Share of Cost Clearance Transaction
To clear a subscriber’s SOC, the provider accesses the Medi-Cal eligibility verification system, enters a provider number, Provider Identification Number (PIN), subscriber identification number, BIC issue date, billing code and service charge. The SOC information is updated and a response is displayed on the screen or relayed over the telephone. Several clearance transactions may be required to fully certify SOC. In other words, providers must continue to clear SOC until it is completely certified. (Clearing Share of Cost is also referred to as “spending down” the SOC.) Providers must perform an SOC clearance transaction immediately upon receiving payment, or accepting obligation from the subscriber, for the service rendered.
Related posts:
- Share of Cost Clearance Transaction To clear a subscriber’s SOC, the provider accesses the Medi-Cal eligibility verification system, enters a provider number, Provider Identification Number (PIN), subscriber identification number, BIC issue date, billing code and service charge. The SOC information is updated and a response is displayed on the screen or relayed over the telephone. Several clearance transactions may be […]...
- Reversing Share of Cost Transaction To reverse SOC transactions, providers enter the same information as for a clearance but specify that the entry is a reversal transaction. After the SOC file is updated, providers receive confirmation that the reversal is completed. Once a subscriber has been certified as having met the Share of Cost, reversal transactions can no longer be […]...
- Share of Cost is calculated independently for CMSP and Medi-Cal SOC policy also applies to County Medical Services Program (CMSP) providers and subscribers. Share of Cost is calculated independently for CMSP and Medi-Cal, however, the same subscriber income is included in both calculations. Therefore, the same medical expenses may be used to clear SOC for both programs. Providers may apply the same services used to […]...
- Providers may collect SOC payments Providers may collect SOC payments from a subscriber on the date that services are rendered or providers may allow a subscriber to “obligate” payment for rendered services. Obligating payment means the provider allows the subscriber to pay for the services at a later date or through an installment plan. Obligated payments must be used by […]...
- Certifying Share of Cost Benefits and Coverage Subscribers are not eligible to receive Medi-Cal benefits until their monthly Share of Cost dollar amount has been certified online. Certifying SOC means that the Medi-Cal eligibility verification system shows the subscriber has paid or become obligated for the entire monthly dollar SOC amount owed. Claims submitted for services rendered to a subscriber whose SOC […]...
- Consumers’ and Providers’ Responses to Public Cost Reports, and How to Raise the Likelihood of Achieving Desired Results Consumers' and Providers' Responses to Public Cost Reports, and How to Raise the Likelihood of Achieving Desired Results ...
- Phadia First Company To Receive FDA Clearance Of Recombinant Allergen Component Tests Phadia, the global leader in allergy and autoimmunity diagnostics, today announced the FDA clearance of recombinant ImmunoCAP® Allergen Components for marketing in the United States. The FDA clearance applies to all of Phadia’s instrument platforms....
- SOC: What is a Eligibility Verification Confirmation (EVC) number for Share of Cost Once SOC has been certified, an Eligibility Verification Confirmation (EVC) number is displayed in the message returned by the Medi-Cal eligibility verification system. Return of an EVC number does not guarantee that a subscriber qualifies for full-scope Medi-Cal or CMSP benefits. It does, however, indicate that the subscriber qualifies for at least partial services. Providers […]...
- California Dental Plan, New Dental Choice Provider Choices California Dental Plan, New Dental Choice Provider Choices...
- Long Term Care Share of Cost Providers receiving an eligibility verification message (see following example) that indicates a subscriber has an LTC SOC should not clear the SOC online. Subscribers with aid codes 13, 23, 53 and 63 must have their LTC SOC cleared on the claim. The LTC facility includes the LTC SOC amount for Medi-Cal-covered services on the Payment […]...
- Share of Cost, How Does the Careington Discount Dental Plan Work in California? Share of Cost, How does the Careington Discount Dental Plan Work in California?...
- Share of Cost, If Slow Rate Of Health Care Spending Growth Persists, Projections May Be Off By $770 Billion Share of Cost, If Slow Rate Of Health Care Spending Growth Persists, Projections May Be Off By $770 Billion ...
- Recession Contributes To Slowest Annual Rate Of Increase In Health Spending In Five Decades In 2009, US health care spending grew 4.0 percent—a historically low rate of annual increase—to $2.5 trillion, or $8,086 per person. Despite the slower growth, the share of the gross domestic product devoted to health spending increased to 17.6 percent in 2009 from 16.6 percent in 2008. The growth rate of health spending continued to outpace the growth of the […]...
- Share of Cost, Do You Know How to Use Medicare’s Preventive Services? Part 3 Share of Cost, Do You Know How to Use Medicare’s Preventive Services? Part 3...
- Share of Cost, Keep track of what you may owe for your health and drug benefits, and identify if additional action is needed. Share of Cost, Keep track of what you may owe for your health and drug benefits, and identify if additional action is needed....