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Other Health Coverage (OHC) Guidelines for Billing (other guide)

(2 days ago) People also askDoes a recipient have other health coverage (OHC)?A recipient eligible for Medi-Cal may also have Other Health Coverage (OHC). In most circumstances, OHC must be billed prior to billing Medi-Cal. For information about billing Medi-Cal after billing the OHC, refer to the Other Health Coverage (OHC) section in the Part 2 manual. available under the recipient’s private health coverage.Other Health Coverage (OHC) Guidelines for Billing (other guide)mcweb.apps.prd.cammis.medi-cal.ca.govWhat is other health coverage (OHC)?Other Health Coverage Other Health Coverage (OHC) refers to private health insurance. Services may include medical, dental, vision, pharmacy, and/or Medicare supplemental plans (Part C & D). The OHC Processing Center provides a method for members or authorized representatives to modify OHC for Medi-Cal beneficiaries.Other Coverage - DHCSdhcs.ca.govWhat if my OHC coverage is other than DHCS?• In the Medi-Cal Rx Beneficiary Eligibility Lookup tool results, if the beneficiary’s OHC coverage on file with DHCS is other than prescription/medical supply coverage, the “Other Health Coverage” field will be blank.Medi-Cal Rx Pharmacy Claim Processing for Other Health - Californiamedi-calrx.dhcs.ca.govWhat if a patient has an OHC code?Important! Patients with a COV of “O”, “I”, or “M” in combination with an OHC Code of “A”, “C”, “F”, “H”, “K”, “P”, or “W” must have SUD services billed to the OHC prior to billing When an OHC Code appears in AEVS, this is an indication that the patient has other health insurance.Other Health Coverage Provider Billing Manual - LA County Departmen…publichealth.lacounty.govFeedbackca.govhttps://mcweb.apps.prd.cammis.medi-cal.ca.gov/file/manual?fn=otherguide.pdf[PDF]Other Health Coverage (OHC) Guidelines for Billing (other guide)File Size: 205KBPage Count: 10Medi-Cal after billing the OHC, refer to the Other Health Coverage (OHC) sectionin the Part 2 manual. Cost-Avoided OHC and HMO Coverage Codes . If a recipient’s OHC code is one of the following and the service … Medi-Cal after billing the OHC, refer to the Other Health Coverage (OHC) sectionin the Part 2 manual. Cost-Avoided OHC and HMO Coverage Codes . If a recipient’s OHC code is one of the following and the service rendered falls within the recipient’s Scope of Coverage (COV) under the OHC, the provider must advise the recipientBilling OHC Before Medi-CalIn most situations, providers are required by law to exhaust the recipient’s OHC before billing Medi-Cal. In those situations where OHC utilization is not required before billing Medi-Cal, providers are still encouraged to bill OHC first. See more

https://mcweb.apps.prd.cammis.medi-cal.ca.gov/file/manual?fn=otherguide.pdf#:~:text=%E2%80%B9%E2%80%B9OHC%20code%20%E2%80%9CH%E2%80%9D%20identifies%20Medi-Cal%20recipients%20who%20have,with%20a%20provider%20in%20their%20health%20plan%20network.%E2%80%BA%E2%80%BA

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Other Health Coverage - DHCS

(8 days ago) WebOther Coverage. Other Health Coverage . Other Health Coverage (OHC) refers to private health insurance. Services may include medical, dental, vision, pharmacy, and/or …

https://www.dhcs.ca.gov/services/Pages/TPLRD_OCU_cont.aspx

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Other Health Coverage (OHC) (oth hlth)

(2 days ago) WebOther Health Coverage (OHC) Page updated: February 2023. This section describes the required steps for billing Medi-Cal when a recipient also has Other Health Coverage …

https://mcweb.apps.prd.cammis.medi-cal.ca.gov/file/manual?fn=othhlth.pdf

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APPENDIX A OHC Code Descriptions - DHCS

(9 days ago) WebProvider Organization/Prepaid Health Plan/Health Any carrier other than the above (includes multiple coverage) W: Multiple plans non-comprehensive . Scope of Coverage …

https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2021/APL21-002-APP-A.pdf

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Adding or Removing Other Health Coverage for Medi …

(9 days ago) WebMembers and/or providers may also call the fee-for-service Medi-Cal Telephone Service Center, 8 a.m. to 5 p.m., Monday through Friday, except holidays, at the toll-free number …

https://medi-calrx.dhcs.ca.gov/cms/medicalrx/static-assets/documents/provider/bulletins/2022.01_A_Adding_or_Removing_Other_Health_Coverage_for_Medi-Cal_Beneficiaries.pdf

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Other Health Coverage (OHC)

(4 days ago) WebOther Health Coverage (OHC) MC recipients are required to report and utilize any other health insurance that is available. Federal law prohibits MC from paying for services …

https://stgenssa.sccgov.org/debs/program_handbooks/medi-cal/assets/13MCPHCOOHC/Other_Health_Coverage.htm

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Other Health Coverage Reference Guide - DHCS

(9 days ago) WebOther Health Coverage Reference Guide 3. Carrier Code – Input the carrier code needing to be removed. The carrier code is a 4 character alpha-numeric number starting with a …

https://www.dhcs.ca.gov/provgovpart/Documents/OHC-Reference-Guide.pdf

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Other Health Coverage (OHC) FAQ - LA County …

(2 days ago) WebPer DHCS’s Provider Training guide, the codes that appear on the eligibility transaction results, such as “OIMV -R” are in reference to the OHC’s scope of coverage (COV) …

http://publichealth.lacounty.gov/sapc/NetworkProviders/FinanceForms/ohc/OHC%20FAQ%20Published%20March%202022.pdf

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Other Health Coverage (OHC): CPT® and HCPCS Codes

(5 days ago) WebRecipients with OHC Coverage. Codes. Description (alphabetical order) When to Bill Medi-Cal Directly. Z5400 thru Z5470, Z5499. CCS (California Children’s Services) HCPCS …

https://mcweb.apps.prd.cammis.medi-cal.ca.gov/file/manual?fn=othhlthcpt.pdf

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MEDI-CAL WITH OTHER HEALTH COVERAGE (OHC)

(Just Now) WebThese are the instructions for Medi-Cal with Other Health Coverage (OHC): Contact the OHC and verify if the client has insurance or Other Health Coverage (OHC) and if …

https://file.lacounty.gov/SDSInter/dmh/1035411_MedicalwithOHCInstr.pdf

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Medi-Cal Rx Pharmacy Claim Processing for Other Health

(3 days ago) Webthe other insurer has been billed and they have either partially paid or denied the claim, a pharmacy claim can then be submitted to Medi-Cal Rx containing the OHC details and …

https://medi-calrx.dhcs.ca.gov/cms/medicalrx/static-assets/documents/provider/bulletins/2022.02_A_Medi-Cal_Rx_Pharmacy_Claim_Processing_for_Other_Health_Care_Benefits_Coordination.pdf

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Other Health Coverage Provider Billing Manual - LA County …

(Just Now) WebTo determine whether the OHC carrier covers SUD services, AEVS or other eligibility determination methods will return a message stating the beneficiary’s OHC code and …

http://publichealth.lacounty.gov/sapc/NetworkProviders/FinanceForms/ohc/SAPCOtherHealthCoverageProviderBillingManual.pdf

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Federal Medicaid and California Medi-Cal laws and …

(7 days ago) WebThe basic federal law on billing Other Health Coverage (OHC) is the Social Security Act, Title 19, Section 1902(a)(25). The basic regulations on billing OHC are in Title 42 of the …

https://www.marinbhrs.org/sites/default/files/2021-09/DMC%20Q%26A%20Other%20Health%20Coverage.pdf

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Other Health Coverage Reference Guide - DHCS

(9 days ago) WebOther Health Coverage Reference Guide . P. age 3 of 7 provide the policy top date for the OHC being requested to be removed. If carrier name is not ist, provide name in comment …

https://www.dhcs.ca.gov/services/Documents/OHCReferenceGuide_0619.pdf

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LOS ANGELES C M HEALTH M D RMD Bulletin - LA County

(6 days ago) WebHCP: COMMUNITY HLTH PLAN CALL: (800) 475-5550. PCP: RODERICK N SEAMSTER CALL: (323)564-4331. OTHER HEALTH INSURANCE COV UNDER CODE P …

https://file.lacounty.gov/SDSInter/dmh/1049233_NGARMDBulletin10-035-OtherHealthCoverageCodes.pdf

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Medi‐Cal Automated Eligibility Verification - MHN

(Just Now) WebSUBSCRIBERLAST NAME: DOE. EVC #: 1111X111XX. CNTY CODE: 36. PRMY AID CODE: 30. MEDI ‐ CAL ELIGIBLE W/ NO SOC/SPEND DOWN. OTHER HEALTH …

https://www.mhn.com/content/dam/centene/mhn/pdf/WCBHN%20AEVS%20training_12072021_Final.pdf

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AEVS: Carrier Codes for Other Health Coverage (aev ohc car)

(4 days ago) WebPart 1 – AEVS: Carrier Codes for Other Health Coverage AEVS: Carrier Codes for Other Health Coverage Page updated: May 2024 A218 Coventry Healthcare Plan A219 …

https://mcweb.apps.prd.cammis.medi-cal.ca.gov/file/manual?fn=aevohccar.pdf

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VERIFYING MEDI-CAL ELIGIBILITY

(4 days ago) WebOther Health Insurance (OHC) • Eligibility response message: OTHER HEALTH INSURANCE COV UNDER CODE A. CARRIER NAME: BLUE SHEILD OF …

https://bhcsproviders.acgov.org/providers/network/docs/2022/Provider%20Eligibility%20Training%202022.pdf

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Other health coverage for 2021 HealthCare.gov

(Just Now) WebLearn how your healthcare insurance will impact your 2021 federal tax filing. What you need to know for maximum return, premium tax credit, and more. Get 2021 federal tax …

https://www.healthcare.gov/taxes-2021/other-health-coverage/

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Medi-Cal Managed Care Plans - LA County

(3 days ago) WebPCP: DR. C CALL: (123) 123-1234. OTHER HEALTH INSURANCE COV UNDER CODE V. CARRIER NAME: CALIFORNIA CARE BLUE CROSS HMO. ID: XXXAXXXXX. …

https://file.lacounty.gov/SDSInter/dmh/202968_NGA_RMD_Bulletin_13-006_-_Medi-Cal_Managed_Care_Plans.pdf

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OHC Resources - DHCS

(6 days ago) WebOther Hea lth Coverage Resources. OHC Forms Reference Guide . All County Welfare Director's Letter (ACWDL 13-12) OHC Provider Manual 01. OHC …

https://www.dhcs.ca.gov/services/Pages/OHCResources.aspx

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Reporting Other Health Insurance CMS

(3 days ago) WebReporting Other Health Insurance. If you have Medicare and other health insurance or coverage, each type of coverage is called a "payer." When there is more …

https://www.cms.gov/medicare/coordination-benefits-recovery/beneficiary-services/reporting-other-health-insurance

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How Medicare Works with Other Insurance

(7 days ago) WebInsurers must report health coverage changes to Medicare, but it can take some time before they appear in Medicare’s records If that happens, call the Benefits Coordination …

https://www.medicare.gov/publications/02179-how-medicare-works-with-other-insurance.pdf

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