“Dual Eligibles,” “Duals,” and “Medi-Medis” are all phrases that are used to describe a class of beneficiaries who qualify for coverage under two separate governmental health care programs: Medicare and Medicaid (or Medi-Cal as it is known in California). Medicare is a program funded and managed by the federal government. Medicaid is a state-driven program… Continue reading New Coordinated Care Programs for Dual Eligible Beneficiaries in California

Nearly 2 million Californians have gained coverage with the expansion of the Medi-Cal program. But roughly 800,000 more applications are still pending.

Stakeholders have expressed concern about the California Dual Eligibles project, noting participants could be forced to seek a new managed care plan.

Concerns persist about California's dual eligibles transition project, one of 15 state pilots approved by CMS providing new approaches for coordinated care.

In 2014, Covered California drove national enrollment in Obamacare. Nearly 20% of all 8 million national ACA sign-ups went through the insurance exchange.

Shield HealthCare specializes in third-party insurance billing for medical supplies on the customer’s behalf. Contracted providers include Medicare, state Medi-Cal program, HMOs and private insurance plans. We verify customer insurance eligibility and obtain all necessary documentation to ensure compliance with insurance carrier guidelines. We provide direct billing for the following contracted insurance plans in California:

California Department of Aging http://www.aging.ca.gov/ Mesothelioma Group – A Mesothelioma Support Community http://www.mesotheliomagroup.com/treatment/ Rancho Los Amigos National Rehabilitation Center http://www.rancho.org State of California Department of Developmental Services http://www.dds.ca.gov UOAA – Ostomy Support Groups http://www.ostomy.org/

CAMPS – California Association of Medical Product Suppliers http://www.campsone.org/ CAHSAH – California Association for Health Services at Home http://cahsah.org/ CAPG – California Association of Physician Groups http://www.capg.org/

From the Los Angeles Times 11/13/11 article, Red tape hampers care for patients who are poor and disabled. Such patients qualify for Medicare and Medicaid, but bouncing back and forth between state and federal agencies can increase medical costs and reduce their quality of care. M.C. Kim had four heart attacks in as many years.… Continue reading L.A. Times: Red tape hampers care for patients who are poor and disabled