Policy: 07-04 Claims Processing Guidelines and Procedures

Attachments:
Attachment A : Procedure for Preparing and Distributing EOP’s
Attachment B: Procedure for Receiving and Processing Claims from Providers
Attachment C : Procedure for Processing Payable MHP Contractor Claims
Attachment D : Procedure for Processing Denied MHP Claims
Attachment E : Procedure for Investigating Pended Claims Before Final EOP Run
Attachment G: Procedure for Adjusting Overpaid and Underpaid Claims
Attachment I: Procedure for Setting Up Providers and Fee Schedules
Attachment J: Procedure for Processing Non-Contractor Claims
Attachment L: Procedure for Reimbursing Provider Claims for Telehealth and Phone Services
Attachment M: Procedure for Identifying, Reporting, and Recovering Mental Health and Drug Medi-Cal Overpayments
Attachment N: Procedure for System Maintenance