The Medi-Cal Telephone Service Center (TSC) toll-free number is 1-800-541-5555. TSC is available 8 a.m. to 5 p.m., Monday through Friday, except holidays. For border providers and out-of-state billers billing for in-state providers, please call (916) 636-1200.
Bulletins - Providers can access bulletin updates about Part 1 Medi-Cal Programs and Eligibility, Psychological Services, ADHC, Clinics and Hospitals, EAPC, General Medicine, Pharmacy, CHDP and Family PACT.
Medi-Cal Subscription Service - The Medi-Cal Subscription Service (MCSS) is a free service that keeps you up-to-date on the latest Medi-Cal news. Subscribers receive subject-specific emails for urgent announcements and other updates shortly after they post to the Medi-Cal website.
Manuals - The manual is divided into two parts, Part 1 (Program & Eligibility) and Part 2 (Billing and Policy). There is also a Specialty Program Manual that works with Medi-Cal Parts 1 and 2 manual.
Part 1– Medi-Cal Program and Eligibility - is a general reference that applies to all Medi-Cal providers. It offers an orientation to Medi-Cal services, programs, claim reimbursement and complete information about recipient eligibility and provider participation. Overview sections in Part 1 generally correlates to the more detailed Part 2 sections of the manual.
Part 2 – Medi-Cal Billing and Policy - is a custom manual for day-to-day use that is divided among various topics, i.e. Allied Health, Inpatient/Outpatient, Long Term Care, Medical Services, Pharmacy, Vision Care, Specialty Programs, and Other Sections. It contains specific program policies, code lists, claim form and follow-up instructions pertaining to your provider community.
Specialty Program Manuals - such as the CHDP Provider Manua l and the Family PACT Policies, Procedures and Billing Instructions manual, work together with Medi-Cal Part 1 and 2 manuals. It refers to specific program policy, eligibility requirements, code lists and claim form completion instructions that is relevant to each specialty program.
Training Seminars and Tools
Medi-Cal Education & Outreach provides a variety of support services to help providers bill Medi-Cal and other programs, assist in claims troubleshooting, and clarify the reimbursement process.
CMS Medicare Administrative Contractor (MAC) – A MAC is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries. CMS relies on a network of MACs to serve as the primary operational contact between the Medicare program and the health care providers enrolled in the program. MACs are multi-state, regional contractors responsible for administering both Medicare Part A and Medicare Part B claims. California currently has two different MACs who process claims and provide training.
National Government Services
A/B MAC Jurisdiction E
CA, HI, NV, American Samoa, Guam, Northern Mariana Islands
|DME MAC Jurisdiction D
AK, AZ, CA, HI, ID, IA, KS, MO, MT, NE, NV, ND, OR, SD, UT, WA, WY, American Samoa, Guam, Northern Mariana Islands
CPCA Staff Contact
Elle Grant, Senior Program Coordinator, Licensing & Provider Enrollment
Revenue Cycle Management Program
In partnership with:
CPCA is proud to offer revenue cycle management (RCM) services to help community health centers improve their bottom line and allow health center administrators to focus on what matters most – patient care. CPCA, has been providing RCM services to community health centers since 2013. To meet the needs of community health centers of all sizes, CPCA has strategically partnered with ALTRUIS to expand our RCM services. CPCA is committed to bringing community health centers unmatched expertise in revenue cycle management.
CPCA RCM Program Services
- The key to a successful partnership is communication. Listening to our health centers and providing them with candid feedback on progress made and opportunities for improvement. Together we are able to improve RCM performance.
- We work with the health centers to understand their unique needs and customize solutions for them. Here are some examples of the types of services that we can provide:
- Full end-to-end RCM Services
- AR Management
- Payment Posting and Reconciliation
- Key Performance Indicator (KPI) Reporting
- On-going AR Management
- Coding & Coding Audits
- RCM Consulting
- RCM Assessments
- Specific project based assistance (i.e. AR Clean-up, COVID Billing, Staff augmentation, etc.)
- Manages the overall RCM contract
- Provides ongoing program management
- Facilitates a smooth and streamlined transition into the program
- Ensures services meet or exceed expectations
- Provides Altruis staff with direct technical assistance regarding California-specific billing requirements
- Communications with specific payers to ensure appropriate payment of claims
- Addresses participants’ questions and concerns
- Facilitates conversations between participants and Altruis when necessary
FREE Billing Assessment
A FREE assessment of current revenue cycle process and identification of opportunities and challenges. This assessment will be done for no cost!
In addition to services outlined above, each Revenue Cycle Management member will receive a personal vendor management liaison to answer questions, expedite support issues, and ensure smooth transition to the RCM program.