MedicaidAdministrativeMedium impact
Reminder: Guidelines for Correspondence Specialist Unit Inquiry
Medi-Cal·CA·Provider Bulletin
Effective date
Jun 30, 2026
We identified it
Jul 1, 2026
Summary
This is a reminder policy from Medi-Cal clarifying the proper procedures and required documentation for submitting inquiries to the Correspondence Specialist Unit (CSU) regarding recurring billing issues, claim denials, and unsatisfactory payments. Providers must follow specific submission guidelines including postal mailing address, NPI, dates of service, claim control numbers, and supporting documentation (claim forms, eligibility proof, RADs, CIF/appeal acknowledgments). Medical records cannot be resubmitted for reconsideration of previously adjudicated claims.
Action Required
Effective immediately (June 30, 2026): Billing team must update CSU inquiry procedures to ensure all correspondence includes: (1) postal mailing address, (2) relevant NPI, (3) dates of service, and (4) 1-3 claim control number examples. Billing staff submitting CSU inquiries must attach supporting documentation (legible claim forms, proof of eligibility if beyond 1 year, RADs in PDF format only, CIF/appeal acknowledgments, and dated MMIS FI correspondence). Train billing team that electronic RADs are not acceptable and medical records should not be submitted to CSU. Ensure that when appeal forms are included with CSU inquiries, staff understand appeal status will not be provided. Update internal CSU submission checklist and training materials to reflect these guidelines.