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San Francisco Health Plan Claims Billing: Inpatient Services, Facility Outpatient, Medical Supply, Duplicate Billings San Francisco Health Plan Claims Billing Notes described below regard to some points not mentioned in the previous posts devoted to EDI requirements. Inpatient Services, Facility Outpatient, Medical Supply, Duplicate Billings notes are presented in general. Inpatient Services San Francisco Health Read More →

San Francisco Health Plan EDI Claims: Common Requirements San Francisco Health Plan EDI Claims are processed for the following medical groups: San Francisco Community Clinic Consortium, San Francisco Health Network (previously known as the Community Health Network) and UCSF Medical Group. Any delegated medical group must submit encounter EDI data to San Francisco Health Plan Read More →

medical codes

Medical Codes Overview San Francisco Health Plan uses medical codes according to Medi-Cal billing guidelines in addition to Optum coding books application for claim activities. The following procedure medical codes must be used for a claim to be processed: Professional charges – HIPAA compliant HCPCS Level 1 (CPT) & level 2 Inpatient hospital/facility/institutional charges – Read More →