ClinikEHR Claims for Medi-Cal

ClinikEHR Claims makes the electronic file Medi-Cal takes from the claims you already have on CMS-1500 forms. You add the claims, check every field, approve them, make the file, and upload it to Medi-Cal yourself in the Medi-Cal Provider Portal.

What it does, and what it does not

ClinikEHR Claims does	You still do
Reads fillable CMS-1500 PDFs and CSV exports, and gives you a typed form beside a scan	Check every field against the original
Checks procedure codes, modifiers, units and diagnoses and tells you what looks wrong	Decide what to do about each finding. The checks are advice
Makes a test file (free) and a production file	Upload the file in the Medi-Cal Provider Portal
Keeps your claims, your files and a count of what this month has used	Download Medi-Cal’s reports from the Provider Portal and add them under Reports

There is no clearinghouse in the middle. ClinikEHR does not send anything to Medi-Cal for you, and it has no way to see your Provider Portal account. ClinikEHR is not certified or approved by Medi-Cal; Medi-Cal decides whether your Submitter ID is active, whether your test passes and whether each claim is accepted.

This is the United States insurance track. The pages for clinics outside the US are under Hospital insurance, and the older electronic-claims page for US practices is File insurance claims.

The four steps

The bar at the top of Medi-Cal claims shows where you are: Add claims, Review, Generate, Upload to Medi-Cal.

Get set up with Medi-Cal, once

Ask Medi-Cal for a Submitter ID, register in the Provider Portal and send the test claims. See Get set up with Medi-Cal.

Add claims

Drop in PDFs, pictures or a CSV, or type a claim. See Add claims.

Review and confirm

Open each claim, compare it with the page, confirm every field and run the code checks. See Review and confirm a claim and Approve claims.

Make the file and upload it

Make a test or production file, download it and upload it in the Provider Portal. See Make a Medi-Cal file.

What it costs

Test files are free. A claim in a production file uses clinical credits the first time it goes into one: 25 on Free, 15 on Essential, 10 on Team, included on Enterprise. See Make a Medi-Cal file and Clinical credits.

All the pages

Get set up with Medi-Cal

Submitter ID, Provider Portal, the 10-claim test and the Setup checklist.

Add claims

PDFs, scans, CSV exports and the CSV template.

Review and confirm a claim

Confirm each field and use the code checks.

Approve claims

Who approves, and why a biller cannot approve their own.

Make a Medi-Cal file

Test and production files, credits, Free limits, download and upload.

Corrected claims and voids

Fix or cancel a claim Medi-Cal already has.

Saved details and copying a claim

Fill a new claim from earlier ones.

Read Medi-Cal's reports

Add the Error report, Volser Summary or payment advice and see each claim’s result.

Dashboard, files and your data

The claims summary, the Files screen and how long things are kept.

Sign up for a Claims workspace

A Claims-only account, and how to turn on the full EHR.

Start here

Every day

Clinical work

Forms

Money