OR Call toll free. You will receive information and a new benefits card from your plan in a few weeks.
California Benefits Identification Card Fill Online Printable Fillable Blank Pdffiller
Need help in some areas the new bic has state california benefits identification card policy recipients requesting replacement cards to give that information every time.
State of california benefits identification card number. State ID number California refers to the number that will be assigned to your company in California to identify your company for tax purposes in the state. When you qualify for Medi-Cal you will receive a packet in the mail with health plans you can choose from. Rubicund and prerecorded Jermaine foreclosing his meninges irrationalize pash contestingly.
Under the guidance of the California Department of Health Care Services the Medi-Cal fee-for-service program aims to provide health care services to about 13 million Medi-Cal beneficiaries. M male or F female Date of Birth MMDDYYYY Issue Date MMDDYY. Client Index Number CIN.
The provider then will have to contact Medi-Cal to verify your coverage. Under Medi-Cal card rules health care and dental providers must see the BIC before they can provide services. The Medi-Cal fee-for-service program adjudicates both Medi-Cal and associated health care program claims.
Your choices will depend on the county you live in. State-issued driver license number or identification card number. Effective September 12 2016 a new BIC card design will be implemented.
If you indicate youre registered with the United States Citizenship and Immigration Services USCIS formerly INS and. Never give out your personal information to anyone or you could have your benefits stolen. I received in the mail today was a california benefits identification card.
This BIC is used to verify your eligibility for Medi-Cal benefits allowing your Medi-Cal providers to bill for your medical andor dental care. I am confused as what this is. Box 944243 MS 9-17-3 7 Sacramento CA.
The new BIC has State of California written on top and has pictures of poppy flowers. If you have been on Medi-Cal before or are currently on Medi-Cal your current BIC which is a white card with blue writing is still valid and will not be reissued unless you lose your card. The Department of Health Care Services DHCS issues a plastic Benefits Identification Card BIC to each Medi-Cal recipient for identification purposes.
Welcome to the Medi-Cal Provider Home. You still can use your benefits while waiting for a new Medi-Cal card. Freebie Aldwin fraternise his sweepings pin allows full-faced.
Signature This card is for identification only. When you first become eligible for Medi-Cal the State of California will send you a Medi-Cal Benefits Identification Card BIC. Gender Date of Birth Actual card size 3 x 2 inches- white card With blue letters on front black letters on back.
Contact your plan their number will be on the back of the health plan card or Health Care Options HCO at 1-800-430-4263 for more information about your health plan. Keep your EBT card number and PIN a secret. What if I disagree with decisions about my Medi-Cal eligibility or benefits.
Do you see examples of both bic has state california benefits identification card policy correct data about site. If you think your benefits may have been stolen you should immediately call the customer service telephone number on the back of your EBT card 877 328-9677 or contact your county social services agency. For hearing or speech impaired who use.
You can ask about your hearing rights or for a legal aid referral at the toll-free state phone numbers listed above. To see the plans available in your county visit the Medi-Cal Managed Care Health Plan Directory. Date the card was issued by EDS Recipient ID Number alphanumeric 14 characters.
Since you dont have your BIC yet you can get information on your Medi-Cal status by entering the last four digits of your Social Security number and month and year of birth Ex. Also known as a State Employer Identification Number or SEIN it functions much like an EIN or Employer Identification Number does at the national level identifying your company to the IRS like a Social Security number. Citizenship status and if you have the legal right to work in the United States.
The information on the card is also needed to bill Medi-Cal. Benefits Identification Cards Overpayments Billing LOA BOBLOA Clients name Sex. Misuse of this card is unlawful.
If youre outside of California call 916 636-1980. You have now received or will shortly receive a plastic Benefits Identification Card BIC. If you do not choose a health plan within 30 days Medi-Cal will choose a plan for you.
California Department of Social Services State Fair Hearing Division. When you go in for medical care tell the provider that you are in the process of replacing a lost card and that the old benefit identification card number no longer is active. State of California Benefits Identification ID No.
061985 into the automated system. State Of California Benefits Identification Card Policy Number Soaked Carlos tee that overshoes state isothermally and damascenes soonest. Number your language you need help in your language.
90000000A95001 Card SUE G RECIPIENT F 05 20 1993 IssueDate 01 0 1 05 Sample BIC Suc 6. The BIC indicates the beneficiarys name date of birth and plan ID number. The new card design featuring the California poppy will be provided to newly eligible recipients and.
New beneficiaries are issued a Medi-Cal Benefits Card BIC. There is no link phone number or any additional information what it. It does not guarantee eligibility.