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OHC Identification by DHCS
DHCS currently receives OHC data from over 20 health insurance carriers, the Department of Child Support Services, the Social Security Administration, California Children’s Services, and other automated systems.
Discrepancies
When DHCS discovers a discrepancy, MEDS is updated with the insurance information and scope of coverage codes (cost avoidance OHC codes).
Affected individuals are sent a letter explaining cost avoidance and informed that their providers must bill the other health coverage carrier prior to billing MC. Individuals are instructed to contact their EW if they no longer have the coverage.
Clients who have further questions about the health insurance coverage may call the DHCS, OHC Section's toll-free number, 1 (800) 541-5555.
Related Topics
Overview of the Managed Care Two-Plan Model
Health Care Options Enrollment Contractor
Managed Care for Mental Health Services
Coordinated Care Initiative - Cal MediConnect
Health Insurance Premium Payment (HIPP) Program
Removal of OHC Codes for Victims of Domestic Violence
OHC for Foster Care/Adoption Assistance Children
Repayment for Medical Services