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Medi-Cal Ordering, Referring, and Prescribing (ORP) project and change management

May 25, 2016

Under the Affordable Care Act (ACA) Medi-Cal billers are required to include the NPI ID of Ordering, Referring, and Prescribing (ORP) providers when submitting a bill to Medi-Cal. In addition, the ORP provider submitted on the claim must be registered with Medi-Cal. Sabot has been contracted to manage a portfolio of ORP related projects with the objective of ensuring that Medi-Cal is compliant with ACA ORP legislation without negatively impacting beneficiaries access to care. Sabot will be responsible for working with DHCS programs to define the business rules and requirements to implement ORP, taking care to account for California statutes and legislation and access to care exceptions. Sabot has also been tasked with developing and executing a comprehensive transition strategy to enroll providers that generate orders, referrals, or prescriptions for Medi-Cal beneficiaries.

 

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