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Provider Tips


                                All Providers:                                   

Blue Bullet   February 4, 2009 -   Paper Biller Tips Powerpoint
Blue Bullet  February 4, 2009 -  Tips for Billing Secondary/Tertiary Claims Electronically
Blue Bullet
  December 5, 2008 -    MDCH General Billing Tips and Resources Powerpoint
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  June 14, 2005 - ListServ Instructions - Updated 9/22/2009 
Blue Bullet  June 6, 2005 - MDCH Payment Liability 
Blue Bullet  November 19, 2004 - Documentation Requirements 


  Physician:

Blue Bullet July 1, 2009 Physician Billing Information and Reference Powerpoint
Blue Bullet  July 1, 2009- Physician Billing Claim Examples
                   Blue Bullet Claim with CLIA number
                   Blue Bullet Co-Insurance deductible after Blue Cross                   
                   Blue Bullet Commercial Insurance Co-Insurance                   
                   Blue Bullet Correct EOB Information                   
                   Blue Bullet Incorrect Billing
                   Blue Bullet Medicare Deductible                   
                   Blue Bullet Multiple Surgery
                   Blue Bullet NDC Claim
                   Blue Bullet Reporting NOC (injectible drug) codes
                   Blue Bullet Non-Covered by Medicare
                   Blue Bullet Other Insurance Not Covered
                   Blue Bullet Replacement Claim
                   
                  


Hospital:

Blue Bullet   February 27, 2009-  Update on Michigan Medicaid Hospital Audits
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 April 20, 2009 -   Billing Information and Reference Powerpoint 
Blue Bullet  April 20, 2009 - Nursing Facility Claim Examples:  
                    Blue Bullet County Medical Care Facility Billing Oxygen 
                    Blue Bullet Nursing Facility Billing Hospital Leave Days  
                    Blue Bullet Nursing Facility Billing Multiple Theraputic Leave Days 
                    Blue Bullet Nursing Facility Billing Patient Pay and Offset 
                    Blue Bullet Nursing Facility Billing Physical Therapy 
                    Blue Bullet Nursing Facility Replacement Claim Example 
                    Blue Bullet Nursing Facility Void Claim Example
Blue Bullet  
September 7, 2006 - LOCD Billing Issues 
Blue Bullet   September 17, 2008 -Criteria for billing Oxygen for county medical care facility or hospital long-term care unit only 


Hospice

Blue Bullet   April 29, 2009 - Billing Information and Reference Powerpoint
Blue Bullet  April 29, 2009 - Hospice Claim Examples
                  Blue Bullet Billing Theraputic Leave Days                 
                  Blue Bullet Billing Hospital Leave Days                 
                  Blue Bullet Billing Continuous Home Care                 
                  Blue Bullet Billing Inpatient Respite Care                 
                  Blue Bullet Billing General Inpatient Care-Non respite
                  Blue Bullet Billing Physician Services                
                  Blue Bullet Reporting Patient Pay Amount
                  Blue Bullet Other Insurance Denied                 
                  Blue Bullet Other Insurance Terminated
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.


Private Duty Nursing:

Blue Bullet September 10, 2009 -  Agency Billing Information and Reference Powerpoint  
                                      
(CHAMPS information included)
Blue Bullet  September 10, 2009 Independent Nurse Billing Information and Reference Powerpoint 
                                       (CHAMPS information included)



  Pharmacy and DME:

Blue Bullet  January 17, 2006 - Diabetic Supplies 


Ambulance Providers:

Blue Bullet  July 7, 2009 Ambulance Billing Information and Reference Powerpoint
Blue Bullet  June 18, 2007 - Multiple Transports 


Dental Providers

Blue Bullet  August 12, 2009 - CHAMPS, NPI, and General Updates Powerpoint 
Blue Bullet  August 12. 2009 - Dental Billing Claim Examples:
                    Blue Bullet Other Insurance Claim Example 
                    Blue Bullet Replacement Claim Example
                    Blue Bullet Void Claim Example           


Out of State Providers: 

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



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