Last month, the California Department of Health Care Services (DHCS) informed providers that its system was not yet able to appropriately process claims for the bivalent booster dose for children six months to 4 years, and urged Medi-Cal providers to hold such claims until the claims adjudication system was prepared to appropriately adjudicate submitted claims.

The California Medical Association (CMA) has learned that the DHCS system fix is being implemented this week and an Erroneous Payment Correction (EPC) will be initiated to automatically reprocess the impacted claims. 

No action is required on the provider’s part at this time, however, physicians may elect to resubmit their claims vs. waiting for the EPC, if they so choose.