To file a claim, you must submit a Medi-Cal Claim Form for Beneficiary Reimbursement. • The claim form must be filled out in blue or black ink;.Subrogation is an arrangement between insurance companies to prevent insured parties from receiving double compensation. The claim forms that providers use to bill Medi-Cal are listed below. Subrogation in California can apply anytime an insurance carrier makes payments to an individual who is not primarily at fault for an accident. Subrogation is the legal process through which an insurance company steps into the place of the insured and recovers costs from a third party. Insurance companies can utilize this letter template to seek reimbursement from the person or entity legally responsible for a loss. It's the process where an insurance company steps into your shoes to recover funds from the party responsible for your injury. In California, Sections 3850 through 3865 of the Labor Code govern workers' compensation related subrogation claims. Providers: Learn about Health Net claim procedures for Commercial, MediCal, Medicare, Salud con Health Net and more.