Medi-Cal Billing and Administration

End-to-end billing and contracting solutions that help Medi-Cal providers navigate compliance requirements, secure reimbursement, and sustain high-quality care.

Heluna Health’s Provider All-Inclusive Income Delivery (PAID) program delivers comprehensive billing, contracting, credentialing, and implementation support to community-based organizations and independent providers participating in Medi-Cal. We partner with organizations navigating Medi-Cal expansion to build compliant, sustainable reimbursement infrastructure that strengthens financial stability and program readiness. Currently serving doulas, community health workers, and Enhanced Care Management programs across California, our team helps providers focus on delivering high-quality care while we manage the administrative complexity behind the scenes.

Community Translational Research Institute (CTRI)

A Case Study

Since 2025, Community Translational Research Institute (CTRI) has partnered with Heluna Health’s Provider All-Inclusive Income Delivery (PAID) program to deliver Medi-Cal Enhanced Care Management (ECM) services. As a benefit under California’s CalAIM initiative, ECM centers whole-person care by providing personalized, community-based care management to Medi-Cal members with complex health and social needs. Through this partnership, CTRI has built the contracting, billing, and operational infrastructure required to successfully launch and sustain ECM services, supporting more than 125 adults and youth in the Inland Empire and strengthening access to coordinated care for high-risk communities.

Services

Medi-Cal Contracting

Secure and manage contracts with the California Department of Health Care Services (DHCS) and managed care plans on behalf of our partners to establish compliant, sustainable reimbursement pathways.

Comprehensive Billing

Ensure accurate, timely claims submission and reimbursement through expert billing management tailored to Medi-Cal requirements.

Credentialing

Navigate Medi-Cal provider credentialing with DHCS and managed care plans to meet regulatory standards and maintain compliance.

Administration and Operations

Strengthen Medi-Cal program delivery with administrative and operational support, including access to HIPAA-compliant electronic health records (EHR) and case management systems built to support provider reporting and billing needs.

Testimonial

“As we worked to establish the Vital Space Center and implement Enhanced Care Management (ECM) and Community Health Worker (CHW) services in Riverside and San Bernardino, Heluna Health stood beside us at every stage. Their guidance—from research grant development and fiscal management to launching new programs such as our HRSA support for innovations in the mental health workforce - has been invaluable, making it possible to focus on our twin missions of serving our communities optimally while advancing the science of health promotion and disease prevention.”
Dr. Aparna Jain, MBBS, MD, MPH
Community Engagement and Screening Task Force Lead, CTRI

Medi-Cal Billing Team

Payshia Edwards-Smith, MPH, Doula, CLES

Director of Health-Related Social Needs Initiatives

Elizabeth Suarez, CPC

Billing and Coding Manager

Interested? Get in Touch With Our Team

Contact us to discuss how Heluna Health can support your organization’s specific needs.

(800) 201-7320 | hello@helunahealth.org

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