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MEDICAL QUARTERLY CLAIM FOR REIMBURSEMENT MENTAL HEALTH MEDICAL ADMINISTRATIVE ACTIVITIES (MH MAY) MC 1982 D (Revised 7/12) Date: Claiming Unit: Fiscal Year:County Code:County:Legal Entity #: Provider

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How to fill out medi - cal quarterly

01

Gather all necessary information such as income, assets, and household members.

02

Visit the Medi-Cal website or contact your local Medi-Cal office to obtain the quarterly report form.

03

Carefully fill out the form, providing accurate and up-to-date information.

04

Submit the completed form by the specified deadline either online, by mail, or in person.

05

Keep a copy of the submitted form for your records.

Who needs medi - cal quarterly?

01

Individuals who are enrolled in the Medi-Cal program and are required to report changes in income, household size, or other eligibility factors on a quarterly basis.

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What is medi-cal quarterly?

Medi-Cal quarterly is a reporting requirement for individuals receiving Medi-Cal benefits to provide updates on their income, household composition, and other relevant information every three months.

Who is required to file medi-cal quarterly?

Individuals receiving Medi-Cal benefits are required to file Medi-Cal quarterly.

How to fill out medi-cal quarterly?

Medi-Cal quarterly can be filled out online, through a paper form, or by phone with the assistance of a Medi-Cal representative.

What is the purpose of medi-cal quarterly?

The purpose of Medi-Cal quarterly is to ensure that individuals receiving benefits are still eligible based on their current circumstances and to prevent fraud and abuse.

What information must be reported on medi-cal quarterly?

Information such as income, household members, changes in employment status, and any other changes that may affect eligibility for Medi-Cal benefits.

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