Bill for retroactive Medi-Cal coverage

If a client does not have Medi-Cal, bill the services rendered to the client to the County of Santa Clara guarantor. If a client obtains Retroactive Medi-Cal coverage, then void the services billed to the County of Santa Clara guarantor and rebill the services after the Financial Eligibility form has the Medi-Cal guarantor added as primary. How to do this:

1. Send in void services billed to Guarantor: County of Santa Clara (50024). If you billed manually, use the Void Claim Assignment form.  If you billed via 837, mark the services as void and send them to the county on a new 837 file.
2. Add Medi-Cal Guarantor to Financial Eligibility as Guarantor #1. 
   1. MH: MSO DMH Medi-Cal (18500)  
   2. SUTS: MSO Drug Medi-Cal (20000)   
3. Resubmit claims with the P-Auth that corresponds with Medi-Cal. 
4. The Take Back Amount for voided services will appear on the following EOB Report/835 file generated after the voided service(s) was updated. For example, if a service was voided on 6/10, and the following EOB Report/835 file was generated on 6/12, the voided service will appear as a Take Back on that EOB Report/835 file under the Take Back section.

_{Published November 2, 2022}