Current System Status as of: Monday, November 24, 2014 6:31:03 AM
The Medi-Cal Program has been affected by a temporary problem that has affected some providers using electronic Treatment Authorization Request (eTAR). Systems personnel are aware of the problem and are working on a resolution.
RAD 0002: Erroneously Denied Crossover Claims
The Department of Health Care Services identified a claims processing issue causing some paper and electronic crossover (outpatient and medical) claims to erroneously deny with Remittance Advice Details code 0002: The recipient is not eligible for benefits under the Medi-Cal program or other special programs. The issue affected claims processed from September 22, 2014, through October 3, 2014.
No action is required on your part. Xerox State Healthcare, LLC will resubmit any of the claims identified to have been erroneously denied.
835 Health Care Claim Payment/Advice Files: MIA & MOA segments
835 files for August 6, 13 and 20 were incorrectly created with both MIA & MOA segments. Those files have been regenerated and are available on the Medi-Cal website. Providers are advised to promptly download the corrected files.
Update: RAD Code 008 Denial
Some providers billing for incontinence supplies are being erroneously denied with Remittance Advice Details (RAD) code 008: The provider of service is not eligible for the type of services billed.
Medi-Cal is aware of this issue and it is being addressed. There will be an Erroneous Payment Correction to reprocess all of the claims that were denied in error.
Providers who are affected should continue to bill their claims promptly and check for updates on the Medi-Cal website.
Medi-Cal is experiencing technical difficulties accepting claim attachments. Systems personnel are aware of the problem and are working on a resolution; please continue to check this page for updates.
Note:This message will update whenever there is a change to the Medi-Cal Website availability.