DHCS to automate Medi-Cal provider enrollment

March 21, 2014
Area(s) of Interest: Payor Contracting Payor Issues and Reimbursement Public Payors 

The California Department of Health Care Services (DHCS) will soon be automating its Medi-Cal provider enrollment processes. The hope is that the new system, expected to go live this fall, will improve the provider enrollment experience by minimizing errors in the application process and significantly reducing the time required to process provider enrollments.

The new enrollment system, called the Provider Application and Validation for Enrollment (PAVE) system, will be a web-based portal that providers can use to submit application and verifications and report changes.

Initially, PAVE will only be available for providers that currently enroll to serve fee-for-service beneficiaries directly through the DHCS Provider Enrollment Division. However, DHCS plans to expand access to Medi-Cal providers who enroll through other divisions and departments until all Medi-Cal enrollment activities are directed through the PAVE system.

PAVE will also permit online payment of fees, if applicable, allow providers to check application status online, and will use electronic signatures for all provider types. PAVE will include checklists of required attachments that will let the provider know that a complete application has been prepared and will ensure that the provider has provided responses to all required questions before the application is submitted. PAVE will allow providers to attach required supporting documentation electronically and verify that attachments are complete prior to submission.

PAVE will also allow providers to quickly revalidate their information in accordance with the Affordable Care Act (ACA).

Beta Testers Needed

DHCS is seeking providers to assist in testing the PAVE system late in the summer of 2014. A wide variety of providers will be needed to ensure that the system is functioning correctly. This will require a short training period and the ability to connect with DHCS in a test mode. If you are interested in participating as a beta tester, please provide a contact name and phone number, provider type, location, and NPI to dhcspedpave@dhcs.ca.gov.

DHCS is also seeking providers to participate in a workgroup to assist in reviewing the “help” information that will be included in the PAVE online application. The purpose of this review is to provide clear direction to the applicant to reduce the potential for errors or misunderstanding in the application process. DHCS plans to conduct the workgroups as conference calls during the week of April 7, 2014. If you are willing to participate in the workgroup, please notify DHCS at dhcspedpave@dhcs.ca.gov.


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