Eligibility
who establishes member eligibility?
what is county social services office
How can providers verify eligibility? name all of them
what is by calling the AEVS hotline
Online using the medi-cal provider portal
online using the medi-cal dental provider web application
online using the AEVS provider portal
where can you find a list of aid code definitions?
what is provider handbook& manual on the Medi-cal website
SOC stands for ?
share of cost
a _______ must have been eligible on the date of service in order for a claim to be payable.
who is a member
can you sign up for medi-cal dental without having medi-cal?
what is No, you will need to be eligible/ have medi-cal in order to get medi-cal dental
All providers must go through the revalidation process every __ years.
5
can a member have multiple aid code and be eligible with multiple program benefits ?
what is yes, they can have multiple aid codes and multiple program benefits
what does CRA stand for ?
what is Caries Risk Assessment
a share of cost is a(n) ______ amount stablished by the county office.
are you as a CSR able to make changes to the members account, like change of address?
what is no, we do not make any changes that would change eligibility
where can providers find detailed instructions on how to complete medi-cal dental forms, including Claim/TAR's, NOA's, and RTD's ?
where is provider handbook on medi-cal dental provider website
what is the CDT code for an adult prophylaxis, (cleaning)?
what is D2140
MCP stands for ?
what is Managed care plan
a member may initiate a state fair hearing when they are dissatisfied with __________, ___________, and ___________.
Postpartum benefits last for how long after the end of the month a pregnancy end in ?
when is 12 months
how can providers check a member's remaining share of cost amount?
what is calling AEVS hotline and/or online using the medi-cal website
Pregnant members, regardless of age, aid code & scope of benefits, are eligible to receive ALL dental procedures listed in the MOC (manual of Criteria), if criteria is met?
what is yes, as long as criteria is met
what does OHC stand for ?
what is other health care
you can file a quality of care complaint by, ______, _______, and _________.
what is by email, in writing, and by phone
which services does medi-cal cover at no charge to the member ?
what is ASL interpreters, translation services, and a ride to a dental appointment/pharmacy
After reimbursing a member, providers may send a claim to medi-cal dental?
what is Yes.
what aid code E7 stand for and what benefits does it have ?
what is Full benefits, no share of cost. It provides health care services through medical managed care plans, (medical, dental, and vision) to infants and children's age 0-2 years old. also known as MCAP
what does CIF stand for ?
what is claim inquiry form
the member has ____ year or within ____ days as the deadline to file for a Conlan Retroactive Reimbursement on a claim
what is within 1 year of receipt of services and/or within 90 days after the issuance of medi-cal card. Which ever is longer