The CMS Net Provider Electronic Data Interchange (CMS Net PEDI) is a web-based tool that enables approved CCS providers to electronically access the status of California Children Services (CCS) Requests for Services/Authorizations. In addition to viewing authorizations each approved provider/facility shall have the ability to print service authorization requests (SARs), denial letters, Notices of Action and generate standard reports.
- Sign Up for PEDI
The Provider Electronic Data Interchange (PEDI) is a web-based tool that enables approved CCS providers to electronically access the status of Requests for Services/Authorizations. Providers and Plans have access to view select client eligibility data and view/print service authorizations, denial letters and Notices of Action. In addition, for providers which are approved as a Trading Partner, can submit electronic Service Authorization Requests (eSARs) and supporting attachments to the CCS Program through PEDI.
Apply for PEDI Here: CCS PEDI Application (cahwnet.gov)
- Become a CCS Paneled provider
Thank you for your interest in becoming a paneled California Children's Services (CCS) provider. Prior to applying as a CCS Program provider, your National Provider Identifier (NPI) number must be enrolled with Medi-Cal. Allied Health Professionals are not required to enroll their NPI with Medi-Cal in order to become a CCS Program provider. If an Allied Health Professional chooses to use their individual NPI, they must register it with Medi-Cal. Otherwise, they may use the facility's NPI where they are employed.
All providers required to be paneled must submit their paneling application through the CCS Panel Portal website. This website allows providers to submit their application and track the application status with a unique tracking number. It is not necessary for a provider to apply multiple times under the same specialty or subspecialty. Once paneled, a provider's paneling remains in effect regardless of what facility they are employed within California or bordering states. A provider may re-apply when adding a different specialty or subspecialty.
Apply Here: CCS Panel Application (cahwnet.gov)
- Submit an eSAR/request to CCS
- PEDI Users: use the Provider Electronic Data Interchange (PEDI) web portal to request an electronic Service Authorization Requests (eSAR) for a new client and provide medical reports supporting the request.
- Non-PEDI Providers may request services for CCS clients using one of the following Service Authorization Request, or SAR, forms and faxing to 951-358-7905 or 951-358-5150
- Who do I call if I have a question about my claim?
If you have any questions, please call the Conduent Telephone Service Center, also known as TSC, at 1(800) 541-5555. If you need further assistance, obtain a ticket number from TSC, and request your representative review your claims with you. The representative can arrange an office visit, as needed.
CCS claims are not adjudicated by CCS. All claims are processed through Conduent, the state of California fiscal intermediary. Claims issues should be directed to Conduent. Providers are encouraged to attend the Medi-Cal Providers Trainings, which are offered on a regular basis throughout the state. Dates and locations of training are available on the Medi-Cal Learning Portal.
- Why was my claim denied? What do I do if my claim is being denied?
Review the Remittance Advice Details (RAD). Correct any errors and resubmit your claim accordingly.
If you have any questions, please call the Conduent Telephone Service Center, or TSC, at 1(800) 541-5555. If you need further assistance, obtain a ticket number from TSC and request your representative to review your claims with you. The representative can arrange an office visit, as needed.
- How do I view my authorizations/SARs online?
- Complete the Application for Provider Electronic Data Interface, which is also known as PEDI.
- Fax: (916) 440-5346, or scan and email firstname.lastname@example.org.
- Pending, approved, and denied SARs are viewable in real-time.
- Each user must have their own log-in password.
- Remember to include all individual National Provider Identification (NPI) numbers associated with Group NPIs and Special Care Center affiliations on your PEDI application so that all possible client SARs are accessible.