October 8, 2008 - A Long Term Care Billing Session will be held on 10/30/08, at the Lewis Cass Building 320 S Walnut Lansing MI 48909. This session will consist of a one hour power point presentation with a questions and answer session following. If necessary, a problem focused session will be available following the presentation and questions. Space is limited, please e-mail providerconsultant@michigan.govfor confirmation. Please include your NPI number, how many wish to attend, a contact number phone number, and if you are requesting time for a problem focused session.
October 2, 2008 - The Michigan Department of Community Health (MDCH) would like to clarify existing policy and provide additional information regarding the reporting requirements for present on admission (POA) indicators.
Effective October 1, 2008, Medicare and Blue Cross Blue Shield of Michigan (BCBSM) will be implementing policies to not pay a higher diagnosis-related group (DRG) [inpatient hospital] payment for specific Hospital Acquired Conditions (HACs) considered not POA. MDCH will keep with current policy published in the Coordination of Benefits (COB) Chapter (refer to Section 2 and 2.6) of the Michigan Medicaid Provider Manual in following the rules of the primary payer. For hospital discharges on and after October 1, 2008, providers must follow the POA reporting requirements for Medicare and Blue Cross Blue Shield of Michigan on secondary claims to Medicaid, also requiring providers to report the prior payers DRG appropriately when submitting secondary claims to Medicaid for reimbursement. MDCH will pend for review all secondary inpatient claims for possible HAC's and payment assignment by the primary payer.
This is not a requirement for providers submitting primary claims to Medicaid. MDCH does not require POA indicators on Medicaid primary claims at this time.
October 2, 2008 - CHAMPS revalidation has been very successful and we want to thank all the providers that have accessed the system and completed their revalidation. If you have begun your revalidation, please complete it as soon as possible. MDCH will now begin disenrollment activities which will be completed by the end of October for those who have not revalidated in CHAMPS.
September 15, 2008 - On September 25, 2008 - MDCH is offering Provider Consultant Sessions, for new professional providers. The session will be located at the Lewis Cass Bldg, 320 S. Walnut St, Lansing, MI. Please e-mail your Medicaid Provider NPI#, Contact Name and Phone Number to providerconsultant@michigan.gov to reserve your place, seating is limited. A consultant will contact you for confirmation.
September 4, 2008 -
Attention Practitioner Providers: Providers may now submit claims with modifiers UA and UD directly to Medicare. Claims should process correctly and automatically crossover to Michigan Medicaid. Medicare will no longer deny due to the use of the UA and UD modifiers.
August 14, 2008 -
Effective immediately, MDCH will grant providers a one month extension (through September 30, 2008) to access the CHAMPS PE online system and enter their required revalidation information. Providers who have not revalidated prior to October 1, 2008 will be end-dated in the CHAMPS PE system, resulting in the rejection of any service provided on or after that date. Please reference
MSA Bulletin 08-33
.
July 24, 2008 - Attention Outpatient Providers: MDCH has resolved the OPH systems error which caused incorrect adjudication off of the Revenue code. All OPH claims from Pay Cycle 27, 28 & some claims from Pay Cycle 29 with this adjudication error have been identified and will be adjusted starting on Pay Cycle 31 (7/30/08) and continuing through Pay Cycle 33.
July 21, 2008 - Because of
MDCH's continued commitment to bring the current 30 plus year old processing system into the 21st century, building CHAMPS has become a primary focus for the department. This project involves many staff members who are working to create a better, more user friendly system. This means (and will continue to mean) that current system issues cannot be corrected in the old system while building a new one.
In this transitional period until claims goes live in the new system, MDCH providers have several valid concerns about payment when their claim is billed correctly and the system cannot adjudicate for payment. Therefore, if Provider Inquiry (PI) hotline staff review your claim issue and determine it to be a valid system malfunction, the issue may be referred (after PI's determination) to a Provider Consultant for them to consider the means appropriate to have your claim adjudicated. If, however, lack of correct billing guidelines on the part of the provider is the issue, correction according to those guidelines and resubmission of the claim will be the responsibility of the provider. Only if this is determined to be a system issue by Provider Inquiry will a claim be escalated to a consultant.
Thank you for your continued patience as MDCH works diligently to bring you a processing system that will allow direct claims entry, the means to track the status of your claims, and online correction to pending or rejected claims. You will also be able to track your payments online. These are the goals of our department to help build a better working relationship, involving claims processing and submission, with our providers.
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October 8, 2008 -
A Long Term Care Billing Session will be held on 10/30/08, at the Lewis Cass Building 320 S Walnut Lansing MI 48909. This session will consist of a one hour power point presentation with a questions and answer session following. If necessary, a problem focused session will be available following the presentation and questions. Space is limited, please e-mail 