Instructions for Form DHS3092 Medi-Cal Supplemental Cost Report - California

This document contains official instructions for Form DHS3092 , Medi-Cal Supplemental Cost Report - a form released and collected by the California Department of Health Care Services.

FAQ

Q: What is Form DHS3092?
A: Form DHS3092 is the Medi-Cal Supplemental Cost Report for California.

Q: Who should use Form DHS3092?
A: This form should be used by medical providers in California who provide services under the Medi-Cal program.

Q: What is the purpose of Form DHS3092?
A: The purpose of Form DHS3092 is to document the costs incurred by medical providers and submit them to the California Department of Health Care Services.

Q: When should Form DHS3092 be filed?
A: Form DHS3092 should be filed annually, within 120 days after the close of the provider's fiscal year.

Q: What information is required on Form DHS3092?
A: Form DHS3092 requires information about the provider's financial statements, costs, revenues, and other relevant financial data.

Q: Is there a deadline for filing Form DHS3092?
A: Yes, Form DHS3092 must be filed within 120 days after the close of the provider's fiscal year.

Q: What happens if Form DHS3092 is not filed on time?
A: Failure to file Form DHS3092 on time may result in penalties or the loss of reimbursement for Medi-Cal services.