Insurance Transfers
What Type of Insurance Does the Patient Have:
What ID Prefix does the Patient Have:
Go to:
lacare.org
Search the Patient by First Name, Last Name, and Date of Birth
Copy the digits starting with '9' and ending with the first letter from Subsciber ID: that is the Medi-Cal ID
The Medi-Cal ID starts with the '9' after 'JQC', copy this into the medical portal on the next step
Go to:
medi-cal.ca.gov
Enter the patient's medi-cal id (or ssn), date of birth,
and date of service (today's date):
What is the Responsible County?:
Select an Insurance Provider
Are Any of the Following Aid Codes Present:
Do Not Transfer - Not in Los Angeles County
Go to:
onehealthcareid.com
Go to the Eligibility page:
Make sure to select Single Policy and
Member ID & Date of Birth as the search critieria
Add the Member ID,and Member Date of Birth
Set Select a Policy Date Range to Today's Date
and click Verify Eligibility
*Make sure that the Member's Name and
Date of Birth match what you have*
What is the Member Status?
Go to:
lacare.org
Is the patient assigned to
PPG: SERENDIB HEALTHYWAYS, INC?
and
Primary Care Physician/Clinic: One of our providers?
See:ktdoctor.com/our-doctors
Is the patient assigned to
PPG: SERENDIB HEALTHYWAYS, INC?
and
Primary Care Physician/Clinic: One of our providers?
See:ktdoctor.com/our-doctors
Inactive
(Peds offer CHDP for Physicals and Vaccines Only)
Go to:
lacare.org
Is the patient assigned to
PPG: SERENDIB HEALTHYWAYS, INC?
and
Primary Care Physician/Clinic: One of our providers?
See:ktdoctor.com/our-doctors
Already Transfered
Transfer to Serendib La Care: Call (855) 270-2327
Go to:
healthnetcalifornia.com
Under PCP Information is the Name of the PCP One of our providers?
See:ktdoctor.com/our-doctors
and
Under PPG Information is the Name of the PPG SERENDIB HEALTHYWAYS, INC?
Already Transfered
Call (800) 361-3366
On the Dropdown choose Kids and Teens Medical Group and
MOLINA HEALTHCARE CALIFORNIA
Scroll down to Provider Information and select
De Silva, Janesri (NPI: 1568502953 - Tax ID: 208778520)
Scroll down to Patient Information and add the Member ID,
Member Date of Birth, and set the State to California
Scroll down and press Submit
*Make sure that the Member's Name and
Date of Birth match what you have*
What is the Member Status?
Go to the section titled Provider Information:
Is the "Pay to Affiliate" listed as SERENDIB HEALTHYWAYS:
Under Plan Maximums and Deductables > Service Level Contact Information:
Is the Name in this section that of one of our providers?
See:ktdoctor.com/our-doctors
Already Transfered
Click on Member ID Card near the top of the page
Find and Call the Member Services number on the ID card
Click on Member ID Card near the top of the page
Find and Call the Member Services number on the ID card
Inactive
(Peds offer CHDP for Physicals and Vaccines Only)
On the Dropdown choose Kids and Teens Medical Group and
ANTHEM - CA
Scroll down to Provider Information and select
De Silva, Janesri (NPI: 1568502953 - Tax ID: 208778520)
Scroll down to Patient Information and add the Member ID,
Member Date of Birth
Scroll down and press Submit
*Make sure that the Member's Name and
Date of Birth match what you have*
What is the Member Status?
Go to the section titled Provider Information:
Is the "Pay to Affiliate" listed as SERENDIB HEALTHYWAYS:
Under Plan Maximums and Deductables > Service Level Contact Information:
Is the Name in this section that of one of our providers?
See:ktdoctor.com/our-doctors
Already Transfered
Transfer to
Transfer to
Inactive
(Peds offer CHDP for Physicals and Vaccines Only)
On the Dropdown choose Kids and Teens Medical Group and
AETNA (COMMERCIAL & MEDICARE)
Scroll down to Provider Information and select
De Silva, Janesri (NPI: 1568502953 - Tax ID: 208778520)
Scroll down to Patient Information and add the Member ID,
Member Date of Birth
Scroll down and press Submit
*Make sure that the Member's Name and
Date of Birth match what you have*
What is the Member Status?
Go to the section titled Provider Information:
Is the "Pay to Affiliate" listed as SERENDIB HEALTHYWAYS:
Under Plan Maximums and Deductables > Service Level Contact Information:
Is the Name in this section that of one of our providers?
See:ktdoctor.com/our-doctors
Already Transfered
Click on Member ID Card near the top of the page
Find and Call the Member Services number on the ID card
Click on Member ID Card near the top of the page
Find and Call the Member Services number on the ID card
Inactive
(Peds offer CHDP for Physicals and Vaccines Only)
What type of Aid-Code does the patient have?
Do Not Tranfer - Leave as Straight Medi-Cal
What HCP does the patient have?
Transfer to Regal: Call (800) 675-6110
If successfult you will be taken to a page with the Member's Name, check to make sure that the Name and Birth Year match what you have on file.
At this point you will need to Call the Patient and ensure that you have the Patient's Permission to continue
Sample Script:
Patient Response:
Only if the Patient said Yes look for the button next to Medical Plan - May Make Changes and click where it says Make Changes
On the next screen choose Health Net Comm Solutions - 352
On the next screen in the dropdown Choose a partner plan (optional) Select Molina Healthcare Partner unless the Patient wants otherwise and Save & Continue
On the next screen enter NPI of the contracted Provider
Select the option that matches the Provider's Name and with the address of the patient's closest location
You will reach a screen that asks you to confirm your enrollment choices and give a reason for choosing a new plan
Confirm that everything is correct and on the dropdown select Other
On the next screen you will have to click the box that says I accept these terms and enter the Patient's First and Last Name
You should recieve a confirmation that looks like this
You may notify the patient that the transfer is complete and will be effective in a month or two
Thank the patient and Hang Up
Transfer to Regal: Call (800) 526-8196
Do Not Tranfer - Leave as Straight Medi-Cal
Select a Partner
Go to:
lacare.org
Is the patient assigned to
PPG: SERENDIB HEALTHYWAYS, INC?
and
Primary Care Physician/Clinic: One of our providers?
See:ktdoctor.com/our-doctors
Already Transfered
Transfer to Serendib La Care: Call (888) 839-9909
Go to:
availity.com
*Make sure that the Member's Name and
Date of Birth match what you have*
What is the Member Status?
Go to the section titled Provider Information:
Is the "Pay to Affiliate" listed as SERENDIB HEALTHYWAYS:
Under Plan Maximums and Deductables > Service Level Contact Information:
Is the Name in this section that of one of our providers?
See:ktdoctor.com/our-doctors
Already Transfered
Transfer to Serendib Molina: Call (800) 526-8196
Transfer to Serendib Molina: Call (800) 526-8196
Inactive
(Peds offer CHDP for Physicals and Vaccines Only)
Go to:
availity.com
*Make sure that the Member's Name and
Date of Birth match what you have*
What is the Member Status?
Transfer to Serendib La Care: Call (888) 839-9909
Inactive
(Peds offer CHDP for Physicals and Vaccines Only)
Go to:
healthnetcalifornia.com
Under PCP Information is the Name of the PCP One of our providers?
See:ktdoctor.com/our-doctors
and
Under PPG Information is the Name of the PPG SERENDIB HEALTHYWAYS, INC?
Already Transfered
Transfer to Serendib Molina: Call (800) 675-6110
Transfer to Serendib Molina: Call (800) 526-8196
Do Not Transfer - Patient REFUSED (Add a note as to why the PT Refused)
Transfer Complte Procedure : Excel Sheet > ECW > Excel Sheet
Transfer Complte Procedure : Excel Sheet > ECW > Excel Sheet