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CCS Temporary Physician Paneling Process

CCS Temporary Physician Paneling Process. Temporary Physician Paneling. Effective immediately the CMS Branch has changed the name of Emergency paneling to Temporary paneling. . Temporary Physician Paneling.

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CCS Temporary Physician Paneling Process

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  1. CCS Temporary Physician Paneling Process

  2. Temporary Physician Paneling Effective immediately the CMS Branch has changed the name of Emergency paneling to Temporary paneling.

  3. Temporary Physician Paneling The CMS Branch requires CCS service authorizations to be issued to physicians who are CCS paneled. If the physician applicant meets all the criteria required, the physician is eligible for full-approval or provisional panel status.

  4. Temporary Physician Paneling However, there are situations when a physician who does not meet CCS paneling criteria renders emergency services for the treatment of an eligible medical condition of a CCS-eligible client. In this circumstance, the physician can be temporarily paneled.

  5. Temporary Physician Paneling • Physicians must request authorization for services rendered. • Non paneled physicians must complete a paneling application for full panel or temporary paneling approval. • Physicians applying for temporary paneling must have an active Medi-Cal provider number. • Temporary paneling is limited to dates of service as indicated on the request for authorization.

  6. Temporary Physician Paneling • The CCS county program or regional office can initiate the temporary paneling process when a request to authorize emergency services is received. • The CCS county program or regional office must contact the Provider Services Unit (PSU) by either telephone or fax to indicate they want to issue an authorization to the non-paneled physician and request that the physician by considered for temporary paneling.

  7. Temporary Physician Paneling The county or regional office must provide the following information to PSU: • Name of County or Regional office • County or regional office contact name and phone number • Name of physician • Physician active individual Medi-Cal provider number • Date(s) of services • Type of service • Name of CCS client

  8. Temporary Physician Paneling • PSU will store the information received in an internal data base pending receipt of the paneling application. • The same application is used for temporary paneling and regular paneling. • The physician must complete & send the CCS panel application to PSU indicating “Temporary Paneling” on the top portion of the application

  9. Temporary Physician Paneling • Physicians applying for temporary panel status are exempt from the board eligibility/certification requirement. • Applicants for temporary paneling are not required to enclose the documentation indicated on the paneling application. • The paneling application may be faxed to PSU to expedite the process, and followed by an application with an original signature mailed to PSU.

  10. Temporary Physician Paneling • Temporary paneling applications will be processed on an expedited basis. • PSU will notify the physician in writing of the temporary paneling decision. • PSU will notify the county or regional office contact person of the temporary paneling decision via email, telephone, etc.

  11. Temporary Physician Paneling • However, if a physician renders non-surgical emergency services in a hospital or clinic outpatient facility, and the facility is issued a CCS authorization containing Service Code Grouping (SCG) 01, the physician can utilize the facility’s authorization number to bill for services rendered without going through the temporary paneling process.

  12. Temporary Physician Paneling The physician must indicate the facility’s provider number as the referring provider and must indicate their own provider number as the rendering provider. For questions related to temporary paneling or to check the status of a panel application, please contact the PSU at (916) 322-8702.

  13. 2006 CCS/Medi-Cal Provider Training • The first 2006 CCS/Medi-Cal provider training will be held in Redding, Ca. at the Red Lion Inn on March 28-29, 2006. • CCS county and regional office staff attendance is recommended at the training. • Please help get the word out to your provider community. • Copies of the 2006 Training Schedule are located in the back of the auditorium for your convenience.

  14. Any Questions?

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