Note: Some links on this page may require Adobe Reader
• Corrections: Cover incorrect data using correction tape and re-enter the correct information. Do not strike over errors or use correction fluid.
• Avoid using dot matrix and light ink printers. The Alliance scans claims using Optical Character Recognition (OCR) software, which may not be able to interpret data from such printers.
• An original signature is required on all hardcopy claims. The signature must be written, not printed.
• Do not staple your hardcopy claims as it delays processing time.
• Pharmacy providers: When billing for metric quantity, use decimals.
• Before submitting your hardcopy claims, remove side perforations. Using side perforations delays claim processing time.
• Use appropriate fonts: 10 point font or larger (not to exceed the size of the field).
• Review monthly Medi-Cal bulletins for ongoing updates by going to www.medi-cal.ca.gov.
• Please reference the following tutorial for requirements and instructions on filling out the new CMS-1500 claim forms: CMS-1500 Claim Form
• Please reference the following tutorial for requirements and instructions on filling out the new UB-04 claim forms: UB-04 Claim Form
600-1001 – Claims Processing
600-1006 – Breast Pumps and Coordination of Benefits
600-1007 – DME Rent-To-Purchase Pricing
600-1008 – Modifier 59, Distinct Procedure Service
600-1009 – Corrected Claim Submissions
600-1010 – Miscellaneous Drugs and Medical Supplies
600-1011 - Surgical Implantable Devices Billed with HCPCS Z7610, Miscellaneous Drugs and Medical Supplies Administered
600-1013 - Billing Epidural, Subarachnoid, and Nerve Block Injections for Postoperative Pain Management
600-1015 - National Correct Coding Initiative
600-1016 - Non-Covered Service Billed with GY Modifier to Medicare
600-1018 - Modifier Placement
600-1019 - Modifier 99 (Multiple Modifiers - Not recognized)
600-1021 - Billing Guidelines for Home Phototherapy Devices
600-1022 - Charpentier Billing Procedure
600-1024 - Durable Medical Equipment Pricing
600-1025 - Durable Medical Equipment Serial Number Requirement
600-1026 - Incontinence and Medical Supply Pricing
600-1029 - Orthotics and Prosthetics Pricing
600-1030 - Reimbursement for Medicare/Medi-Cal Crossover Nephrology and Dialysis Services
600-1031 - Twins Delivery Reimbursement
600-1032 - Wheelchair/Scooter Repair Mileage and Medicare Denials
600-1033 - Wheelchair, Wheelchair Accessories and/or Replacement Parts for Patient-Owned Equipment Pricing
600-1034 - Slings (A4565) Reimbursement
600-1036 - Modifier Reference Grid
600-1037 - Global Surgery