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How does a Crossover Only provider receive approval for reimbursement for a service provided to a dual-eligible beneficiary by Medi-Cal?

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How does a Crossover Only provider receive approval for reimbursement for a service provided to a dual-eligible beneficiary by Medi-Cal?

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If a provider is Medicare enrolled and not Medi-Cal enrolled and provides services to a beneficiary who is eligible for both Medicare and Medi-Cal, the provider may receive approval for reimbursement for services rendered to the beneficiary by completing and submitting MC 0804 to the Provider Enrollment Division. The mailing address is listed on the form.

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