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Instructions for Form DHCS6700 Multiple Billing Override Certification - California
This document contains official instructions for Form DHCS6700 , Multiple Billing Override Certification - a form released and collected by the California Department of Health Care Services. An up-to-date fillable Form DHCS6700 is available for download through this link.
FAQ
Q: What is Form DHCS6700?A: Form DHCS6700 is the Multiple Billing Override Certification form in California.
Q: What is the purpose of Form DHCS6700?A: Form DHCS6700 is used to certify that a provider has a valid written agreement with a patient allowing them to bill the patient for medical services that are normally covered by Medi-Cal or another health insurance.
Q: Who needs to complete Form DHCS6700?A: Healthcare providers who want to bill a patient for services that would otherwise be covered by Medi-Cal or another health insurance need to complete Form DHCS6700.
Q: Is there a fee to submit Form DHCS6700?A: No, there is no fee to submit Form DHCS6700.
Q: Are there any supporting documents required with Form DHCS6700?A: Yes, you will need to attach a copy of the written agreement with the patient.
Q: What happens after I submit Form DHCS6700?A: The California Department of Health Care Services (DHCS) will review your form and notify you of their decision.
Q: How long does it take to process Form DHCS6700?A: The processing time for Form DHCS6700 may vary, but it typically takes several weeks.
Q: Is Form DHCS6700 specific to California?A: Yes, Form DHCS6700 is specific to California and is used for multiple billing override certification in the state.
Instruction Details:
- This 1-page document is available for download in PDF;
- Actual and applicable for the current year;
- Complete, printable, and free.
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