Frequently Asked Questions (FAQs)

Q:  If I redact the PHI (black-out names of patients, numbers, etc.) how will DHCS know that it is truly a Medi-Cal encounter?

A:  DHCS will follow up with each provider if additional information is needed for verification.  Keep in mind that all original documentation must be maintained by Eligible Providers (EPs) for 6 years post-attestation, and for audit purposes.  In other words, you must be able to provide original reports to an auditor (with the original names, numbers, insurance, etc.) if necessary for six years following attestation (similar to a tax return).


Q:  What are the size limits for uploading files?  Is it 10MB total or 10MB per file?

A:  The limit is 10MB per file.  Larger documents should be broken up into sections and uploaded accordingly.


Q:  How do we handle compliance if a practice bases their encounter volume on manual counts using daily logs and charts?

A:  You will need to provide a letter identifying the Eligible Provider (including their NPI and TIN) that explains the process used by the practice, and provide samples (examples) of the various types of encounters considered in Medi-Cal volumes.


Q:  Our Group volume was used to establish eligibility.  Do we need to upload the information requested for each individual provider in the SLR even though it was already submitted to cover the entire group?

A:  If there is a problem, it is possible that the Group information is not matching up with the individual Eligible Provider’s (EP’s) NPI/TIN.  In these cases, a letter linking the EP to the corresponding Group will be needed.  Also, it is important to identify the NPI/TIN used for the Group in the SLR registration.

-OR-

A:  It is possible that the Group itself had deficient documentation.  In this situation, it will be necessary to upload the Group/Clinic’s reports that substantiate the volumes reported in the SLR.


Q:  When is the deadline for uploading the report?

A:  Currently, there is no deadline for responding to this request.  However, you are encouraged to answer the request as soon as possible.  It is important to note that until the matter is resolved, no EHR Incentive payment will be made for Year 1 attestation, and the Eligible Provider will not be able to submit an SLR attestation for Year 2.


Q:  In the case of managed care encounters, what types of documentation can be used for verification?

A:  For managed care encounters, capitation reports (or any documents showing the patient panel for the Eligible Provider) can be used for documentation.


Q:  If we discover that we inadvertently submitted an erroneous figure, can we submit a correction?  If so, how?

A:  A letter should be submitted which explains your specific situation and includes any corrected figures.  Any documentation that substantiates the corrected figures should also be uploaded.


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