California
§ 50657. Completion of Form MC 177S.
1 provisions · California regulatory authority
Provisions
Citable source units
22 CCR 50657Reimbursement PaymentProvider Enrollment
Completion of Form MC 177S.
The provision requires beneficiaries and Medi-Cal providers to complete Form MC 177S with service, billing, coding, identification, and payment-attestation information for share-of-cost purposes.
Group
Payment Program Integrity
Category
Reimbursement Payment
Domain
Billing Reimbursement
Topics
Medi Cal share of cost, Form MC 177S, Provider payment attestations