There is no single statewide Medi-Cal payer ID. The county decides the plan. Medi-Cal is run by the Department of Health Care Services. In most counties the member is in a managed-care plan, and the plan depends on the county. Two-plan, Geographic Managed Care, and County Organized Health System counties do not share one payer ID. A Los Angeles member and a San Francisco member are not billed the same way.
There is no single statewide Medi-Cal payer ID. The county decides the plan.
Medi-Cal is run by the Department of Health Care Services. In most counties the member is in a managed-care plan, and the plan depends on the county. Two-plan, Geographic Managed Care, and County Organized Health System counties do not share one payer ID. A Los Angeles member and a San Francisco member are not billed the same way.
Medicare Part A and Part B for a California practice go to Noridian Healthcare Solutions, Jurisdiction E, with Hawaii and Nevada. Oregon is the next state north and uses Noridian Jurisdiction F. Arizona also uses Jurisdiction F.
California is a tort state for auto, not a no-fault state. A work injury is billed under the Division of Workers' Compensation, often inside a medical provider network. That is not a Medi-Cal claim and not a Noridian claim.
The first California question is the county on the eligibility response. Credentialing follows that plan. Fee-for-service Medi-Cal still exists for some members and some services, and it is a different submission from the county plan. The office logging into the EHR is in Jamaica, NY.
No. The Department of Health Care Services runs Medi-Cal, and the managed-care plan follows the county. Fee-for-service Medi-Cal is a separate submission.
Noridian Healthcare Solutions, Jurisdiction E. Oregon and Arizona use Noridian Jurisdiction F.
The fee is a percentage of net collections. The written rate follows volume, specialty, and how much of the cycle you hand over. There is no setup fee, and the agreement is month to month. The state is not a surcharge. How pricing is set.
