Medi-Cal

The DSG system was the first to yield payment on an electronic Medi-Cal claims submission and is the most comprehensive Medi-Cal billing system available. Our customers currently process several hundred thousand Medi-Cal claims every month.

Features & Benefits

Extensive industry edits with documented and undocumented adjudication criteria built into the system, with the ability to add customized edits based on your specific organizational needs

• Standard DSG Medicaid/Medi-Cal modules include UB04, 1500, LTC, Eligibility and RA reporting and posting to Accounts Receivable

• CHDP PM160 Electronic Billing
  
  
• Automatic and manual combination of mother/baby claims
  
  
• Edits on CPT4 codes for modifiers, TARs, non-covered procedures and remarks
  
  
• Automatic conversion of HCPC codes to CPT4 codes
  
  
• Automated CIF generation
  
  
• Edits on the Medi-Cal recipient aid code for share of cost and/or restricted services. Special processing (including custom or site-specific edits) are available for:

• Inpatient claims
• Outpatient claims
• California Children's Services (CCS)
• Rural health clinics
• Home healthcare
• County health plans
• Local initiatives
• FQHC programs (counties)
  

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