Must have a Medi-Cal provider number and PIN and have a Medi-Cal POS Network/Internet Agreement form on file.
The provider must be enrolled in the HPE Program.
The provider must have a Hospital Presumptive Eligibility (HPE) Program Provider Election Form and Agreement on file. For questions regarding the form and enrollment, please see the Hospital Presumptive Eligibility (HPE): Provider Enrollment Instructions and the Presumptive Eligibility (HPE) Provider Enrollment Checklist
Please call the TSC at 1-800-541-5555 for enrollment forms.
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