California Medi-Cal Billing Simplified
California Medi-Cal billing is uniquely complex — treatment authorization requests, managed care plan variations, level-of-care certifications, and documentation requirements that change with every regulatory update. AssistedCare handles the complexity so your billing team can focus on revenue.
Challenges in Revenue Cycle
Treatment Authorization Requests Are a Full-Time Job
TARs require specific clinical documentation, timely submission, and constant follow-up. Missed or delayed TARs result in denied claims for services already provided — a direct hit to your bottom line.
Managed Care Plans Have Different Rules
California has dozens of Medi-Cal managed care plans, each with its own authorization requirements, billing formats, and documentation standards. Keeping track of which rules apply to which resident is a constant challenge.
Reauthorization Deadlines Slip Through the Cracks
When coverage authorizations expire without timely renewal, your facility provides care it cannot bill for. Manual tracking of reauthorization deadlines across dozens of residents is error-prone and unreliable.
How AssistedCare Solves It
Automated TAR Management
The system tracks every treatment authorization request from initial submission through approval or denial. Upcoming expirations trigger automatic alerts, and the clinical documentation needed for renewal is pre-assembled.
Managed Care Plan Profiles
Each Medi-Cal managed care plan is profiled with its specific authorization requirements, billing rules, and contact information. The system applies the correct rules automatically based on the resident's plan assignment.
See Billing Platform→Reauthorization Deadline Tracking
Coverage authorization expiration dates are tracked and visible on dashboards. Your team receives advance warnings at thirty, fourteen, and seven days before expiration — with the documentation package pre-assembled for renewal.
Medi-Cal-Specific Documentation Templates
Level-of-care certifications, continued stay reviews, and Medi-Cal-specific assessment requirements are built into clinical workflows. Documentation that satisfies Medi-Cal requirements is captured during normal care activities.
Medi-Cal Claim Scrubbing
Claims are validated against Medi-Cal-specific edit rules before submission. Common Medi-Cal rejection reasons — rate code mismatches, missing authorizations, invalid provider numbers — are caught and corrected upfront.
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Frequently Asked Questions
Yes. The system supports Medi-Cal fee-for-service and all California Medi-Cal managed care plans. Each plan's authorization requirements, billing formats, and reimbursement rates are built into the claim generation workflow.
When California updates Medi-Cal reimbursement rates, the system is updated accordingly. Rate changes are applied to new claims automatically, and your billing team is notified of any rate adjustments that affect open claims.
Yes. Residents with Medi-Cal pending status or share-of-cost obligations are tracked with expected eligibility dates and obligation amounts. The system alerts your team when eligibility is confirmed so billing can proceed.
AssistedCare tracks evolving CalAIM requirements including Enhanced Care Management and Community Supports billing. As the CalAIM initiative expands, the system is updated to support new billing categories and documentation requirements.
We offer transparent per-bed pricing with no hidden fees, no long-term contracts, and no charges for updates or support. Contact our team for a customized quote based on your facility size and needs.
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