Home Encounter Data Improvement Resources Health Plan Quick Reference Guide (Medi-Cal)

Health Plan Quick Reference Guide (Medi-Cal)

February 2023

Developed by CMA Physician Services, the Health Plan Quick Reference Guide outlines available encounter data submission resources, requirements, and contacts from the major Medi-Cal health plans.

Author

California Medical Association Physician Services (CMA PSO)

Why use it

Save time and effort searching for encounter data submission resources. The reference guide is editable so provider practices and community health centers can update and expand it as needed.

Who it’s for

These printable resources are intended for business office, billing, and administrative staff at physician practices and community health centers in California serving patients with Medi-Cal coverage. Users can add Commercial and Medicare plan information using the template provided.

If you are a health plan representative and have edits or additions for this guide, please fill out IHA’s Contact Us form so your update may be incorporated.

Key take-aways

The Health Plan Quick Reference Guide lists encounter data submission information, including format and timeliness requirements as well as available resources, for the following Medi-Cal managed care plans:

  • Health Net
  • Blue Shield of California Promise Health Plan
  • CalViva Health
  • Inland Empire Health Plan
  • Molina Healthcare
  • L.A. Care Health Plan

Have edits or additions for this resource? Please let us know.

IHA’s Resource Hub is made possible through a grant from Health Net, LLC’s Encounter Data Improvement Program.

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