Revised Other Health Coverage (OHC) Reporting and Correction Procedures

The Department of Health Care Services has All County Welfare Directors 10-23, dated November 23, 2010 to inform counties of:

• Automatic changes to the Other Health Coverage code for certain records on the Medi-Cal Eligibility Data System (MEDS).
• New Procedures to temporarily override OHC coverage codes in certain situations.
• Procedures to change OHC codes and carrier information on a long term basis.
• Documentation requirements before removing or changing OHC information

Removing or Changing OHC Carrier Information

The OHC removal or OHC carrier information change request must be submitted by either secure email to WATS@dhcs.ca.gov or via fax to (916) 440-5675.  For OHC removal or OHC carrier change requests please do the following:

Type or print the following information in blue or black ink:

• The Client Index Number or the beneficiary’s complete county identification number.  Use of the social security number is strongly discouraged through e-mail and fax due to a potential breach of confidentiality.
• The name of the commercial insurance carrier.
• The termination date, if known.  If the termination date is not indicated, then DHCS will use the last day of the first prior month.
• The county Medi-Cal worker name and telephone number.

Although the county is required to keep OHC documentation of insurance coverage changes, please do not fax or email this information to DHCS; the additional paperwork can lead to delays in processing the request.

Regarding OHC Correction Procedure

Email sent to WATS@dhcs.ca.gov for correction processing should be completed in a matter of 30 days.  Please do not include any Protected Health Information in any email that is unsecured.

After allowing 60 days, should a County MHP experience a difficulty in processing correction, please call (916) 651-3283 or email MedCCC@dhcs.ca.gov for further assistance.