Get Medi-cal Administrative Activities

Filling out the Medi-Cal Administrative Activities form online can appear complex, but with clear guidance, it can be a straightforward process. This guide provides detailed instructions to help you navigate each section and complete the form effectively.

Follow the steps to complete the form accurately.

1. Press the ‘Get Form’ button to access the Medi-Cal Administrative Activities form and open it in your editor.
2. Begin with identifying the claiming unit name and relevant invoice information, ensuring that all required fields are completed accurately.
3. Input the Medi-Cal percentage, which you can calculate using the total number of Medi-Cal beneficiaries divided by the total number of individuals served by the claiming unit.
4. Fill out the Activities and Medi-Cal Percentages worksheet by providing details for each activity code performed during the time period specified.
5. Enter necessary salary and benefit costs on the Direct Charges worksheet, including only non-federally funded costs.
6. Complete the Payroll Data Collection worksheet by detailing all applicable costs associated with personnel for the billing period.
7. On the Costs and Revenues worksheet, ensure that you accurately report all revenue offsets and direct charge costs to prevent duplicate billing.
8. Review the MAA Summary Invoice to ensure all information is consistent with the details provided throughout the previous worksheets.
9. Ensure all required documentation is attached, and verify the invoice's accuracy before submitting to DHCS.
10. Click to save your changes, download, print, or share the form according to your needs.

Start completing your Medi-Cal Administrative Activities form online now for efficient processing.