Claiming

​​Medi-Cal Claiming Status

Timely claiming is processing claims after the 20th of the following month of service.

SUPT- Completed on March 2026 services for services ready to be claimed.

MH- Completed March 2026 services for services ready to be claimed.

See ​​Previous Claiming Pause Archive

​​Updated Guidance

Updated guidance for Delay Reason Code usage for denials due to an issue with the implementation of CalAIM.

  • ​Claims Correction Spreadsheets (CCS) must be submitted to BHS-EHRBilling@saccounty.gov no later than 600 days from the date of service to ensure timely processing.
  • Please ensure all corrections have been completed and that your request is fully reviewed for accuracy prior to submitting your CCS.
  • The timeline has been reduced from 700 days to 600 days to allow for additional processing time requested by DHCS. This additional time is also necessary for our Billing Team to complete review and ensure timely processing.
Current Avatar Claim S​tatus​​ ​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​(Updated 10/31/2023)​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​

Questions

If you have questions specific to claiming or fiscal matters, including the addition​ of new OHC guarantors send them to:​​​ BHS-EHRBilling@saccounty.gov

View the Aid Code Master Chart (SDMC)​

 

Resources

Cal AIM References and Manuals Effective July 1​​ 

  • ​​Billing manuals
  • Denial codes (Claims Adjustment Reason Codes [CARC] and Remittance Advice Remark Codes [RARC])
  • Medi-Cal Aid​ Codes​​​

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Medi-Cal

Enhanced Care Management (ECM)

Mental Health (MH)

SUD