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Part 1 - Medi-Cal Program and Eligibility

Medi-Cal Program (00medi-cal) (Revision Date Aug 31, 2020) | (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 Nov 16, 2020) | (275KB)

AEVS: General Instructions (aev gen) (Revision Date Oct 16, 2020) | (222KB)

AEVS: Transactions (aev trn) (Revision Date Aug 31, 2020) | (223KB)

Form: Automated Eligibility Verification System (AEVS) Response Log (aev trn1 form) (Revision Date Aug 31, 2020) | (74KB)

AEVS: Transactions – SOFP (aev trn sofp) (Revision Date Oct 27, 2020) | (244KB)

Aid Codes Master Chart (aid codes) (Revision Date Nov 16, 2020) | (490KB)

Appeal Process Overview (appeal) (Revision Date Aug 31, 2020) | (98KB)

Checkwrite (check) (Revision Date Sep 16, 2020) | (150KB)

CIF Overview (cif) (Revision Date Sep 16, 2020) | (117KB)

Claim Payment Flowchart (claim pay) (Revision Date Aug 14, 2020) | (121KB)

Claim Submission and Timeliness Overview (claim sub) (Revision Date Aug 31, 2020) | (468KB)

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 Aug 14, 2020) | (120KB)

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 Aug 14, 2020) | (107KB)

Eligibility: Recipient Identification (elig rec) (Revision Date Aug 14, 2020) | (124KB)

Eligibility: Recipient Identification Cards (elig rec crd) (Revision Date Aug 31, 2020) | (468KB)

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 Aug 31, 2020) | (110KB)

MCP: An Overview of Managed Care Plans (mcp an over) (Revision Date Aug 31, 2020) | (117KB)

MCP: Code Directory (mcp code dir) (Revision Date Nov 16, 2020) | (293KB)

MCP: County Organized Health System (COHS) (mcp cohs) (Revision Date Sep 16, 2020) | (221KB)

MCP: Geographic Managed Care (GMC) (mcp gmc) (Revision Date Sep 16, 2020) | (228KB)

MCP: Imperial, San Benito and Regional Models (mcp imperial) (Revision Date Sep 16, 2020) | (227KB)

MCP: Primary Care Case Management (PCCM) (mcp prim) (Revision Date Aug 31, 2020) | (184KB)

MCP: Special Projects (mcp spec) (Revision Date Nov 16, 2020) | (174KB)

MCP: Two-Plan Model (mcp two plan) (Revision Date Sep 16, 2020) | (231KB)

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 Sep 1, 2020) | (81KB)

Programs Overview (prog) (Revision Date Aug 31, 2020) | (203KB)

Provider Guidelines (prov guide) (Revision Date Aug 31, 2020) | (183KB)

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 Aug 31, 2020) | (300KB)

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 Aug 31, 2020) | (101KB)

Form: Main Menu Prompt Options (prov rel frm3) (Revision Date Aug 31, 2020) | (100KB)

Provider Telecommunications Network (PTN) (prov tele) (Revision Date Oct 16, 2020) | (271KB)

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 Aug 31, 2020) | (135KB)

Remittance Advice Details (RAD): Electronic (remit elect) (Revision Date Aug 31, 2020) | (168KB)

Share of Cost (SOC) (share) (Revision Date Aug 31, 2020) | (548KB)

TAR Overview (tar) (Revision Date Aug 31, 2020) | (267KB)

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