MIA Claims

The MIA program funds:

• Inpatient specialty physician care (excluding psychiatry)
• Authorized ER physician care (authorization may be required)
• Inpatient and outpatient hospital facility services 
• Outpatient specialty and ancillary care for many specialties not available in our Health Care Centers:
  • authorized office visits
  • dental extractions for abscessed teeth
  • limited durable medical equipment
  • limited vision care
  • limited orthotics and prosthetics
  • limited physical therapy
  • limited home health services
  • emergent outside pharmacy prescriptions during non-working hours or weekends

Requirements:

• Claims are required to be submitted according to Medi-Cal guidelines and time frames.
• The client must be MIA eligible during the time period the service was provided
• Claims for elective services must have an authorized MIA referral which has been approved by the patient’s SBC Health Care Center Primary Care Provider