PCS codes with dates of service/dates of discharge, using a test implementation date prior to October 1, 2015.
  • Be able to generate test claims containing ICD-10-CM/PCS codes based on medical scenario test cases.
  • Be trained on billing ICD-10-CM/PCS.
  • Be able to identify a single point of contact (POC) for the testing effort.
  • Be the claim submitter or have a single POC for their claim submission service.

Testers must satisfy all end-to-end testing requirements to be considered for testing.

Medi-Cal will require that testers submit test claims in the same manner as claims for reimbursement. For example, if a tester normally submits claims via a clearing house, Medi-Cal will expect that claims submitted through the test program be submitted through the same clearing house.

Test results will be announced to providers in a future Medi-Cal Update.

Participation Information
If you would like to participate in the test program, please register by sending an email request by 11:59 p.m. (PDT) on June 5, 2015, to the ICD-10 mailbox ICD-10Medi-Cal@xerox.com and include the following:

  1. Organization name
  2. Point of contact name
  3. Point of contact email address
  4. Point of contact telephone number
  5. The NPI the organization will be using for testing purposes
  6. Submitter ID (if applicable)
  7. Submitter name (if applicable)
  8. Submitter Type – Clearing house, billing service, hospital group, individual provider, etc.
  9. Submission Path – Identify whether you currently submit claims directly to the Department of Health Care Services, through a billing service or a clearing house. If submitted through a service, identify the name of the service.
  10. If you use a third party to submit claims, include the submitter POC name, email and telephone number.
  11. Identify the following claim type and NPI number you plan on submitting for testing:
      a. 837 Professional – Medical
      b. 837 Institutional – Inpatient, Outpatient, LTC
  12. List the types of services you plan on submitting for testing
  13. List the average number of claims submitted per month (in production)
  14. A statement of confirmation satisfying end-to-end testing requirements, expressed in the bulleted list above

Not all providers who register will be selected for testing. If your organization is selected for testing, additional details/instructions will be provided.