Identification of Responsible Payor. Contractor shall provide the information that identifies the payor responsible for reimbursement of services provided to a Member enrolled in Contractor’s Medi- Cal Managed Care health plan to DHCS’ Fiscal Intermediary (FI) contractor. Contractor shall identify the subcontractor (if applicable) or Independent Physician Association (IPA) responsible for payment, and the Primary Care Provider name and telephone number responsible for providing care. Contractor shall provide this information in a manner prescribed by DHCS once DHCS and the FI contractor have implemented the enhancement to the California Automated Eligibility Verification and Claims Management System (CA- AEV/CMS).
Identification of Responsible Payor. Contractor shall provide the information that identifies the payor responsible for reimbursement of services provided to a Member enrolled in Contractor’s Medi- Cal Managed Care health plan to DHCS’ Fiscal Intermediary (FI) contractor. Contractor shall identify the Network Provider or Subcontractor responsible for payment, and the Provider name and telephone number responsible for providing care. Contractor shall provide this information in a manner prescribed by DHCS once DHCS and the FI contractor have implemented the enhancement to the California Automated Eligibility Verification and Claims Management System (CA-AEV/CMS).
