Mosescure handles most of the complex healthcare billing regulations in California.

• AB 72 (Surprise Billing Protection Act)
  AB 72 prohibits out-of-network providers from balance-billing patients beyond in-network cost-sharing for services at in-network facilities. Mosescure makes sure that every claim submitted by your out-of-network providers correctly adheres to IDR processes and the payment standard benchmarks defined under AB 72 and DMHC guidance.
• Medi-Cal Billing Compliance (DHCS)
  California’s Medi-Cal program, administered by DHCS, requires strict adherence to Medi-Cal billing manuals, correct NPI usage, and timely filing limits.
• Department of Managed Health Care Regulations
  DMHC enforces network adequacy, timely payment standards, and grievance resolution timelines for HMO and managed care plans.
• California Confidentiality of Medical Information Act
  CMIA imposes stricter data privacy rules than HIPAA for California patients’ medical information.
• Each California city has a distinct payer landscape
  Los Angeles practices deal heavily with LA Care, Anthem Medi-Cal, and Covered California exchange enrollees.
  San Francisco practices navigate SF Health Plan, Medi-Cal managed care, and UCSF’s integrated networks.
  San Diego involves Molina, Community Health Plan of San Diego, and Sharp HealthCare contracts.
• California’s complex system of 58 county health departments and 27 Medi-Cal managed care plans