Ha! I finally found it!
For a long time I have been telling people if you are not a Medi-Cal provider, that you can see a Medi-Cal patient as a private pay patient. I have had a lot of people argue with me, but they can never point me to a definitive source from Medi-Cal that states that it cannot be done (unlike in Florida, where you cannot see the patient for cash if they have Medicaid).
Well, I finally found it, straight from the horse's mouth! It happens to be on a FAQ page for out of state providers, but it is not restricted to out of state providers. Here is the FAQ page: files.medi-cal.ca.gov/pub...os_faq.htm
FAQ #3:
3. Does a provider have to enroll in Medi-Cal to bill Medi-Cal?
Yes. To bill Medi-Cal, a provider must complete the appropriate enrollment forms. For questions on which forms to use, contact the Out-of-State Provider Unit at (916) 636-1960. If a provider chooses not to enroll, they may bill the patient. However, an enrolled Medi-Cal provider cannot bill a Medi-Cal-eligible patient for a covered service.
By the way, that page has a lot of links embedded in it, so it is a good resource for all providers regardless of their location. For instance, there is a shortcut to aid codes, so you don't have to flip thru your manual to decipher them.
Sharon
For a long time I have been telling people if you are not a Medi-Cal provider, that you can see a Medi-Cal patient as a private pay patient. I have had a lot of people argue with me, but they can never point me to a definitive source from Medi-Cal that states that it cannot be done (unlike in Florida, where you cannot see the patient for cash if they have Medicaid).
Well, I finally found it, straight from the horse's mouth! It happens to be on a FAQ page for out of state providers, but it is not restricted to out of state providers. Here is the FAQ page: files.medi-cal.ca.gov/pub...os_faq.htm
FAQ #3:
3. Does a provider have to enroll in Medi-Cal to bill Medi-Cal?
Yes. To bill Medi-Cal, a provider must complete the appropriate enrollment forms. For questions on which forms to use, contact the Out-of-State Provider Unit at (916) 636-1960. If a provider chooses not to enroll, they may bill the patient. However, an enrolled Medi-Cal provider cannot bill a Medi-Cal-eligible patient for a covered service.
By the way, that page has a lot of links embedded in it, so it is a good resource for all providers regardless of their location. For instance, there is a shortcut to aid codes, so you don't have to flip thru your manual to decipher them.
Sharon
