CMISP Provider Enrollment-Reimbursement


Provider Enrollment
Sacramento County healthcare providers should contact the CMISP Provider Relations Unit at 916-875-9843 to enroll with the Program. The enrollment is open-ended. Provider enrollment requirements address program information, the provider's responsibilities for minimum insurance coverage's, and some brief information about maintenance of records, etc. The provider copy of the enrollment should be kept with the handbook.

Interpreter Services
The Department of Health and Human Services has enrolled several on-call interpreters/translators.  If you have a need for these services, you may contact medical case management at 916-875-9843.  This unit will only authorize such services for CMISP authorized visits.

No Show Policy
It is the policy of CMISP case management to reimburse community clinician providers for Medically Indigent (MI) patients that do not show up (no-show) for any office consultation (current Procedure Terminology [CPT] codes 99241-99245) and/or any follow-up office visit (CPT codes 99211-99215) authorized by Case Management. The reimbursement rate is a fixed rate of $25.00 per "no-show" visit.

CMISP Policy Information/Bulletins
CMISP Provider Relations will periodically send out provider bulletins to all providers or specialty bulletins to a particular specialty containing pertinent program information. These bulletins should be maintained for reference in the CMISP Provider Handbook. For copies of the Provider Handbook, call CMISP Provider Relations at 916-875-9843.

Provider Technical Assistance
Providers are encouraged to contact the program's Provider Relations Unit for questions regarding program information or for desired training and technical assistance.

Reimbursement
Reimbursement rates and guidelines are consistent with the State's Medi-Cal program unless otherwise contractually negotiated. Claims for reimbursement are submitted to the CMISP Accounts Payable Unit.

Non-enrolled Providers
In emergency situations any payment to non-enrolled providers is subject to CMISP maximum reimbursement guidelines.

Important Addresses
Below are addresses for submission of claims and medical reports. Please do not enclose claims within the envelope intended for medical reports, as this may delay payment.

Send CLAIMS to:
CMISP Accounts Payable Unit
7001-A East Parkway, Suite 250
Sacramento, California 95823
 
Send MEDICAL REPORTS to:
CMISP Medical Case Management
9616 Micron Avenue, Suite 670
Sacramento, California 95827



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