Medical billing services in California
California combines Medi-Cal managed care, heavy regulatory oversight and a workers compensation system with its own fee schedule. We bill all three properly so your claims stop coming back.
- CABilled end to end
- 8+Plans commonly billed
- 50+Specialties covered
What actually goes wrong with California claims
These are important areas to check when configuring a California billing workflow. The applicable plan and date of service determine the requirements.
- Medi-Cal changes by county
The managed care plan a Medi-Cal patient belongs to depends on where they live. Practices serving more than one county are effectively billing more than one program.
- Workers compensation fee schedule
California workers compensation runs on the Official Medical Fee Schedule with its own authorization and lien rules. These claims need separate handling or they age out.
- Two regulators, two complaint paths
Plans fall under either the Department of Managed Health Care or the Department of Insurance. Knowing which one covers a payer determines where an unpaid claim can actually be escalated.
Medi-Cal billing
Medi-Cal, administered by the Department of Health Care Services.
Medi-Cal is delivered largely through county organized and commercial managed care plans such as L.A. Care, Health Net, Molina and Anthem. Which plan operates depends on the county, so a practice serving two counties bills two different rule sets.
Plans a California practice bills
These are plans operating in California. Your account is configured for the ones you actually see, not a statewide average. If yours is not listed, ask.
Before a California claim is submitted
Configure the work around Medi-Cal and the plans your practice actually sees.
- Confirm the member plan and billing destination for each date of service.
- Check provider enrollment, service location and authorization requirements.
- Use the applicable filing and appeal deadlines in the claim worklist.
- Reconcile payments against the relevant contract or fee schedule.
Serving practices across California
We work remotely inside your practice management system, so where you sit inside the state does not change what we can do. These are simply where California practices most often are.
California billing questions
Do you bill Medi-Cal managed care?
Yes, including county organized health systems. We set your account up for the specific plans operating in the counties you serve.
Do you handle California workers compensation billing?
Yes. It runs on the Official Medical Fee Schedule and needs its own authorization tracking, so it is worked separately from your commercial claims.
Our Los Angeles practice has a large aged A/R. Is it too late?
Not necessarily. Timely filing limits vary by payer and some aged claims are still appealable. The ninety day review tells you what is genuinely recoverable and what is not, honestly.
Can you support a practice across multiple California counties?
Yes, and it matters that we do. Medi-Cal plan assignment is county based, so multi county practices need each location configured separately.
Find out what California payers owe you
Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.