What is a temporary out-of-state provider?
The Out-of-State Provider Unit may enroll certain out-of-state providers and allow payment for up to $599.99, or 10 paid claim lines per calendar year, before they are required to complete the standard enrollment forms. Once this billing limit is reached, the provider is informed through a system-generated letter that enrollment as a permanent provider in the Medi-Cal program is necessary prior to receiving further payment. The letter instructs the provider to bill Medi-Cal again for non-paid claims after the Department of Health Care Services (DHCS) has received and approved a provider’s enrollment. Providers unable to use the temporary enrollment format should complete the permanent provider enrollment forms available on the Medi-Cal Web site’s Provider Enrollment Division (PED) Web page. For questions about which forms to use, contact the Out-of-State Provider Unit at (916) 636-1960.
