Form DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification - County Contracted Provider - California

Form DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification - County Contracted Provider - California

What Is Form DHCS100186?

This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. Check the official instructions before completing and submitting the form.

FAQ

Q: What is DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification?
A: DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification is a document used by county contracted providers in California to submit claims for reimbursement under the Drug Medi-Cal (DMC) program.

Q: What is the purpose of DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification?
A: The purpose of DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification is to certify that the services provided by the county contracted provider are in compliance with the requirements of the DMC program.

Q: Who uses DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification?
A: County contracted providers in California use DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification to submit claims for reimbursement under the DMC program.

Q: What is the Drug Medi-Cal (DMC) program?
A: The Drug Medi-Cal (DMC) program is a Medi-Cal specialty mental health services program that provides substance use disorder treatment to eligible individuals in California.

Q: What are the requirements for submitting a claim under the DMC program?
A: To submit a claim under the DMC program, the services provided by the county contracted provider must meet the requirements specified by the program, and the provider must complete and submit the DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification.

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Form Details:

  • Released on June 1, 2014;
  • The latest edition provided by the California Department of Health Care Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form DHCS100186 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.

Download Form DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification - County Contracted Provider - California

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  • Form DHCS100186 Drug Medi-Cal (Dmc) Claim Submission Certification - County Contracted Provider - California, Page 1
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