Transaction Enrollment Requirements
Enrollment Requirements for Medi-Cal Internet Transactions |
|
|
Eligibility, Share of Cost, Medi-Services, Medicare Drug Pricing, Automated Provider Services, Batch Eligibility |
Must have a Medi-Cal Provider number and PIN and have a
Medi-Cal POS Network/Internet Agreement form
on file.
For information on Provider Enrollment
Click Here.
Please call the Telephone Service Center (TSC) at 1-800-541-5555 for more information. |
| Family PACT |
Must have a Medi-Cal Provider number and PIN and have a
Medi-Cal POS Network/Internet Agreement form
form on file. The provider must be enrolled in the Family PACT program.
Please call the TSC at 1-800-541-5555 for enrollment forms. |
| BCCTP Enrollment |
Must have a Medi-Cal Provider number and PIN and have a
Medi-Cal POS Network/Internet Agreement form
form on file.
The provider must be enrolled in the BCCTP program. |
| Pharmacy (RTIP) | Must have a Medi-Cal POS Network/Internet Agreement form form on file for each pharmacy provider. Must have Medi-Cal Telecommunications Provider and Biller Application/Agreement. on file with a check mark in the “Internet” box under “Real Time Submission Type” and a check mark in the “Pharmacy” box under “NCPDP Version” with a version of “5.1”. |
| CMC Upload & Inquiry |
Must have
Medi-Cal Telecommunications Provider and Biller Application/Agreement.
on file with a check mark in the “Internet” box under “CMC Batch
Submission Type” and a check mark in the appropriate box(es) in the
"Claim Type" area.
Call the TSC at 1-800-541-5555 for information about enrollment. |
| Drug Rebate |
To access Labeler Information (i.e. for Drug Rebate), you must download
this
Subscription Form and send it to the address listed on the form.
Please call the Drug Rebate group at 916-636-1955 for any additional information. |
| ARDS Downloads |
Must have either a Medi-Cal Electronic Remittance Advice Detail (RAD)
Enrollment form or a Medi-Cal Electronic Remittance Advice Detail (RAD)
Service Agreement form on file.
Call 1-916-636-1060 for information about enrollment. |
| Managed Care/Insurance Carrier Uploads & Downloads | Must complete the Medi-Cal Web Site Managed Care Plan/Insurance Carrier Agreement Form |
| Disproportionate Share Hospital (DSH) Eligibility Re-Verification |
Must have a Medi-Cal Web Site Agreement Form for Disproportionate Share
Hospital Eligibility Re-Verification on file.
Call the Medi-Cal Eligibility Branch (MEB) at 1-916-552-9507 for information. |
Note:
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