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Provider Tips


All Providers:

Blue Bullet  August 27, 2008 - CMS 1500 Claim Completion Instructions 
Blue Bullet  August 19, 2008 -Professional Providers CHAMPS, NPI, and General Updates Powerpoint 
Blue Bullet  September 12, 2007 -CMS 1500 & UB04 Paper Claim Format General Instructions 
Blue Bullet  June 14, 2005 - ListServ Instructions 
Blue Bullet  June 6, 2005 - MDCH Payment Liability 
Blue Bullet  November 19, 2004 - Documentation Requirements 


Hospital:

Blue Bullet   October 13, 2008 - Edit 244, 245 & 247 -  The claim is being reviewed for possible Medicare coverage. Providers should report Medicare payer ID number (i.e. C00245) for Medicare Fee-For-Service, Medicare commercial insurance (i.e. Medicare Advantage), and Medicare health plan.
Blue Bullet   September 17, 2008 -Billing tip for when beneficiary transfers from one hospital to another 
Blue Bullet  August 14, 2008 - Tips for Billing Observation Room 
Blue Bullet  August 7, 2008 Noncovered Emergency Diagnosis Codes (Updated 10/13/2008)
Blue Bullet  August 4, 2008 - Outpatient hospital providers are referred to the below links for more information regarding NDC: NDC Format For BillingNDC Frequently Asked Questions and Letter L 08-14.
Blue Bullet  May 19, 2006 - Contractual Adjustment Examples 
Blue Bullet  May 13, 2008 - MDCH Institutional Billing Resource 
Blue Bullet  April 1, 2007 - Dialysis Billing Valid for DOS PRIOR to 4/1/07
Blue Bullet  April 1, 2007 - Edit 185- The end date of service is invalid OR, for Outpatient Hospital, the claim line date of service is not included in the range of dates indicated by the "from" and "through" dates on the claim. All series services should be reported one calendar month per claim.


Nursing Facility:

Blue Bullet   September 17, 2008 -Criteria for billing Oxygen for county medical care facility or hospital long-term care unit only 
Blue Bullet  August 21, 2008 - Billing Information and Reference Powerpoint - Updated 10/27/08
Blue Bullet  September 7, 2006 - LOCD Billing Issues 


Hospice

Blue Bullet  October 7, 2008 - Billing Information and Reference Powerpoint
Blue Bullet September 8, 2008 - Edit 100- The amount to be paid for this procedure is being determined manually. The Medical Services Administration has identified a problem with Hospice Room and Board claims. Claims pending 100 will require review of the Hospice Membership Notice DCH-1074, to determine if the appropriate nursing facility provider ID number was reported. To avoid future 100 edit pends, Hospice Membership Notice (DCH-1074) must be submitted to correct the eligibility file. The DCH- 1074 version dated 7/08 or 11/06 may be used.


Pharmacy and DME:

Blue Bullet  January 17, 2006 - Diabetic Supplies 


Ambulance Providers:

Blue Bullet  June 18, 2007 - Multiple Transports 


Dental Providers

Blue Bullet  August 19, 2008 - CHAMPS, NPI, and General Updates Powerpoint 


Out of State Providers: 

Blue Bullet  April 26, 2006 - Out of State Billing Tips 



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