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  • Kmc Health Plan Enrollment Eligibility Audit Checklist - Dhcs Ca

Get Kmc Health Plan Enrollment Eligibility Audit Checklist - Dhcs Ca

E of 19-64 (See MICRS, Page 1 for Date of Birth field)? DOB: (a) Yes. Please proceed to Step 2. (b) No. This individual does not qualify for LIHP. Please stop the process. 2. Is a resident of Kern County (See MICRS, Page 1, under Co Resident field)? (a) Yes. Please proceed to Step 3. (b) No. This individual does not qualify for LIHP. Please stop the process. 3. Has been a legal resident of the United States for the past 5 years or more (Please attach a copy of the orig.

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How to use or fill out the KMC Health Plan Enrollment Eligibility Audit Checklist - Dhcs Ca online

This guide provides clear instructions on how to accurately complete the KMC Health Plan Enrollment Eligibility Audit Checklist - Dhcs Ca online. Following these steps ensures a smooth enrollment process, facilitating access to necessary health coverage for eligible individuals.

Follow the steps to effectively complete the enrollment eligibility checklist.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by filling out the patient's last name and first name in the designated fields.
  3. Enter the patient's medical record number in the appropriate space.
  4. Confirm if the patient is between the age of 19-64 by checking the date of birth. If yes, proceed to the next step; if no, note that they do not qualify for LIHP.
  5. Verify the patient's residency in Kern County. If confirmed, move to the next step; if not, they do not qualify for LIHP.
  6. Check if the patient has been a legal resident of the United States for five years or more. If yes, indicate the type of supporting documentation and continue filling the form, otherwise stop here as they do not qualify.
  7. Determine if the patient is enrolled in or eligible for other state health plans. Fill in the eligibility period and insurance code. If applicable, follow specific instructions regarding pending insurance status.
  8. Assess if the patient's income is at or below 100% of the Federal Poverty Level. Enter the family size and total income. If they meet this criterion, proceed; otherwise, they do not qualify for LIHP.
  9. Verify patient identification by checking the relevant documentation. If verified, indicate this on the form to enroll the patient into the LIHP program; if not, they do not qualify.
  10. After filling in all required fields, review all provided information for accuracy. Once confirmed, save changes, download, print, or share the completed form as needed.

Start filling out the KMC Health Plan Enrollment Eligibility Audit Checklist online to ensure access to health coverage.

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While insurance carriers and the government routinely conduct audits as mandated through the Fraud and Abuse program, some factors can actually trigger a health insurance audit. Let's look at some of the factors that could trigger an audit of your medical records and what you can do to prevent that from happening.

DHCS will only report a person's coverage to the IRS and FTB if that person receives coverage from Medi-Cal. Every person in the home enrolled in Medi-Cal will get their own Form 1095-B. If you have family members enrolled in Covered California, they should receive Form 1095-A.

One of the critical aspects of this environment is the scrutiny imposed by Medicare and Medi-Cal audits. These audits are conducted to ensure compliance with billing and coding practices and to prevent fraud and abuse.

Medicare and Medi-Cal audits can be triggered by various factors, such as irregular billing patterns, whistleblower complaints, or random selection. Once selected for an audit, healthcare providers will receive a notification letter outlining the scope of the audit and requesting specific documents.

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

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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
Help Portal
Legal Resources
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