Medi-Cal Recipient Eligibility Tutorial

Recipient Eligibility • Resources

Acronyms | Medi-Cal Manual references | New terminology

Acronyms

AEVS - Automated Eligibility Verification System

BIC - Benefits Identification Card

CCS - California Children’s Services

CIN - Client Identification Number

GHPP - Genetically Handicapped Persons Program

HIPAA - Health Insurance Portability and Accountability Act

OHC - Other Health Coverage

POS - Point of Service

SOC - Share of Cost

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Medi-Cal Manual references

AEVS: General Instructions (aev gen)

AEVS: Transactions (aev trn)

Aid Codes Master Chart (aid codes)

Eligibility: Recipient Identification (elig rec)

Other Health Coverage (OHC) Codes Chart (other)

Share of Cost (SOC) (share)

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New Terminology

This tutorial addresses the current POS device printouts as well as the current Internet Eligibility Transaction. Under HIPAA, eligibility transactions will include new terminology as follows:

Previous Terminology

New Terminology

Date of Birth

Subscriber Birth Date

Date of Card Issue

Issue Date

Date of Service

Service Date

Eligibility Verification Number

Trace Number (Eligibility Verification Confirmation [EVC] Number)

First Name

Subscriber First Name

Last Name

Subscriber Last Name

Medi-Services

Medical Services Reservation

Provider Number

Service Provider Number

Recipient

Subscriber

Recipient ID

Subscriber ID

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Previous Terminology	New Terminology
Date of Birth	Subscriber Birth Date
Date of Card Issue	Issue Date
Date of Service	Service Date
Eligibility Verification Number	Trace Number (Eligibility Verification Confirmation [EVC] Number)
First Name	Subscriber First Name
Last Name	Subscriber Last Name
Medi-Services	Medical Services Reservation
Provider Number	Service Provider Number
Recipient	Subscriber
Recipient ID	Subscriber ID