INP HELP
INP's if you need help with any issue, request "Your Area Representative"
Call Medi-Cal #: 800 541-5555 and get a personal representative assigned to you. They will help you with billing, address any billing issues you have regarding our program.
*** DO NOT BILL FOR MORE THAN 16 HOURS PER DAY
*** Only Bill Nursing Hours: If You Are Physically Present & Your Hands Are Providing The Nursing Care
- No exceptions, it's considered fraud and you'll jeopardize your nursing license.
Requesting more hours may jeopardize your nursing license! INP's need to show adequate sleep! 16 hours usually requires TPN / Central lines, Ventilator Dependent, Dialysis... but with these conditions no guarantee of getting 16 hours, it is based on the medical necessity, the quality of your POT, and your nursing notes showing the skilled nursing hours required/needed. Then the final say is Medi-Cal/CCS and then an appeal.
* INP's: Get acquainted with your regional representative and your small billing unit person ASAP!
New Codes:
RN: S9123 AND modifier EP
LVN: S9124 AND modifier EP
RN Case Management: G0162 each 15 minutes modifier EP
TAR Numbers: Place a "0" at the END of your TAR for billing.
Questions about coverage of PDN services under EPSDT can be directed to the DHCS Systems of Care Division, EPSDT Unit by phone at 1-855-347-9227 or by email at EPSDT@dhcs.ca.gov.
Program Information & Forms
Information:
(INP's PleaseCheck Your Download Folder After Clicking The Link)
The EPSDT Private Duty Nursing Program
CHANGES IN THE AUTHORIZATION PROCESS FOR PRIVATE DUTY NURSING (PDN) REVISEDCounty Offices and phone #'s for California Children's Services
SAR Process Change for Providers of EPSDT Private Duty Nursing Service SAR for CCS
ALL MEDI-CAL MANAGED CARE HEALTH PLANS INFO
INP FORMS
Need Initial Bates Intake Form? Click Here!
Need A POT Form Long Form? Click Here!
Need Sample Nursing Notes? (Modifiable) Click Here!
Nursing Notes & Narrative Click Here!
Need Medication MAR? Click Here!
Need Initial Nursing Head-To-Toe Assessment Form? Click Here!
Licensed Vocational Nurse (LVN) Skills Assessment and Training Form
*** 56262. Provider Grievance and Complaint Form.
CERTIFICATE OF MEDICAL NECESSITY FORMS:
(Click the embedded links below).
CERTIFICATE OF MEDICAL NECESSITY FOR APNEA MONITORS
CERTIFICATE OF MEDICAL NECESSITY FOR OXYGEN
CERTIFICATE OF MEDICAL NECESSITY FOR NEBULIZERS
MEDICAL REVIEW/PROLONGED MEDICAL FRAGILE FOSTER CARE ASSESSMENT
Link to Medi-Cal Forms: Click Here
Link to Medi-Cal Phone Numbers: Click Here
NEEDED CONTACT INFORMATION
Regional Representatives:

The 22 Regional Representatives live and work in cities throughout California and are ready to visit providers at their homes to assist with billing needs or provide training to INP's at no cost. To schedule a Regional Representative on-site visit please call the Telephone Service Center (TSC) at 1-800-541-5555
INP's Use your Small Provider Billing Unit Person:
* * You have their help for billing & e-Tar, etc. For a one-year period of time USE THEM! For more information, call (916) 636-1275 or 1-800-541-5555, ext. 1275. Representatives are available from 8 a.m. to 5 p.m., Monday through Friday, except holidays.
EPSDT Sacramento Office: 916 552-9105
E-TAR Help: To check status on a claim: 800 786-4346
Moving & Change of Address? Call your Regional Representative to ask for the proper forms.
Kathy Tello (916) 317-7960 EPSDT TARs
Kathy is our go-to for TARs for EPSDT (not CCS). Not for various questions - just the TARs. She said if we do not hear news about our TARs after 2-3 days, call her with the TAR number. She will make sure it has gone in the correct queue.
Tuesdays-Fridays, 0630-1500.1099
Forms & Other Info:
Department of Health Care Services Provider Enrollment Division
MS 4704
(916) 323-1945
P.O. Box 997413
Sacramento, CA 95899-7413
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Know Your Rights!
ALL PLAN LETTER 23-005
INP's Place This Letter in your POT to all MCP:
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Know Your Rights:
CCS Grievance & Appeal Information:
​Manage Care Grievances:
https://www.dmhc.ca.gov/​​
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IEHP INFOMATION
IEPH Provider Information 866 223-4347
Provider Relations 909 890 2054
Once your contracted with i.e. HP you have to take a mandatory training for EPSDT: www.IEHPprovider.myabsorb.com
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Juvenile Law Attorneys
Mark Hirabayashi
www.hirabayashiadoptionlaw.com
5410 East Beverly Boulevard,
Los Angeles, California 90022
Email:
markadoptlawyer@gmail.com
Phone:
P: 323.722.7559
F: 323.724.8279
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Felice A Webster
323 664-5600
1920 Hillhurst Ave. #402
Los Angeles, Ca 90027
Join Our Private Facebook Page
INP's Join Our Private Facebook Page:
Please go to "Your Facebook Home Page" and search for AIW Nurses & Angels Page, Answer the two questions. Our Closed Facebook Group of INP Is Important For Information, Program Changes, and Foster Care Placements Requests. Here is the FB Link: https://www.facebook.com/groups/295604344524798/