How To Become A Health Care Provider
|
|
- Annabelle Bradford
- 3 years ago
- Views:
Transcription
1 Institutional: Code Description 0A 0B 0C 0D 0E 0F 0G 0H 0I 0J 0K 0L 0M 0N 0O 0P 0Q 0R 0S 0T 0U 0V 0W 0X 0Y 0Z FE FR IH LT OF PF Intern/Residency Hospital Plan Intern/Residency Uniform Pre-Payment (U.P.P.) Freestanding Dialysis Coordinated Home Care Plan Hospital Uniform Pre-Payment (U.P.P.) Hospital Freestanding Surgicenter State Hospital Foreign Hospital (outside of U.S.A) Christian Science Sanitarium Freestanding Physical Therapy Center Freestanding Alcohol & Substance Abuse Treatment Center Alcohol & Substance Abuse - Outpatient Only Non-Plan Provider Extended Care Facility Out-of-State Plan Hospital Medicare Approved Extended Care Facility (ECF) Ambulance Hospice (Plan) Medicare Approved Home Heath Service (Coordinated Home Care) Medicare Approved Freestanding Dialysis Center State Licensed Ambulatory Surgicenter JCAH Approved Extended Care Facility (ECF) JCAH Approved Alcohol Rehabilitation (Inpatient & Outpatient) Nursing Home Contracted Provider Affiliation Free Standing ER Free Standing Rehab Inpatient Hospital Psych Long Term Acute Care Occupational Therapy Facility Physical Therapy Facility Page 1 of 5
2 RH SF ST TH TI TJ T1 T2 T5 Rural Health Provider Skilled Nursing Facility Speech Therapy Facility Birthing Center Psychiatric/Partial Day Hospital Rehabilitation Hospital Non-Member Hospital Government Hospital Renal Dialysis Non-Contracting Professional: A0 Chiropractor D.C. A1 Regular Medical Doctor, Medical Genetics (Ind) M.D. A2 Podiatrist D.P.M., D.S.C. A3 Dentist D.D.S., D.M.D. A4 Radiology Technician, Laboratory Technician, Bacteriologist/Microbiologist -- A5 Group Medical Practice, Clinic or Mixed Therapy Group, Medical Genetics (Grp) -- A6 Osteopath, Medical Genetics (Ind) D.O. A7 Physical Therapist R.P.T A8 Clinical Psychologist or Neuropsychologist Ph.D. A9 Registered Nurse R.N. AB Hospital Based Physician, Medical Genetics (Ind) -- AC Ambulance Service -- AD Prosthetic-Orthotic Devices -- AE Durable Medical Equipment -- AF Optometrist O.D. AG Optician -- AH Hearing Aid Supplier -- AI Audiologist -- AJ Christian Science Healer -- AK Paramedic -- AL Clinical Social Worker or Licensed Clinical Social Worker C.S.W, L.C.S.W AM Pharmacist -- AN Home Health Agency H.H.A. AP Pastoral Counselor -- AQ Registered Dietician -- AR Licensed Physician Assistant L.P.A. AS Occupational Therapist O.T, O.T.R. AT Speech Therapist S.T., R.S.T., S.L.P., S.P.T. AU Dental Group D.D.S., D.M.D. Page 2 of 5
3 AV Podiatry Group -- AW Clinical Psychiatry Group or Neuropsychologist Group -- AX Registered Nurse Group R.N. AY Chiropractic Group D.C. AZ Osteopath Group D.O. B0 Naprapath Individual D.N. B1 License Clinical Professional Counselor L.C.P.C. B2 Acupuncturist (Individual) L.Ac. B3 Home Infusion Therapist Group -- B4 Massage Therapist -- B5 License Clinical Professional Counselor Group L.C.P.C. B6 Licensed Clinical Social Worker Group L.C.S.W. B7 Physical Therapy Group P.T., R.P.T., L.P.T. B8 Rural Health Clinic -- B9 Advanced/Registered Nurse Practitioner R.N.P. BA Licensed Marriage & Family Therapist L.M.F.T. BB Hospital Based Physician Group, Medical Genetics (Grp) -- BC Registered Nurse First Assistant -- BD Prosthetic Orthotic Group -- BE Surgical Assistant -- BF Optometrist Group O.D. BG Optician Group -- BI Audiologist Group -- BL Certified Registered Nurse Anesthetist C.R.N.A. BM Skilled Nurse/Home Health Aide/Durable Medical Equipment (DME) Therapy Group -- BN Skilled Nurse Therapist Group -- BP Specialty Pharmacy -- BQ Nutritionist/Dietician Group -- BR Licensed Physician Assistant Group L.P.A. BS Occupational Therapist Group O.T., R.O.T., O.T.R. BT Speech Therapist Group S.T., R.S.T., S.L.P. BU Mixed Therapy Occupational Physical Speech BV Certified Diabetes Educator -- BW Licensed Midwife -- BX Certified Nurse Specialist/Individual C.N.S. BY Naprapath Group D.N. CA Licensed Marriage & Family Therapist Group L.M.F.T. CB Imaging Center CC Registered Nurse First Assistant Group -- CD Certified Nurse Practitioner/Individual C.N.P. CE Surgical Assistant Group -- CH Doctor of Oriental Medicine Group -- CI Early Intervention Specialist Individual CG Early Intervention Specialist Group CP Certified Nurse Practitioner C.N.P. CV Certified Diabetes Educator Group -- Page 3 of 5
4 CW Licensed Midwife Group -- CX Certified Nurse Specialist/Group C.N.S. C0 Licensed Clinical Social Worker Group, Licensed Clinical Professional Counselor Group L.C.S.W., L.C.P.C. C2 Acupuncture Group -- C4 Massage Therapist Group -- C9 Advance/Registered Nurse Practitioner Group R.N.P. DA License Genetic Counselor (Individual) DD Certified Nurse Practitioner Group C.N.P. DP Certified Nurse Practitioner Group C.N.P. DW Certified Nurse Midwife Individual C.N.M D4 License Genetic Counselor Group D6 Behavioral Health Mixed Specialty Group D7 Telemedicine Group D8 Licensed Social Worker Individual D9 Dietitian Individual E1 Lactation Consultant Individual E2 Lactation Consultation Group E3 Physical Therapy Assistant - Individual PTA E4 Occupational Therapy Assistant - Individual OTA E5 Speech Therapy Assistant - Individual SLPA EW Certified Nurse Midwife Group C.N.M F1 Federally Qualified Health Center (FQHC) F2 Family Planning F4 Immunization Clinic Pharmacy FW Licensed Practical Nurse L.P.N IC Immunization Clinic ID Independent Diagnostic Testing Facility IR Immediate Care Centers IS Ambulatory Infusion Suites HA Board Certified Behavioral Analyst Individual HB Assistant Behavioral Analyst Group HC Doctorial Behavioral Analyst Group HD Doctorial Behavioral Analyst Individual HG Board Certified Behavioral Analyst Group HP Hospitalist Individual HS Assistant Behavioral Analyst Individual PD Cardio Pulmonary Diagnostic Testing PH Pharmacist RT Respiratory Therapist Individual SI Free Standing Imaging Center SL Sleep Lab SS Home Sleep Study TA Advanced Nurse Practitioner R.N.P. TB Licensed Practical Nurse Group L.P.N TC Licensed Professional Counselor L.P.C. TD Residential Treatment/Crisis Stabilization Center -- Page 4 of 5
5 TE Home Infusion Therapist -- TF Licensed Chemical & Dependency Counselor -- TG Athletic Trainers Group TK Athletic Trainer (Individual) T4 Licensed Marriage & Family Therapist L.M.F.T. T6 Disease Management/Education -- T7 Licensed Psychological Associates -- T8 Certified Registered Nurse Anesthetist C.R.N.A. T9 Certified Registered Nurse Anesthetist Group C.R.N.A. WS Wellness Screening YZ Foreign Provider (Outside U.S.A.) -- ZZ Technologist Technician -- Page 5 of 5
Chapter 5. Credentialing
Chapter 5 Credentialing Overview This chapter describes the South Country Health Alliance (South Country) Credentialing Program. Practitioner Credentialing Credentialing is the process used to determine
More informationCHAPTER 600 PROVIDER QUALIFICATIONS AND PROVIDER REQUIREMENTS 600 CHAPTER OVERVIEW... 600-1 610 AHCCCS PROVIDER QUALIFICATIONS...
600 CHAPTER OVERVIEW... 600-1 REFERENCES... 600-2 610 AHCCCS PROVIDER QUALIFICATIONS... 610-1 EXHIBIT 610-1 AHCCCS PROVIDER TYPES 620 AHCCCS FFS MINIMUM NETWORK REQUIREMENTS... 620-1 630 MEDICAL RECORD
More informationChapter 5. Credentialing
Chapter 5 Credentialing Overview This chapter describes the South Country Health Alliance (South Country) Credentialing Program. Organizational Assessments South Country maintains contracts with Organizational
More information4123-6-02.2 Provider access to the HPP - provider credentialing criteria.
4123-6-02.2 Provider access to the HPP - provider credentialing criteria. (A) The bureau shall establish minimum credentialing criteria for provider certification. Providers must meet all licensing, certification,
More informationLicensed Counselors (LPCC)
CREDENTIALING Molina Healthcare of Ohio s credentialing process is designed to meet the standards of the National Committee for Quality Assurance (NCQA). In accordance with those standards, Molina Healthcare
More informationDHL EXPRESS CANADA E-BILL STANDARD SPECIFICATIONS
DHL EXPRESS CANADA E-BILL STANDARD SPECIFICATIONS 1 E-Bill Standard Layout A B C D E F G Field/ DHL Account Number Billing Customer Name Billing Customer Address Billing Customer City Billing Customer
More informationAcceptance Page 2. Revision History 3. Introduction 14. Control Categories 15. Scope 15. General Requirements 15
Acceptance Page 2 Revision History 3 Introduction 14 Control Categories 15 Scope 15 General Requirements 15 Control Category: 0.0 Information Security Management Program 17 Objective Name: 0.01 Information
More informationForwardHealth-Required Taxonomy Codes
ForwardHealth-Required s Provider Type Ambulance Air Ambulance 3416A0800X Air Transport Ambulance Land Ambulance 3416L0300X Land Transport Federally Qualified Health Ambulance Water Ambulance 3416S0300X
More informationICD-10 Implementation Billing Guide
ICD-10 BILLING INSTRUCTIONS: SERVICES Split Claims s who submit claims for the following services are required to split the claim so that claims for dates of service through September 30, 2015, contain
More informationCYE09 RFP Minimum Network Standards Excel Spreadsheet Instructions
TABLE of CONTENTS CYE09 RFP Minimum Network Standards Excel Spreadsheet Instructions Definition of Terms... Introduction/Overview... Attachment 1 Provider Types Requiring NPI.... Attachment 2 Service Provider
More informationCigna Supported Service Types for Eligibility and Benefit Inquiries
This document lists the service type codes that can be submitted to Cigna on an eligibility and benefit inquiry transaction. If a service type code not included on this list is submitted, Cigna's general
More informationTYPE AND SPECIALTY LIST AND DOCUMENTATION REQUIREMENTS FOR PROVIDER PARTICIPATION AGREEMENTS
New Mexico Medicaid Project 1720-A Randolph Road SE Albuquerque, NM 87106 505-246-9988 505-246-8485 (fax) TYPE AND SPECIALTY LIST AND DOCUMENTATION REQUIREMENTS FOR PROVIDER PARTICIPATION AGREEMENTS Please
More informationHOUSE OF REPRESENTATIVES FINAL BILL ANALYSIS SUMMARY ANALYSIS
HOUSE OF REPRESENTATIVES FINAL BILL ANALYSIS BILL #: CS/HB 639 FINAL HOUSE FLOOR ACTION: SPONSOR(S): Health Quality Subcommittee; Harrell and others 117 Y s 0 N s COMPANION BILLS: (SB 604) GOVERNOR S ACTION:
More informationStaffingForce direct and interim staffing services are available throughout the U.S. and in 45 other countries on six continents.
StaffingForce Healthcare Solutions Our search, recruitment and staffing services are specifically designed to reduce your cost per hire while expediting the time it takes to fill your direct and interim
More informationOregon Health Care Regulatory Agencies
Citizen s Guide to Oregon Health Care Regulatory Agencies Prepared by: Oregon State Board of Nursing This is a guide to Oregon health care regulatory agencies. The boards and agencies listed here protect
More informationCMS SPECIALTY CODES/HEALTHCARE PROVIDER TAXONOMY CROSSWALK. This table reflects Medicare Specialty Codes as of April 1, 2003.
CMS SPECIALTY CODE CMS SPECIALTY CODES/HEALTHCARE PROVIDER TAXONOMY CROSSWALK This table reflects Medicare Specialty Codes as of April 1, 2003. This table reflects Healthcare Provider Taxonomy Codes (HPTC)
More informationFuture Trends in Airline Pricing, Yield. March 13, 2013
Future Trends in Airline Pricing, Yield Management, &AncillaryFees March 13, 2013 THE OPPORTUNITY IS NOW FOR CORPORATE TRAVEL MANAGEMENT BUT FIRST: YOU HAVE TO KNOCK DOWN BARRIERS! but it won t hurt much!
More informationPROVIDER TYPE CODE DESCRIPTION OF PROVIDER TYPE SPECIALITY CODE DESCRIPTION OF PROVIDER SPECIALITY 01 INPATIENT FACILITY 010 ACUTE CARE HOSPITAL 01
PROVIDER TYPE CODE DESCRIPTION OF PROVIDER TYPE SPECIALITY CODE DESCRIPTION OF PROVIDER SPECIALITY 01 INPATIENT FACILITY 010 ACUTE CARE HOSPITAL 01 011 PRIVATE PSYCHIATRIC HOSPITAL 01 012 INPATIENT MEDICAL
More informationFacility Classification
Facility Classification Facility Enrollment Required Document Checklist To avoid processing delays gather these items before you get started. If applying to network, complete the application signature
More informationCMS SPECIALTY CODES/HEALTHCARE PROVIDER TAXONOMY CROSSWALK
CMS SPECIALTY CODES/HEALTHCARE PROVIDER TAXONOMY CROSSWALK This document walks the CMS Medicare specialty codes to the taxonomy codes currently maintained by the Washington Publishing Company as mandated
More informationAN ACT RELATING TO HEALTH INSURANCE; AMENDING A SECTION OF THE NEW MEXICO INSURANCE CODE TO PROVIDE FOR FREEDOM OF CHOICE OF
AN ACT RELATING TO HEALTH INSURANCE; AMENDING A SECTION OF THE NEW MEXICO INSURANCE CODE TO PROVIDE FOR FREEDOM OF CHOICE OF HOSPITAL AND PRACTITIONER TO INCLUDE LICENSED PROFESSIONAL MENTAL HEALTH COUNSELORS
More informationREFERENCE ACTION ANALYST STAFF DIRECTOR or BUDGET/POLICY CHIEF. 2) Health & Human Services Committee 14 Y, 0 N Holt Calamas
HOUSE OF REPRESENTATIVES STAFF ANALYSIS BILL #: CS/HB 349 Treatment Programs for Impaired Professionals SPONSOR(S): Health Quality Subcommittee; Renuart TIED BILLS: IDEN./SIM. BILLS: REFERENCE ACTION ANALYST
More informationINTRODUCTION. The Workers Compensation Act provides in part as follows:
INTRODUCTION The Maryland Workers Compensation Commission (Commission) amended COMAR 14.09.03.01 (Guide of Medical and Surgical Fees) on February 12, 2004. AUTHORITY The Workers Compensation Act provides
More informationFacility Enrollment Required Document Checklist
Facility Enrollment Required Document Checklist Facility Classification Ambulatory Infusion Center (AIC) Ambulatory Surgical Facility (ASF) End Stage Renal Disease Facility (ESRD) - Accreditation Commission
More informationBusiness-Facts: Healthcare NAICS Summary 2015
Business-Facts: Healthcare Summary 5 Radius : 9444 WAPLES ST, SAN DIEGO, CA 9-99,. -. Miles, 6 Healthcare and Social Assistance 8,694 59.9 6 Offices of Physicians (except Mental Health Specialists) 56
More informationHealth Care Employment Projections:
Health Care Employment Projections: An Analysis of Bureau of Labor Statistics Settings and Occupational Projections, 2012-2022 May 2014 The Center for Health Care Workforce Studies School of Public Health,
More informationDC Health Professional Licensing Fees
Profession Description of Service Fees Acupuncturist Application Fee (original, temporary, or reinstatement) 85 Acupuncturist License Fee 145 Acupuncturist Re-Examination 119 Acupuncturist Paid Inactive
More informationSubtitle 09 WORKERS' COMPENSATION COMMISSION. 14.09.03 Guide of Medical and Surgical Fees
Subtitle 09 WORKERS' COMPENSATION COMMISSION 14.09.03 Guide of Medical and Surgical Fees Authority: Labor and Employment Article, 9-309, 9-663 and 9-731, Annotated Code of Maryland Notice of Proposed Action
More informationVictims Compensation Claim Status of All Pending Claims and Claims Decided Within the Last Three Years
Claim#:021914-174 Initials: J.T. Last4SSN: 6996 DOB: 5/3/1970 Crime Date: 4/30/2013 Status: Claim is currently under review. Decision expected within 7 days Claim#:041715-334 Initials: M.S. Last4SSN: 2957
More informationIHS/638 Facility FAQ s
Q: Who determines the provider type? Does this happen during provider Registration? A: The Provider Registration production staff determined the provider type based on the licenses and the information
More informationTaxonomy Code Mapping Professional Providers
Mapping Professional s Adult Care Nurse Adult Psychiatric Mental Health Nursing 363LA2200X 364SP0809X Adult Health Practice Nursing s Clinical Nurse Specialist Adult Psychiatric/Mental Health Allergy and
More informationBenefit Plan Comparison*
Benefit Plan Comparison* Services Category 1: Ambulatory Services Primary Care Provider No Limits No Limits No Limits Physician Office 4 visits per calendar year Certified Registered Nurse Practitioner
More informationVehicle Identification Numbering System 00.03
Vehicle Identification Numbering System 00.03 IMPORTANT: See Subject 050 for the vehicle identification numbering system for vehicles built before May 1, 2000. Federal Motor Vehicle Safety Standard 115
More informationTaxonomy Code Mapping Professional Providers
Professional s Adult Care Nurse Adult Psychiatric Mental Health Nursing 363LA2200X 364SP0809X Adult Health Nursing s Clinical Nurse Specialist Adult Psychiatric/Mental Health Allergy and Immunology 207K00000X
More informationBenefit Plan Comparison*
Benefit Plan Comparison* Services Category 1: Ambulatory Services Primary Care Provider Physician Office Certified Registered Nurse Practitioner Federally Qualified Health Center/Rural Health Clinic except
More informationEXHIBIT 1 ACTIVELY RECRUITED POSITIONS LIST (Final 12/09/15)
EXHIBIT 1 ACTIVELY RECRUITED POSITIONS LIST (Final 12/09/15) 340B Program Analyst 340B Program Manager Administrative Analyst V Administrative Director ADMINISTRATIVE DIRECTOR-DEPT OF RADIOLOGY Administrator
More informationStudent Medical Malpractice and Student Intern
Student Medical Malpractice and Student Intern Health Specialty Allied Health Care Worker Alcohol and Drug Counseling Anesthesia Tech Art Therapist Athletic Trainer Audiologist BAS Basic Patient Care Biologist
More informationHEALTH PROFESSIONS: CONSEQUENCES OF DUI PROSECUTION & CONVICTION
Health Professionals: Certified or licensed pursuant to chapter 7, 8, 11, 13, 14, 15, 15.1, 16, 17, 18, 19, 19.1, 21, 25, 28, 29, 33, 34, 35, 39, 41 or 42 of this & title 36, chapter 17 1 Acupuncturist
More informationOnline Directory Assistance
P ROVI DR SCARE R Online Directory Assistance 1102 S Hillside Wichita KS 67211 Toll Free (800) 801-9772 Local (316) 683-4111 Fax (316) 683-6255 CustomerService@ProviDRsCare.Net Online Directory http://www.providrscare.net
More informationMedicaid 101. The basics of publicly funded healthcare.
Medicaid 101 The basics of publicly funded healthcare. Medicare Vs Medicaid Medicare: Over 65, or Disabled Federally Managed program Medicaid Resource & Need Based State Federal Partnership Social Security
More informationCovered Service Description
Advanced registered nurse practitioner (ARNP) Ambulatory surgical center (ASC) These are given by an ARNP who s licensed to practice in the State of Florida The ARNP and a doctor must make decisions about
More informationTechnical Appendices. California s Health Workforce Needs: Training Allied Workers. Contents. Shannon McConville, Sarah Bohn, and Laurel Beck
California s Health Workforce Needs: Training Allied Workers Technical Appendices Contents Appendix A: Health Workforce Occupational Groupings and Projections Appendix B: Health Program Groupings at California
More informationPreauthorization Requirements * (as of January 1, 2016)
OFFICE VISITS Primary Care Office Visits Primary Care Home Visits Specialist Office Visits No Specialist Home Visits PREVENTIVE CARE Well Child Visits and Immunizations Adult Annual Physical Examinations
More informationBenefit Plan Comparison* Services Category 1: Ambulatory Services Primary Care Provider Physician Office Certified Registered Nurse Practitioner Federally Qualified Health Center/Rural Health Clinic except
More informationMental and Behavioral Health Workforce in Nevada
Mental and Behavioral Health Workforce in Nevada Tabor Griswold, PhD Health Services Research Analyst Office of Statewide Initiatives University of Nevada School of Medicine January 7, 2015 Section 1:
More informationIHCP Provider Enrollment Provider Type and Specialty Matrix
Type and Specialty Matrix Specialty Codes In-State Out-of-State (OOS) 01 Hospital 010 Acute Care 011 Psychiatric (distinct part or unit) 012 Rehabilitation (distinct part or unit) 01 Hospital 011 Psychiatric
More informationHealth Care Employment Projections:
Health Care Employment Projections: An Analysis of Bureau of Labor Statistics Occupational Projections 2010-2020 March 2012 The Center for Health Workforce Studies School of Public Health, University at
More informationDEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION PROFESSION PAGE PROFESSION PAGE Barber 04 Facialist 04 Cosmetologist 04 Nail Technician 04
Preface Persons working in the healthcare industry must be knowledgeable about difficult and complex HIV/AIDS issues. It is vital that they have access to up-to-date information on legal and patient care
More informationCERRITOS COLLEGE. Career Pathways in Health & Health- Related Fields. Rocio Casillas Counselor
CERRITOS COLLEGE Career Pathways in Health & Health- Related Fields Rocio Casillas Counselor Educational Options Certificate of Achievement Medical Assistant, Pharmacy Technician, Pharmacy Clerk, Dental
More informationProvider Qualifications & Requirements
Nth Carolina Medicaid Management As of May 22, 2012 Infmation System (MMIS) Provider Type In-State Bder Out-of-State** Adult Care Home Ambulance Service Licensed by NC DHSR as a Family Care Home Home f
More informationChapter 5. Billing on the CMS 1500 Claim Form
Chapter 5 Billing on the CMS 1500 Claim Form This Page Intentionally Left Blank Fee-For-Service Provider Manual April 2012 Billing on the UB-04 Claim Form Chapter: 5 Page: 5-2 INTRODUCTION The CMS 1500
More informationHigh School to College and Career Pathway: Secondary Career and Technical Education Area of Study: Health Science Education
Biotechnology is predicted to be one of the most important applied sciences of the 21st century. While biotechnology is still in its infancy, it is a dynamic career field that is expanding by leaps and
More informationPREVENTIVE CARE See the REHP Benefits Handbook for a list of preventive benefits* MATERNITY SERVICES Office visits Covered in full including first
Network Providers Non Network Providers** DEDUCTIBLE (Per Calendar Year) None $250 per person $500 per family OUT-OF-POCKET MAXIMUM (When the out-of-pocket maximum is reached, benefits are paid at 100%
More informationAPPLICATION TO PARTICIPATE IN THE FAMILY PACT (FAMILY PLANNING, ACCESS, CARE AND TREATMENT) PROGRAM (Section 24005, Welfare and Institutions Code)
State of California Health and Human Services Agency Department of Health Care Services IMPORTANT: APPLICATION TO PARTICIPATE IN THE FAMILY PACT (FAMILY PLANNING, ACCESS, CARE AND TREATMENT) PROGRAM (Section
More informationSession 14. Act Now-Review of the 2015 Telemedicine Law. 2016 Minnesota e-health Summit June 7, 2016, 2:15 PM
Session 14 Act Now-Review of the 2015 Telemedicine Law 2016 Minnesota e-health Summit June 7, 2016, 2:15 PM 1 Speakers Moderator: Mark Sonneborn Presenter: Maureen Ideker RN, BSN, MBA, Great Plains Telehealth
More informationSUMMARY OF BADGERCARE PLUS BENEFITS
SUMMARY OF BADGERCARE PLUS BENEFITS Medical, mental health and substance abuse services Dental emergency NOT Pharmacy, chiropractic and dental services NOT 13 Ambulatory surgery centers Coverage of certain
More informationIncident To Services Documentation and Correct Billing July 23 2013 Presented by: Ellen Berra, Outreach Senior Analyst Karen Kroupa, Outreach Analyst
Incident To Services Documentation and Correct Billing July 23 2013 Presented by: Ellen Berra, Outreach Senior Analyst Karen Kroupa, Outreach Analyst Agenda Overview Documentation Requirements Part A Part
More information$250 copay per admit. $250 copay per admit
BENEFIT IN- NETWORK OUT- OF- NETWORK Deductible NONE NONE Out- of- Pocket Maximum $6,350 Single/ $12,700 Family NONE HOSPITAL INPATIENT FACILITY - NON MATERNITY Medical/Surgical Skilled Nursing Facility
More informationBoard Certified and licensed Medical Doctor with specialization as a Neonatologist, Primatologist, Critical Care Pediatrics
Schedule of Service SIN TITLE Description Education Licensing or Certification Experience Bill Rate 621-002 Physician- Emergency Medicine specialization in Emergency Medicine. Assigned Physician will be
More informationFederally Qualified Health Center Billing (100)
1. As a federally qualified health center (FQHC) can we bill for a license medical social worker? The core practitioner must be a licensed or certified clinical social worker (CSW) in your state. Unless
More informationSection. CPT only copyright 2007 American Medical Association. All rights reserved. 2Texas Medicaid Reimbursement
Section 2Texas Medicaid Reimbursement 2 2.1 Reimbursement.................................................... 2-2 2.1.1 Electronic Funds Transfer........................................ 2-2 2.1.1.1 Using
More informationAppendix II - Outpatient settings worksheets
Key Policy Elements for Best Appendix II - Outpatient settings worksheets The following worksheets are intended to increase awareness within public health agencies of the authorities currently in place
More informationWest Virginia Children s Health Insurance Program
West Virginia Children s Health Insurance Program Billing Instruction Manual for Federally Qualified Health Centers (FQHC s) and Rural Health Centers (RHC s) Under a Prospective Payment System December
More informationGeneral Hospital Inpatient Responsibility
= Medical ASO All diagnoses = BHP (ValueOptions) - All diagnoses 3= BHP for Primary Diagnoses 9-36, Medical ASO all other diagnoses 4= Not covered 5=DHP (Benecare) 6=PASRR ASO (Ascend) 7=Pharmacy benefit
More informationWhat Is the Wisconsin Electronic Medical Records Credit?
Limited State Tax Credit for EHR Due January 31 The State of Wisconsin has an Electronic Medical Records Credit is available to individuals and entities for taxable years that begin on or after Jan. 1,
More informationAPPENDIX C Description of CHIP Benefits
Inpatient General Acute and Inpatient Rehabilitation Hospital Unlimited. Includes: Hospital-provided physician services Semi-private room and board (or private if medically necessary as certified by attending)
More informationProvider Network Participation Policy
Participation Policy Blue Cross and Blue Shield of Montana HCS Administrative Policy Version: 8 Original Effective Date: 05/03/2004 Version Effective Date: 09/23/2013 Replaces: N/A Scope This policy applies
More informationNational Quality Management
National Quality Management National Approval Date: Effective Date: 02/24/2015 Subject Practitioner and Provider Availability: Network Composition and Contracting Plan Originating Dept. National Quality
More informationReference Guide for Allowed Services by Provider Types
Reference Guide for Allowed Services by Provider Types Version 6.0 For use in conjunction with MIHMS Enrollment Guides MIHMS_RG_0004_v6.0_20150312.doc Version History Version Date Author Action/Summary
More informationHealth Workforce Trends and Policy in Nevada and the United States
Health Workforce Trends and Policy in Nevada and the United States Tabor Griswold, PhD Health Services Research Analyst Office of Statewide Initiatives University of Nevada School of Medicine CHS Fall
More information(A) Information needed to identify and classify the hospital, include the following: (b) The hospital number assigned by the department;
3701-59-05 Hospital registration and reporting requirements. Every hospital, public or private, shall, by the first of March of each year, register with and report to the department of health the following
More informationUnit 2 Careers in Health Care
Unit 2 Careers in Health Care Education 2:1 Introduction to Health Careers Requirements vary by program and state High school preparation Health Occupations Education (HOE) Post-secondary education Types
More informationFinancing integrated Healthcare in Washington
Financing integrated Healthcare in Washington as of: April 23. 2012 E & M Codes CPT Code 99201-99205 99211-99215 Est. Pt Diagnostic Code May be used only with physical Federally Qualified Health Centers
More information5 Health Care Pathways
Health Care Careers 5 Health Care Pathways All Health Care occupations are organized into 5 pathways. THERAPEUTIC SERVICES DIAGNOSTIC SERVICES HEALTH INFORMATICS SUPPORT SERVICES BIOTECHNOLOGY RESEARCH
More informationPrimary and Acute Medical Services
Primary and Acute Medical Ambulance Medically necessary emergent ground and air ambulance transport. Air (fixed wing and air) ambulance Ground ambulance Chemotherapy Outpatient hospital for radiation therapy
More informationLesser of $200 or 20% (surgery) $10 per visit. $35 $100/trip $50/trip $75/trip $50/trip
HOSPITAL SERVICES Hospital Inpatient : Paid in full, Non-network: Hospital charges subject to 10% of billed charges up to coinsurance maximum. Non-participating provider charges subject to Basic Medical
More informationPayment Methodology Grid for Medicare Advantage PFFS/MSA
Payment Methodology Grid for Medicare Advantage PFFS/MSA This applies to SmartValue and Security Choice Private Fee-for-Service (PFFS) plans and SmartSaver and Save Well Medical Savings Account (MSA) plans.
More informationSection 5: Credentialing
Section 5: Credentialing PRACTITIONER CREDENTIALING CRITERIA...124 All Practitioners... 124 All Physicians... 125 Other Licensed Practitioners... 127 Unlicensed Practitioners... 127 Non-Credentialed Practitioners...
More informationOhio Medicaid Web Portal Enrolling Provider Checklists by Request Type
Ohio Medicaid Web Portal Enrolling Provider Checklists by Request Type Ohio Department of Job and Family Services TABLE OF CONTENTS General Instructions...3 Provider Enrollment Application Checklist: Individual
More informationChapter 8 Billing on the CMS 1500 Claim Form
8 Billing on the CMS 1500 Claim form INTRODUCTION The CMS 1500 claim form is used to bill for non-facility services, including professional services, freestanding surgery centers, transportation, durable
More informationATTACHMENT 1--NAICS STRUCTURE
Part I--Proposed New Industry Structure for Ambulatory Health Care Services, Hospitals, Nursing and Residential Care Facilities, and Social Assistance Section A--NAICS Structure North American Industry
More informationMapping of Health Care Providers in Ireland to the Provider Classification (ICHA HP) within the System of Health Accounts.
Mapping of Health Care Providers in Ireland to the Provider Classification (ICHA HP) within the System of Health Accounts December 2015 Mapping of the Health Care Providers in Ireland to the SHA Provider
More information2015 Medical Plan Summary
2015 Medical Plan Summary AVMED POS PLAN This Schedule of Benefits reflects the higher provider and prescription copayments for 2015. This is not a contract, it s a summary of the plan highlights and is
More informationThe following table details the requirements applicable to practice a discipline in California for the positions listed.
Professional Requirements DDS and CDE share the responsibility for ensuring that all personnel under California's Early Start Program meet the current qualifications in statute, regulations, and policy.
More informationNJ FamilyCare B. Covered by Horizon NJ Health for spontaneous abortions/miscarriages. Abortions & Related Services
NJ FamilyCare B BENEFIT Abortions & Related Services COVERAGE by Horizon NJ Health for spontaneous abortions/miscarriages. by Fee-for-Service for elective/induced abortions. Acupuncture Audiology (see
More informationGateway Health Medicare Assured RubySM (HMO SNP) $6,700 out-of-pocket limit for Medicare-covered services. No No No No. Days 1-6: $0 or $225 copay per
Assured RubySM (HMO Premium $0 monthly plan $0 - $33.90 monthly plan Assured GoldSM (HMO $12.40 - $46.30 monthly plan $43.90 - $77.80 monthly plan In Network Maximum Out-of-Pocket $3,400 out-of-pocket
More informationCase: 1:69-cv-02145 Document #: 3977-2 Filed: 10/22/14 Page 1 of 8 PageID #:26731 EXHIBIT 1 ACTIVELY RECRUITED POSITIONS LIST
Case: 1:69-cv-02145 Document #: 3977-2 Filed: 10/22/14 Page 1 of 8 PageID #:26731 EXHIBIT 1 ACTIVELY RECRUITED POSITIONS LIST Administrative Analyst V Administrative Director ADMINISTRATIVE DIRECTOR-DEPT
More informationWhat is a NURSE PRACTITIONER? Mark P. Christiansen, PhD, PA-C. Program Director FNP/PA Program UC Davis Medical Center Sacramento, CA
What is a PHYSICIAN ASSISTANT? NURSE PRACTITIONER? Mark P. Christiansen, PhD, PA-C Program Director FNP/PA Program UC Davis Medical Center Sacramento, CA 1 Physician assistants are: Highly trained healthcare
More informationEducation and Industry Licenses
Deliverable #2: Health Science sample list of existing credentials (Includes licenses, education and industry certificates, as well as postsecondary degree options) Updated: August 25, 2002 Education and
More informationAllied Health Professions. PRESENTED BY: Harry E. Douglas, III, DPA Interim President Charles R. Drew University of Medicine and Science
Allied Health Professions PRESENTED BY: Harry E. Douglas, III, DPA Interim President Charles R. Drew University of Medicine and Science November 5, 2004 HEALTH CAREERS THE ALLIED HEALTH PROFESSIONS The
More informationUW MEDICINE PATIENT EDUCATION. Your Care Team. Helpful information
UW MEDICINE PATIENT EDUCATION Your Care Team Helpful information In this section: You: The Patient Medical Staff Nursing Staff Allied Health Professionals Support Staff Peer Mentors for People with Spinal
More informationSTUDENT PROFESSIONAL LIABILITY INSURANCE PROGRAM (SPLIP) Coverage Summary
STUDENT PROFESSIONAL LIABILITY INSURANCE PROGRAM (SPLIP) Coverage Summary This is a claims- made policy. Coverage is only provided for claims which are both: (1) first made against the Insured during the
More informationOhio Legislative Service Commission
Ohio Legislative Service Commission Bill Analysis Lisa Musielewicz S.B. 228 129th General Assembly (As Introduced) Sens. Burke, Lehner, Schiavoni, Tavares, Schaffer BILL SUMMARY Authorizes a certified
More informationProvider Enrollment Instructions
Nevada Medicaid and Nevada Check Up Provider Enrollment Instructions Welcome! Thank you for your interest in the Nevada Medicaid and Nevada Check Up program (hereafter referred to as Nevada Medicaid ).
More informationNJ FamilyCare A. Covered by Horizon NJ Health for spontaneous abortions/miscarriages. Abortions & Related Services
NJ FamilyCare A BENEFIT Abortions & Related Services COVERAGE by Horizon NJ Health for spontaneous abortions/miscarriages. by Fee-for-Service for elective/induced abortions. Acupuncture Audiology (see
More informationIntroduction to One Care. MassHealth plus Medicare. www.mass.gov/masshealth/onecare
Introduction to One Care MassHealth plus Medicare www.mass.gov/masshealth/onecare Overview of One Care Starting in fall 2013, MassHealth and Medicare will join together with health plans in Massachusetts
More informationAccess to Health Care Nevada Medicaid
Brian Sandoval Governor Richard Whitley Interim Director Laurie Squartsoff Administrator Division of Health Care Financing and Policy Access to Health Care Nevada Medicaid Assembly Health and Human Services
More informationBadgerCare Plus and Wisconsin Medicaid Covered Services Comparison Chart
and Wisconsin Covered Services Comparison Chart The covered services information in the following chart is provided as general information. Providers should refer to their service-specific publications
More informationMember s responsibility (deductibles, copays, coinsurance and dollar maximums)
MICHIGAN CATHOLIC CONFERENCE January 2015 Benefit Summary This is intended as an easy-to-read summary and provides only a general overview of your benefits. It is not a contract. Additional limitations
More informationSection 3. How you get care
. How you get care Identification cards We will send you an identification (ID) card when you enroll. You should carry your ID card with you at all times. You must show it whenever you receive services
More information