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The California Department of Health Care Services (DHCS) is a department within the California Health and Human Services Agency that finances and administers a number of individual health care service delivery programs, including Medi-Cal, which provides health care services to low-income people.
The Medi-Cal Access Program (MCAP), formerly known as the Access for Infants and Mothers Program (AIM), is a California policy that grants access to Medi-Cal to pregnant and uninsured (or whose coverage contains a co-pay over $500) mothers who would otherwise not qualify due to exceeding income guidelines.
The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
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Denied Claims. These claims are properly filed but do not meet the payor’s criteria for payment. Common reasons include billing for services not covered by the plan, highlighting the importance of verifying insurance coverage during patient registration. Denied claims require investigation to identify the issue and prevent future occurrences.
Electronic visit verification (EVV) is a method used to verify home healthcare visits to ensure patients are not neglected and to cut down on fraudulently documented home visits. Beginning January 1, 2020, home care agencies that provide personal care services must have an EVV solution in place or risk having their Medicaid claims denied, under ...
Claims are packaged into one or more tokens that are then issued by an issuer (provider), commonly known as a security token service (STS). [2] The name "claims-based identity" can be confusing at first because it seems like a misnomer, attaching the concept of claims to the concept of identity appears to be combining authentication ...
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