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  • California Federally Qualified Health Center Instructions Reconciliation Form 3096

Get California Federally Qualified Health Center Instructions Reconciliation Form 3096

STATE OF CALIFORNIA-HEALTH AND HUMAN SERVICES AGENCY DEPARTMENT OF HEALTH CARE SERVICES INSTRUCTIONS Federally Qualified Health Center/Rural Health Clinic Reconciliation Request Forms Please read.

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The 3-day rule requires the patient have a medically necessary 3-consecutive-day inpatient hospital stay. The 3-consecutive-day count doesn't include the discharge day or pre-admission time spent in the Emergency Room (ER) or outpatient observation.

Cutback Ind: This field identifies medical services which are subject to a 20 percent rate reduction when performed in a hospital outpatient department or, for surgical procedures, in a surgical clinic. The cutback does not apply to an emergency room place of service.

DHCS' Managed Care Quality and Monitoring Division (MCQMD) is responsible for ensuring overall monitoring and oversight of MCPs. MCQMD designates the Medical Review Branch (MRB) of DHCS' Audits and Investigations Division (A&I) to perform the mandated audits.

Your county's social services office may contact you by mail or by phone to request paper verification if income, citizenship, and other criteria cannot be verified electronically. Receive Final Notice of Action notifying you of whether or not you can receive Medi-Cal.

A differential rate code (code 18) was established to provide additional reimbursement to FQHCs and RHCs for the difference between their interim rate or PPS rate per visit and payments made by their managed care plans and Medicare.

OHC Code “A” identifies Medi-Cal recipients who have OHC; however providers are allowed, but not required, to bill the OHC carrier prior to billing Medi-Cal if the response from the Medi-Cal eligibility verification system is the “A” OHC code.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232