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DHCS 4521 GUIDE

Medi-Cal Reimbursement (Conlan) Filing Instructions

REIMBURSEMENT PROTOCOL: The DHCS 4521 (Conlan Claim) is the legal mechanism for requesting a refund when you paid out-of-pocket for services Medi-Cal should have covered. Claims are processed by the DHCS Beneficiary Service Center (BSC).

CONTACT DATA

Beneficiary Service Center

BSC VOICE: (916) 403-2007 TDD/TTY: (916) 635-6491

Call for status updates or to request a physical form packet.

ELIGIBILITY

Can I File This Claim?

STATE PROTOCOL

Forensic Submission Strategy

To prevent administrative "loss" of your documents and establish a verifiable timeline, the Rig recommends the following protocol:

1. WET INK RULE

blue or black ink only original form with your original signature — Photocopies, scans, or digital signatures will be rejected by DHCS — they require wet-ink authentication

2. 100% CERTIFIED

USPS Certified Mail with Return Receipt — This gives you a tracking number and a physical signature confirming delivery. This is your primary weapon if DHCS misses their 120-day review window.

3. THE SHADOW ARCHIVE

NEVER Send your only copy. Make a full photocopy or clear digital scan of every page of your signed packet, every receipt, and the envelope before you seal it. Retain these for your personal audit record.

OFFICIAL

Form Repository

DOWNLOAD DHCS 4521 (CLAIM FORM) DOWNLOAD STD 204 (PAYEE RECORD) OFFICIAL CONLAN PORTAL

If the direct PDF links fail, use the **Official Conlan Portal** to access the digital version of the packet.

REQUISITES

Mandatory Documentation

TIMELINE

Submission Deadlines

Claims must be received within 1 year of the date of service, OR within 90 days of receiving your BIC card—whichever is later.

ESTIMATED PROCESSING: Review takes up to 120 days. If the provider refuses to refund you within 30 days of approval, the State will **involuntarily recoup** the funds from the provider's future payments and mail you a check.

ERRORS

Common Rejection Triggers

  • Failing to check the "California Residency" box on the Payee form.
  • Submitting a bill without proof of actual payment.
  • Missing the Itemized Billing Statement (CPT codes).
  • No signature on the Beneficiary Agreement section.
  • Filing after the 1-year/90-day deadline.
SUBMISSION

Mailing Portals

Medical / Mental / IHSS

Beneficiary Service Center P.O. Box 138008 Sacramento, CA 95813-8008

Pharmacy (Medi-Cal Rx)

Medi-Cal Rx Claims Dept. P.O. Box 610 Rancho Cordova, CA 95741-0610

RX HELPLINE: 1-800-977-2273

DENTAL CLAIMS: Use a separate address. Call the BSC at (916) 403-2007 to verify the current dental mailing portal before sending documents.