1 Policy Changes Working to protect, preserve, and promote the health and safety of the people of Michigan by listening, communicating, and educating our providers, in order to effectively resolve issues and enable providers to find solutions within our industry. We are committed to establish customer trust and value by providing a quality experience the first time, every time. -Provider Relations
2 Agenda Welcome! Policy Updates Spend Down Top 10 Denials New Document Management Portal (DMP) Resources
3 POLICY HIGHLIGHTS
4 Policy Highlights New 2014 Policy Changes. Find all Proposed Policy and final Policy on website at and selecting Policy and Forms. Proposed Policy open for Public Comment for 30 days.
5 MSA & MSA Modified Adjusted Gross Income Effective 10/01/13. Eligibility determination through DHS for Medicaid is based on Modified Adjusted Gross Income (MAGI) methodology. The MAGI method will be used to determine eligibility for all Temporary Assistance for Needy Families (TANF) related Medicaid categories; it excludes SSI-related categories (Aged, Blind, or Disabled). The MAGI methodology was implemented October 1, 2013, and became effective for Medicaid eligibility cases on and after January 1, A document is attached to the bulletin outlining the formula.
6 MSA Ordering/Referring and Attending Provider Requirements Effective 7/1/2013. Outlined in MSA 12-55: claims for services rendered as a result of an order or referral must contain the name and individual National Provider Identifier (NPI) of the practitioner who ordered or referred the items or services. All practitioners who order/refer/attend services for Michigan Medicaid beneficiaries must be enrolled/registered in the Michigan Medicaid program. Informational edits were added 7/01/13. These edits changed to DENY as of 10/01/2013. EDIT CARC 208 RARC N286.
7 MSA Healthy Michigan Plan The Healthy Michigan Plan is a new category of eligibility authorized under the Patient Protection and Affordable Care Act and Michigan Public Act 107 of 2013 that began April 1, The Healthy Michigan Plan ensures beneficiary access to quality health care, encourages utilization of high-value services, and promotes adoption of healthy behaviors. The purpose of the bulletin is to inform providers of this new eligibility category and to provide information regarding the services available to Healthy Michigan Plan beneficiaries. Current enrolled providers are automatically active providers for the Healthy Michigan Plan.
8 Spend Down
9 Spend Down Some individuals are ineligible for MA because their countable income (after all applicable disregards) exceeds the applicable MA standard. However, they may become eligible for MA by "spending down" their excess income for eligible medical expenses. An individual that is over-income for MA, but who is otherwise eligible, may qualify for MA if allowable medical expenses exceed their spend down "deductible."
10 Spend Down (continued) Beneficiaries who exceed the income requirement must use their medical costs in order to have their monthly income at or below the allowable income limits for the month. The spend down/deductible amount is usually the amount of a beneficiary s income limit that is OVER threshold. Factors or amounts may vary county to county. The exact formula is determined by the DHS county where the beneficiary resides.
11 Spend Down Highlights Spend Down renews each month. Spend Down dollar amount may change monthly. Determining Factors: Income. Employment. Address. Others in household. Health insurance premiums or coverage changes.
12 Spend Down - Expenses Samples of Expenses: Care from: hospitals, doctors, nurses, clinics, dentists, podiatrists and chiropractors. Most medicines. Medical supplies and equipment. Transportation to and from medical care. Personal care services provided in an AFC home or home for the aged. Beneficiaries may not use costs already paid by other insurances. Beneficiaries may report older unpaid bills and new medical costs within their deductible report which is submitted to the DHS worker.
13 Spend Down Old Bills The expense was incurred one month prior to the month being tested; The expense is/was still unpaid; and Liability for the expense still exists (existed); A third party resource is not expected to pay the expense; and The expense was not previously used to establish MA income eligibility. Different programs are available for PPA with NF.
14 Spend Down - Submitting Documentation Report DHS 114A
15 Spend Down Documentation Unpaid Bills Paid receipts Other statements Superbills Statements must include: Date of service (DOS). Amount owed or paid. (continued) Name of person receiving the service.
16 County Specialist Process Beneficiary submits application to DHS for Medicaid coverage. DHS specialist establishes coverage. DHS worker sends a letter titled Deductible Notice to the beneficiary. This notice is also titled NOTICE OF CASE ACTION (DHS-1605 ). This notice includes the deductible amount and hearing rights.
18 Spend Down Process MSA-Pub. 617 is a brochure sent to beneficiaries outlining the spend down/deductible guidelines and process. It is a beneficiary s responsibility to submit required documents to the DHS caseworker. Some counties have a central location for document submission.
19 Spend Down Process (continued) The local DHS worker reviews the medical bills incurred and determines if the amount of beneficiary liability is met and the first date of Medicaid eligibility. Not all submitted documentation may be included. The DHS worker will chronologically organize dates of service. Bills for services rendered prior to the effective date of Medicaid eligibility are the beneficiary's responsibility. When a beneficiary submits bills that do not pay for the service(s), it is the responsibility of the beneficiary to make arrangements with the provider for payment.
20 Spend Down Process For the first date of eligibility, the DHS worker sends letters to providers whose services are: Entirely the beneficiary's responsibility. Partly the beneficiary's responsibility and partly Medicaid's responsibility. A letter is also sent to the beneficiary indicating which services are the beneficiary s responsibility for that first date of Medicaid eligibility.
21 Dual Coverage Beneficiary may have a MSP (Medicare Savings Plan) in addition to Spend Down. Benefit Plan assignment will be QMB until the Spend Down is met. For any Medicare non-covered service, please provide the beneficiary with proof of the incurred medical expense so this documentation can be provided to DHS as part of satisfying Spend Down. (QMB only pays Medicare Deductible/Co-insurance)
22 Billing Beneficiaries General Information for Providers Chapter Section 11
23 Non-billable Highlights When a provider accepts a Medicaid beneficiary as a patient, the beneficiary cannot be billed for: Medicaid-covered services. Providers must inform the beneficiary before the service is provided if Medicaid does not cover the service. Medicaid-covered services for which the provider has been denied payment because of: Improper billing, Failure to obtain prior authorization (PA), and/or Over filing limit (retro eligibility MSA-1038). Missed appointments. Copying of medical records for the purpose of supplying them to another health care provider.
24 Billable Highlights Copayment, PPA. The provider has been notified by DHS that the beneficiary has an obligation to pay for part or all of a service because services were applied to the beneficiary's Medicaid deductible amount. Medicaid does not cover the service. If the beneficiary requests a service not covered by Medicaid, the provider may charge the beneficiary for the service if the beneficiary is told prior to rendering the service that it is not covered by Medicaid. If the beneficiary is not informed of Medicaid non-coverage until after the services have been rendered, the provider cannot bill the beneficiary.
25 Billable Highlights (continued) Patient refuses Medicare Part A or B. Provider chooses not to accept the beneficiary as a Medicaid beneficiary and the beneficiary had prior knowledge of the situation. It is recommended that providers obtain the beneficiary's written acknowledgement of payment responsibility prior to rendering any nonauthorized or non-covered service the beneficiary elects to receive.
26 Spend Down A beneficiary is responsible for payment of expenses incurred to meet the deductible amount. Payment does not have to be made before Medicaid eligibility is approved. Providers may bill a beneficiary for services rendered after a claim rejects for lack of Medicaid eligibility. Partial deductible met. Reduce amount of providers charges by the Spend Down amounts in Form Locator 24F. Billing & Reimbursement for Professionals Section 6-Special Billing
27 Retro Eligibility May be several days through 3 months. DHS may apply old bills to the past three months or may prospectively apply them to the next several months, depending on the DOS and the date the bill was presented to the DHS worker. It is the provider's choice to bill Medicaid if the beneficiary has paid the provider for services rendered. MDCH encourages the provider to return the amount the beneficiary paid and bill Medicaid for the service. If the provider decides to bill Medicaid, the provider must return all money the beneficiary paid over and above the amount identified as the beneficiary's responsibility on the Medicaid deductible letter.*
28 Health Plan Website
29 Health Plan Website Displays the Spend Down amount in the eligibility response within the MI Health Plan Benefits page. The information is yesterday s information as the eligibility file is sent nightly from CHAMPS.
31 Top 10 Denials
32 Top 10 Denials CARC 18 RARC N30 Duplicates Utilize Claim Limit List. CARC 16 Review associated Remark Codes (RARC). CARC B5 RARC N10 Exceed Limit Utilize Claim Limit List. CARC 208 RARC N286 - NPI Not matched Referring, attending or ordering NPI not enrolled or missing on the claim.
33 Top 10 Denials (continued) CARC 24 RARC N130- Enrolled in Health Plan MA-MC click on CHAMPS ID hyperlink. CARC 31 N130 Patient not Eligible Verify eligibility for date of service (DOS). CARC 22 RARC N36 Other Insurance on File Medicaid is the payer of last resort. CARC 9 RARC N129 Diagnosis Inconsistent with Age Verify age limits on diagnosis.
34 Document Management Portal Phase 1 Claim Attachments and Consents
35 What is DMP? The Document Management Portal (DMP) provides a browser-based interface to perform various tasks pertaining to submission of documents to Michigan Medicaid. In Phase 1 implementation, DMP was integrated within CHAMPS. Users are able to access DMP functionality directly through CHAMPS interface only. DMP is authenticated via the State s Single Sign-On system (SSO).
36 What is DMP? (continued) By directly accessing the DMP, providers are able to submit Medicaid documents that may or may not be related to claims. Users accessing the DMP will be able to: Submit supporting documentation. Submit documentation for authorization and approval. Send and receive messages pertaining to submitted documents. View documents and associated correspondence history.
37 What is DMP? (continued) Directly upload documents. Create cover sheets and fax documents. Search existing uploaded documents. View document notifications within CHAMPS. Have messaging capabilities. Receive notification when documents are approved.
38 Phase I Access Points CHAMPS Provider Portal CHAMPS Direct Data Entry CHAMPS Manage/Adjust Claim
39 DMP will launch in a new window when Upload/View Documents is selected. Tabs at the top of the page are used to navigate features within DMP.
40 When DMP is launched, NPI is prepopulated. Any documents loaded in the past will be shown at the bottom. Search for documents by entering data in the search fields. If no date is entered then the last 100 documents based on upload date will display. *Tip: Search by Beneficiary ID
41 While searching by TCN, the Header TCN must be entered (must end in 000). All search filters MUST match documents in history or search will not yield any results.
42 In the above example searched by Beneficiary ID, multiple NPI s were loaded for these documents. Search results will be listed at the bottom of the screen in sortable fields. Click on the Document Title hyperlink to open the document. Click the View Message Icon to view messages associated with the document. Click the Send Message Icon to send a message regarding the document.
43 To search by Status, select from the following status indicators: Approved, Hold, Rejected, or currently in Review/Process.
44 To search the status of a Consent, filter by Beneficiary ID and drop-box menu option of Consents within Document Type.
45 Upload Documents
46 Select Document Upload from top menu bar. Guidelines for uploading documents are highlighted. Enter required information that is marked with an asterisk (*). Documents may be shared across different NPI s.
47 The example above shows 5 documents selected to upload. Filter options can be changed within each line. Document Type and Document Title can be utilized to search uploaded documents. Once the document is uploaded under a TCN, it will automatically be attached to the TCN and Beneficiary ID will populate within the screen.
48 Upload Document (continued) Only TCNs listed within CHAMPS as IN PROCESS or SUSPENDED are eligible to attach a document within DMP. A document may still be uploaded to the beneficiary ID if there is not an IN PROCESS or SUSPENDED TCN. To connect an electronic claim with documentation submitted through the DMP, for a unknown TCN, the following notation must be included in the Claim Note: Documents sent via DMP (loop 2300 NTE segment )
49 Once information is completed, select BROWSE. A file upload box will launch and allow the selection of the location where the file is stored. Select the file. The FILENAME box will prepopulate. Once file is selected, select OPEN. and SUBMIT.
50 Once document is submitted, the DMP screen will flash. Upload Successful pop up will display. Upload is complete. Click OK.
51 CHAMPS New claim submission
52 Once the necessary information is entered via direct data entry (DDE), click Submit Claim which will launch a pop-up window. The pop up window will contain a new link that states Upload Document. Select the Upload Document hyperlink to launch the DMP portal.
53 The DMP will launch in a separate window and information from the claim will be prepopulated. Changes and adding messages in an option. Documents can be updated to a TCN if IN PROCESS or SUSPENDED. Follow prior Document Upload instructions.
54 CHAMPS Claim Adjustment
55 From CLAIMS menu, select Manage Claims Select, Adjust/Void Claim Provider Enter the header TCN to be adjusted
56 Add any and all necessary changes to the claim. Select SAVE. Selecting "Save creates a new TCN. The TCN change is displayed at the top of the page. Please Note the NEW TCN. You must select SAVE for DMP to attach to the correct TCN.
57 Select the Upload/View documents button to add a document. The DMP will launch in a separate window.
58 Information from the claim in CHAMPS will be prepopulated in DMP. Verify the information is correct, and fill in remaining areas. Continue by following previous Document Upload instructions.
59 Submit Fax
60 Submit Fax A new FAX cover sheet must be created for each submitted document. Re-using the same fax cover sheet will result in the document being attached to an incorrect beneficiary and/or claim and the possibility of your claim(s) being rejected.
62 Select FAX Cover Sheet from top of DMP page.
63 Complete all information regarding the documentation and select Submit
64 An Online Fax Cover Sheet will launch in a new window. A NEW cover sheet for each documentation submission to DMP is required. A barcode is created and used to store the PHI on the previous screen. Print out FAX cover and attach to documents. Send Fax to appropriate number listed on the cover sheet. Add note to claim: Documents sent via DMP (Loop 2300 NTE segment ) Allow 1 business day for document to be attached.
66 Messaging DMP has messaging capability. Messages will be attached to the document in which they were submitted. An notification is sent when a new message arrives in the DMP message box. The notification will be sent to the address that is attached to your single sign on (SSO) login. Please add our address to your address book to avoid the defaulting to SPAM or JUNK mail.
67 Select the Messages tab at the top of the DMP Portal. Messages that are sent to a SSO login ID will be stored in this area. To view a message, select the Message indicator icon. If there is a new message in your box, DMP will generate a generic to the address attached to your Single Sign On (SSO).
68 Message notations can be reviewed. Once in the message, there is an option to Reply to sender and View the document associated with the message. Selecting Ok returns to the Messages Screen. There is a 250 Character limit.
69 CHAMPS Icons
70 New icons display in CHAMPS if there are documents or messages attached to the TCN. The note icon displays if documents are attached to the TCN. The envelope icon displays if there are messages related to the TCN. To see the documents /messages attached, select Upload/View Documents.
71 If you need additional assistance please contact Provider Support Phone:
MMBA Micki Smith 06/17/2014 Working to protect, preserve, and promote the health and safety of the people of Michigan by listening, communicating, and educating our providers, in order to effectively resolve
Add Title Document Management Portal Phase I Claim Attachments and Consents What is DMP? What is DMP? The Document Management Portal (DMP) provides a browser-based interface to perform various tasks pertaining
Medicare-Medicaid Crossover Claims FAQ Table of Contents 1. Benefits of Crossover Claims... 1 2. General Information... 1 3. Medicare Part B Professional Claims and DMERC Claims... 2 4. Professional Miscellaneous...
Add Title Electronic Services Verification Instructions Electronic Services Verification Instructions Access CHAMPS Enter Daily Tasks What to do if the Client is Not in the Home Log services for Multiple
MEDICARE CROSSOVER PROCESS FREQUENTLY ASKED QUESTIONS QUESTION 1. What is meant by the crossover payment? ANSWER When Medicaid providers submit claims to Medicare for Medicare/Medicaid beneficiaries, Medicare
Statewide Medicaid Managed Care (SMMC) Patient Responsibility and Reimbursement of Nursing Facility Services I. Overview of Patient Responsibility for Nursing Facility Services Patient responsibility is
Colorado Medical Assistance Program Web Portal Dental Claims User Guide The Dental Claim Lookup screen (Figure 1) is the main screen from which to manage Dental claims. It consists of different sections
How to Adjust ICD-9 Coded Claims to Create Test ICD-10 Coded Professional Claims Important considerations when working in the CHAMPS ICD10 Parallel/B2B test system: a) MDCH anticipates that providers using
EXPRESSPATH PROVIDER PORTAL USER GUIDE AUGUST 2013 2013-2020 Express Scripts, Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic
Colorado Medical Assistance Program Web Portal Frequently Asked Questions Trading Partner Administrator I have my HCPF Welcome Letter, and am going to be the Trading Partner Administrator. Now what? What
Introduction Eligible Professionals User Guide for the Georgia Medicaid EHR Incentive Program Version 1.0 September 5, 2011 1 Introduction Table of Contents Introduction... 3 How to apply for the Georgia
Question and Answers on Participant Liability and Co-payments 1. If a participant has private insurance as primary, and has Medicaid as secondary: a. Is the participant responsible for the private insurance
State Level Registration for Medicaid EHR Incentive Program - Hospitals - Version 1.3 10/30/14 1 Table of Contents State Level Registration... 3 Year 1 Registration... 7 Year 2 Registration... 11 Hardship
MEDICAID For SSI-related persons Comm. 28 (Rev.7/10) PRINTED ON RECYCLED PAPER Iowa Department of Human Services DHS POLICY ON NONDISCRIMINATION No person shall be discriminated against because of race,
Slide 1 - of 21 Welcome to the Medicare Secondary Payer Recovery Portal (MSPRP) Submitting Settlement Information course. As a reminder, you may view the slide number you are on by clicking on the moving
Wyoming Eligible Professional Meaningful Use Modified Stage 2 User Manual for Program Year 2015 April 2015 Version 1 Table of Contents 1 Background... 1 2 Introduction... 2 3 Eligibility... 3 3.1 Out-of-State
2013 Biller B Aware December 30, 2013: Attention ALL Providers: Due to a CHAMPS system issue, the Remittance Advice (RA) and 835 files for Pay Cycle 52 dated 12/26/2013 may not balance. MDCH will recreate
West Virginia Provider Incentive Program Eligible Provider EHR Incentive Program Application Manual Date of Publication: 08.19.11 Document Version: 1.1 DRAFT Page 1 Privacy Rules The Health Insurance Portability
Add Title Single Sign-On Registration Registration Instructions for Single Sign-On (SSO) Create SSO User ID Create SSO Password Subscribing to CHAMPS Accessing CHAMPS Step 1: Open your web browser (e.g.
LTC Monthly Claims Training How to Bill UB04 on Web Portal Statewide Medicaid Managed Care: Key Components STATEWIDE MEDICAID MANAGED CARE PROGRAM MANAGED MEDICAL ASSISTANCE PROGRAM LONG-TERM CARE PROGRAM
State Level Registration for Medicaid EHR Incentive Program - Professionals - Version 1.2 5/24/11 Page 1 of 19 Providers must register with the CMS registration and attestation system at the federal level
Optum Patient Portal 70 Royal Little Drive Providence, RI 02904 Copyright 2002-2013 Optum. All rights reserved. Updated: 3/7/13 Table of Contents 1 Patient Portal Activation...1 1.1 Pre-register a Patient...1
Precertification Status and Appeals Use the Amerigroup Provider self service website to check the status of a precertification request, submit a request for Amerigroup to change a decision we made on a
Frequently Asked Questions About Your Hospital Bills The Registration Process Why do I have to verify my address each time? Though address and telephone numbers remain constant for approximately 70% of
Collection and Viewing of Insurance Information NYEIS Third Party Insurance Targeted Resource Who can add or edit a child s insurance coverage in NYEIS? Both the child s Early Intervention Official/Designee
Updated 08/2015 Wire Transfer User Guide Wire Transfers The Wire section provides you with the ability to create one-time wires or set up template-based wires for ongoing use. Wiring Funds The tasks you
Overview Creating expense reports is one of the primary functions of Concur. This Guide provides detailed instructions on how to create and submit an expense report. Log into Concur 1. Log into Concur:
Welcome to your Kabel Benefit Accounts Consumer Portal. This one-stop portal gives you 24/7 access to view information and manage your Flexible Spending Account (FSA) & Health Reimbursement Account (HRA).
Kareo Quick Start Guide April 2012 Table of Contents 1. Get Started...1 1.1 Practice Setup... 1 1.2 Training, Help Guides and Support... 1 1.3 User Login... 1 1.4 Dashboard Navigation... 2 1.5 Record Search...
How to do a Resubmit of a paper claim using ProviderOne Changing the NPI or taxonomy code on the line level of a CMS- 1500 Professional claim format Why is this information on the line level? This issue
Sick & In Debt Handling Medical Debt 2007 CAA Forum September 7, 2007 Overview What to do when a client has a medical bill? Medi-Cal Defenses & Reimbursement Defenses for Enrollees of Managed Care Plans
A Quick Guide to Using CommonHelp Introduction CommonHelp is the Commonwealth of Virginia s fast and easy way to apply online for many Virginia social services assistance programs. Through a single online
State Level Registration for Eligible Professionals (EP) 2014 - All Program Years Medicaid Electronic Health Record (EHR) Incentive Program February 2014 (Version 3.2) 1 Table of Contents First Year Providers...
State of Iowa Iowa Medicaid Enterprise Health Information Technology and EHR Incentive Payment Program Provider Incentive Payment Program (PIPP) User Manual Full Version Version No. 1.1 Presented by: Policy
National Government Services Connex Quick Steps Table of Contents Table of Contents... 1 Detailed Setup Instructions... 3 Detailed setup instructions for new Connex users are available by going to http://www.ngsmedicare.com
Welcome to the Online Training for Playback controls are located here should you need to interrupt the demonstration. the Colorado Medical Assistance Program Web Portal Colorado Medical Assistance Program
Patient Portal: Policies and Procedures & User Reference Guide NextMD/Patient Portal Version 5.6 Page 1 of 23 6028-17MR 10/01/11 Welcome to the NextMD Patient Portal We would like to welcome you to the
TPA-Trading Partner Account User Guide for State of Idaho MMIS Date of Publication: 4/8/2016 Document Number: RF019 Version: 11.0 This document and information contains proprietary information and copyrighted
BHW Program Portal for Site Points of Contact User Guide Last Revised: June 6, 2015 1 Contents Part 1: Purpose of the BHW Program Portal for Site Points of Contact... 5 What is a Site Point of Contact?...
Maryland Electronic Health Records (EHR) Incentive Program Registration and Attestation System Provider User Guide Version 2 December 2012 Table of Contents Table of Figures... 3 Introduction... 4 Getting
MITS WEB PORTAL BILLING GUIDE FOR DENTAL CLAIMS Revised 2011.12.21 Fields marked with an asterisk (*) require an entry. Information entered into a field must be "recorded" before the system can use it.
PA OLTL Participant Directed Model of Service Web Portal Instruction Manual for Service Coordinators Customer Service Information PPL Customer Service Phone: 1 877 908 1750. PPL Fax: 1 855 858 8158 PPL
North Carolina Medicaid Electronic Health Record Incentive Program Eligible Professional Stage 1 (2014) Meaningful Use Attestation Guide NC MIPS 2.0 Issue Number 1.8 November 19, 2014 The North Carolina
10/18/2013 MEDGEN EHR Release Notes: Version 6.2 Build 106.6.20 Special Note: Comtron is excited to announce that over the next few weeks all of our Medgen products will be going through a rebranding process.
Submit Fee-for-Service Claims to Medical Assistance Receive Timely and Accurate Payments for Covered Services This Chapter shows how to: Submit claims using any of the following methods: Direct data entry
ACHieve Access 4.3 User Guide for Corporate Customers January 2015 Citizens Bank 1 February 2015 Table of Contents SECTION 1: OVERVIEW... 4 Chapter 1: Introduction... 5 How to Use This Manual... 5 Overview
How to Add or Change a Billing Agent and Other Claim Submission Options in NCTracks Overview This user guide provides step-by-step instructions for adding or changing a billing agent or making other claim
P-00358D Wisconsin Medicaid Electronic Health Record Incentive Program for Eligible Hospitals User Guide i Table of Contents 1 Introduction... 1 2 Before You Begin... 2 2.1 Register with Centers for Medicare
Beginning Billing Workshop Secure Web Portal 837P Colorado Medicaid 2016 Centers for Medicare & Medicaid Services Medicaid Medicaid/CHP+ Medical Providers Xerox State Healthcare Training Objectives Web
Online Services through My Direct Care www.mydirectcare.com WEB PORTAL Employers and Employees associated with Consumer Direct have access to online services available through a secure website www.mydirectcare.com.
The Chicago HIT Regional Extension Center Bringing Chicago together through health IT The Illinois HIT Regional Extension Center Your bridge to health IT < INSERT PICTURE > Illinois Medicaid EHR Incentive
Maryland Electronic Health Records (EHR) Incentive Program Registration and Attestation System Provider User Guide Version 3 January 2014 Table of Contents Table of Figures... 3 Introduction... 4 Getting
Top 50 Billing Error Reason Codes With Common Resolutions (09-12) On the following table you will find the top 50 Error Reason Codes with Common Resolutions for denied claims at Virginia Medicaid. This
Document ID:HPCI-OF01-002E-02 HPCI Help Desk System User Manual Ver. 2 2013/09/30 HPCI Operating Office Revision History Date issued Ver. Descriptions 2012/3/30 1 2013/9/30 2 A full-fledged revision is
Compensation and Claims Processing Compensation The network rate for eligible outpatient visits is reimbursed to you at the lesser of (1) your customary charge, less any applicable co-payments, coinsurance
HSA EMPLOYER RESOURCE GUIDE Fifth Third Bank Health Savings Account Revision 3 CONTENTS Welcome... 3 About Your HSA... 4 Benefits to You... 4 Benefits to Your Employees... 4 Your HSA Implementation Checklist...
NC Medicaid EHR Incentive Program North Carolina Medicaid Electronic Health Record Incentive Program Eligible Professional Stage 1 Meaningful Use Attestation Guide NC-MIPS 2.0 Issue Number 1.6 February
MAWD or Marketplace? What Pennsylvanians with Disabilities Need to Know About Choosing Health Insurance Coverage Summary Choosing health insurance coverage that best meets one s needs is important, especially
Instructions for using Eastpointe s Electronic Systems (Waiver Version) Updated 11/05/2012 Instruction Manual on the MCO and Service Provider Electronic System Processes Eastpointe - 1 - Contents ProviderConnect
West Virginia Electronic Health Record Provider Incentive Program - Hospital West Virginia Electronic Health Records (EHR) Provider Incentive Program (PIP) For Eligible Hospitals Attestation Guide Date
Mimecast Services for Outlook (MSO4) End User Quick Start Guide for Outlook 2010/2013 Mimecast Services for Outlook (MSO 4) is a software application that integrates with your Microsoft Outlook. Once installed,
Frequently Asked Questions: Medicare Savings Programs Q. What are the Medicare Savings Programs (MSP)? A. The MSP helps to pay some of the out-of-pocket costs of Medicare. There are three levels of the
Welcome to SharpConnect User Guide for Sharp Health Plan Brokers Version 1.1 www.sharphealthplan.com SharpConnect User Guide for Brokers page 1 TABLE OF CONTENTS Page I. Introduction to SharpConnect...
Frequently Asked Questions Patient Threshold Questions Q: If Medicaid is the secondary insurance, can it be included when computing Medicaid Patient Volume Threshold? A: Yes, as long Medicaid (including
Washington State Medicaid EHR Incentive Program (emipp) Eligible Professional (EP) Training Guide for Meaningful Use July 15, 2013 Table of Contents 1 Purpose and Scope 2 1.1 Purpose.. 2 1.2 Scope... 2
UCB erequest - CONTENTS 1 INTRODUCTION... 3 2 HOW TO REGISTER AND LOG-IN... 3 2.1 REGISTER TO RECEIVE AN EXTERNAL REQUESTOR USER ID AND PASSWORD... 3 2.2 LOGIN WITH USER ID AND PASSWORD... 5 3 HOW TO SUBMIT
Online School Payments (OSP) User Guide February, 2014 OSP User Guide Table of Contents Overview...3 Site Information...3 Login to Portal...4 Activity Setup...6 OSP Activity Setup Form...6 Add Activity...7
Extra Help Do you have Medicare? Do you live on a limited income? Do you need help to pay for your prescriptions? Extra Help If so you may qualify for the Medicare Low Income Subsidy (LIS) Program also
Medicaid Basics and Indiana Health Coverage Programs (IHCPs) Module #2 Training Resource for Indiana Navigators 2 Module #2 Objectives After reviewing this module, you will be able to: Assess whether someone
0372 SPECIAL TREATMENT COVER GROUPS 0372.05 MEDICARE PREMIUM PAYMENT PROGRAM REV:01/2014 A. Medicare is the federal health insurance to which individuals who are insured under the Social Security system
Handbook for Home Health Agencies Chapter R-200 Policy and Procedures For Home Health Agencies Illinois Department of Public Aid CHAPTER R-200 Home Health Agency Services TABLE OF CONTENTS FOREWORD R-200
The Property Insurance Clearinghouse is an automated, real-time tool that is able to provide you and your customers with access to a growing number of participating private-market companies currently writing
ValueOptions Provider Guide to using Direct Claim Submission www.valueoptions.com Table of Contents Introduction 1 Submitting a New Claim 3 Searching for Claims 9 Changing or Re-processing a claim 13 Submitting
Illinois Mental Health Collaborative Provider Guide to Using Direct Claim Submission www.illinoismentalhealthcollaborative.com Direct Claim Submission allows the provider/submitter to enter claims directly
get the most out of the availity web portal Quick reference guide Availity s Web Portal gives you the tools you need to drive measurable and meaningful organizational improvements, to enjoy the vitality
Electronic Payments & Statements (EPS) Frequently Asked Questions (FAQs) Note: EPS features contained within these FAQs may not be applicable to all Payers. General Questions 1. What is Electronic Payments
Understanding Insurance and Our Billing Process Thank you for choosing Cleveland Clinic for your healthcare needs. We appreciate the confidence you have placed in us. The purpose of this brochure is to
Compensation and Claims Processing Compensation The network rate for eligible outpatient visits is reimbursed to you at the lesser of (1) your customary charge, less any applicable co-payments, coinsurance
AvMed s Physician-to- Physician Referral Program Quick Reference Guide For Primary Care Physicians 1 P age Introduction Primary Care Physicians (PCPs) play a critical role in the health of our Medicare
RockendSMS Enhanced Integration SMS for REST Professional RockendSMS has newly designed and developed an upgrade to the way you send SMS through REST Professional V14 and above (RockendSMS Enhanced Integration).
CHAPTER 9 THIRD PARTY LIABILITY AND COORDINATION OF BENEFITS 9.0 -THIRD PARTY LIABILITY AND COORDINATION OF BENEFITS DETERMINING OTHER HEALTH INSURANCE COVERAGE Behavioral health/integrated care providers