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Part 1 - Medi-Cal Program and Eligibility

Medi-Cal Program (00medi-cal) (Revision Date Apr 16, 2021) |95KB)
How to Use This Manual (0B hw to use) (Revision Date Sep 16, 2020) |371KB)
Getting Started: Where to Find the Answers (0C get start) (Revision Date Jan 15, 2021) |273KB)
AEVS: General Instructions (aev gen) (Revision Date May 14, 2021) |211KB)
AEVS: Transactions (aev trn) (Revision Date May 14, 2021) |201KB)
Form: Automated Eligibility Verification System (AEVS) Response Log (aev trn1 form) (Revision Date Aug 31, 2020) |74KB)
Aid Codes Master Chart (aid codes) (Revision Date Jul 16, 2021) |427KB)
Appeal Process Overview (appeal) (Revision Date Aug 31, 2020) |98KB)
Checkwrite (check) (Revision Date Sep 16, 2021) |163KB)
CIF Overview (cif) (Revision Date Sep 16, 2020) |117KB)
Claim Payment Flowchart (claim pay) (Revision Date Sep 16, 2021) |126KB)
Claim Submission and Timeliness Overview (claim sub) (Revision Date Jan 15, 2021) |280KB)
CMC (cmc) (Revision Date Sep 16, 2020) |115KB)
CMC Enrollment Procedures (cmc enroll) (Revision Date Sep 16, 2020) |160KB)
CMC Enrollment Checklist (cmc enroll check) (Revision Date Sep 16, 2020) |59KB)
County Medical Services Program (CMSP) (county med) (Revision Date Sep 16, 2021) |71KB)
Electronic Fund Transfer (eft) (Revision Date Aug 14, 2020) |110KB)
Form: Electronic Fund Transfer Authorization (eft form) (Revision Date Sep 22, 2020) |91KB)
Electronic Methods for Eligibility Transactions and Claim Submissions (elect) (Revision Date Sep 16, 2021) |108KB)
Eligibility: Recipient Identification (elig rec) (Revision Date Aug 14, 2020) |124KB)
Eligibility: Recipient Identification Cards (elig rec crd) (Revision Date Aug 16, 2021) |331KB)
Eligibility: Service Restrictions (elig rstrict) (Revision Date Aug 14, 2020) |112KB)
Eligibility: Special Groups (elig special) (Revision Date Aug 14, 2020) |117KB)
Health Access Programs (HAP) (health acces) (Revision Date Jan 15, 2021) |121KB)
MCP: An Overview of Managed Care Plans (mcp an over) (Revision Date May 14, 2021) |118KB)
MCP: Code Directory (mcp code dir) (Revision Date Aug 16, 2021) |304KB)
MCP: County Organized Health System (COHS) (mcp cohs) (Revision Date Oct 15, 2021) |206KB)
MCP: Geographic Managed Care (GMC) (mcp gmc) (Revision Date Oct 15, 2021) |216KB)
MCP: Imperial, San Benito and Regional Models (mcp imperial) (Revision Date Oct 15, 2021) |146KB)
MCP: Primary Care Case Management (PCCM) (mcp prim) (Revision Date Oct 15, 2021) |149KB)
MCP: Special Projects (mcp spec) (Revision Date Aug 16, 2021) |143KB)
MCP: Two-Plan Model (mcp two plan) (Revision Date Oct 15, 2021) |218KB)
Medicare/Medi-Cal Crossover Claims Overview (medicare) (Revision Date Aug 31, 2020) |180KB)
OBRA and IRCA (obra) (Revision Date Aug 14, 2020) |139KB)
Other Health Coverage (OHC) Guidelines for Billing (other guide) (Revision Date Sep 16, 2020) |195KB)
Percent Programs (percent) (Revision Date Aug 31, 2020) |141KB)
Form: Medi-Cal Point of Service (POS) Network/Internet Agreement (point frm1 net) (Revision Date Oct 16, 2020) |167KB)
Form: Medi-Cal Eligibility Verification Enrollment Form (point frms) (Revision Date Oct 16, 2020) |120KB)
Medi-Cal Procedure/Drug Code Limitation Introduction (proc intro) (Revision Date Oct 16, 2020) |102KB)
Medi-Cal Procedure/Drug Code Limitation List (proc list) (Revision Date Apr 16, 2021) |81KB)
Programs Overview (prog) (Revision Date Sep 16, 2021) |213KB)
Provider Guidelines (prov guide) (Revision Date Dec 16, 2020) |186KB)
Provider Guidelines: Billing Compliance (prov guide bil) (Revision Date Aug 31, 2020) |136KB)
Form: Provider: Medi-Cal Hardcopy Biller Notification Form (prov guide frm2 prv) (Revision Date Aug 31, 2020) |56KB)
Form: Biller: Medi-Cal Hardcopy Biller Application Agreement (prov guide frm3 bil) (Revision Date Aug 31, 2020) |71KB)
Provider Regulations (prov reg) (Revision Date Apr 16, 2021) |368KB)
Provider Relations Directory (prov rel) (Revision Date Aug 31, 2020) |193KB)
Form: TSC Main Menu Prompt Options (prov rel frm1 ref) (Revision Date Aug 31, 2020) |105KB)
Form: AEVS Main Menu Prompt Options (prov rel frm2) (Revision Date Jan 15, 2021) |98KB)
Form: Main Menu Prompt Options (prov rel frm3) (Revision Date Aug 31, 2020) |100KB)
Provider Telecommunications Network (PTN) (prov tele) (Revision Date Sep 16, 2021) |270KB)
Remittance Advice Details (RAD) and Medi-Cal Financial Summary (remit) (Revision Date Sep 16, 2020) |209KB)
Remittance Advice Details (RAD) and Reconciling Medi-Cal Payment (remit and) (Revision Date May 14, 2021) |134KB)
Remittance Advice Details (RAD): Electronic (remit elect) (Revision Date May 14, 2021) |168KB)
Share of Cost (SOC) (share) (Revision Date Jul 16, 2021) |445KB)
TAR Overview (tar) (Revision Date Sep 16, 2021) |499KB)


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