County of San Diego Health and Human Services Agency HHSA County Medical Services CMS Program Guide Administrative Responsibilities Number Page 0104 1 of 2 Background The administrative sections which support CMS are Health Coverage Access HCA CMS Program staff and the Administrative Services Organization Policy A Health Coverage Access HCA This section oversees eligibility staff located at hospitals public health centers and community clinics Responsibilities include Evaluating eligibility for MediCal and CMS Ensuring that CMS is the program of last resort Helping applicants through the eligibility process Teaching beneficiaries how to receive covered services and how to resolve access to health care problems Referring applicants and beneficiaries to other resources eg MediCal State Disability General Relief communitybased organizations etc Providing CMS applicants and beneficiaries with other program information that is appropriate to their circumstances at the time eligibility to CMS is established or denied B CMS Program Staff The CMS Program staff maintains CMS policies and procedures in the CMS Program Guide CMSPG initiate Disability Determinations Services Division DDSD applications and process various types of recovery for CMS C Administrative Services Organization ASO San Diego County contracts with an ASO to Schedule eligibility appointments Manage patient care Authorize treatment based upon established guidelines Process provider claims Bill MediCal for reimbursement Manage scope of service complaint and grievance process Monitor claim payments or other duties related to County lien assertions The ASO maintains an inventory of CMS Patient Handbooks and coordinates the distribution to FRCs The FRCs may order the CMS Patient Handbooks by calling the ASO at 18584924422 and providing the following information Contact person Phone number Requesting FRC County Mail Stop Number of handbooks needed for each language EnglishSpanish Other Program Impact None County of San Diego Health and Human Services Agency HHSA County Medical Services CMS Program Guide Administrative Responsibilities Number Page 0104 2 of 2 References None Sunset Date This policy will be reviewed for continuance by 10312018 Release Date 1012015