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Providers Disclosures

CONTRACTING PROVIDER DISCLOSURES
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The following information is provided in accordance with 28 CCR 1300.71(o)(2), regarding disclosure of detailed payment policies and rules and nonstandard coding methodologies used to adjudicate claims. Serra Community Medical Clinic, Inc, in its sole discretion, employs the procedures set out in the following descriptions as part of its claims review, as indicated, of hospital and professional fee for service claims.

 

Providers may only look to Serra Community Medical Clinic, Inc, or if subcontracted to a Serra Community Medical Clinic, Inc capitated provider, to that provider, for payment and not to enrollees (except for required co-payments) or to any technical services vendor Serra Community Medical Clinic, Inc may use from time to time to assist in its review of claims