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Biller B Aware

Description: Description: Provider Tips

Description: Description: Medicaid Providers

Description: Description: Provider Manual

Description: Description: Provider Fee Schedule

Description: Description: Forms

 Description: Description: CHAMPS

Description: Description: Policy Bulletins

Description: Description: ICD10

Description: Description: Email Provider Support

 

Description: Description: Phone Menu for Provider Support

Description: Description: Biller B Aware

February 16, 2017: Attention ALL Providers: Beginning on RA date 02/02/2017 Providers may have claims incorrectly being denied with CARC 204 and RARC N448 when the beneficiary is enrolled in the QMB benefit plan. MDHHS has resolved the issue and will resurrect affected claims.

Providers with further questions can contact provider support by phone at 1-800-292-2550 or by email providersupport@michigan.gov .

February 7, 2017: System Outage:  Due to system maintenance, the CHAMPS system will be down between 6:00 PM Saturday, February 11, 2017 through 9:00 AM Sunday, February 12, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

February 1, 2017: Attention ALL Providers: Providers submitting batch 270 eligibility transactions may experience a delay in receiving their 271 response file; providers submitting real time 270 transactions may receive error ‘AAA*42’ if the 271 is unable to be generated. This is due to beneficiaries having an invalid zip code on file in either their address information or their Third Party Liability (TPL) information. MDHHS is working to resolve this issue and will continue to monitor the system. We apologize for any inconvenience.

 

Please contact AutomatedBilling@michigan.gov if you require further assistance.

January 26, 2017 Attention Inpatient Hospital Providers:  This is to remind providers per the MSA Policy Bulletin 14-37 and effective 10/01/2014, the following revenue codes will be covered for nursery related charges: 0170, 0171, 0172, 0173, 0174, 0179

Prior to 10/01/2014, revenue code 0173 was not payable and providers should be advised that this code is only to be used for admissions on or after 10/01/2014. Designated providers with an alternate weight assignment, per Medicaid policy, may continue to use Revenue Code 0174 for Neonatal Intensive Care Unit admissions and proper reimbursement.

Providers with further questions can contact Provider Support by email at ProviderSupport@michigan.gov. 

January 26, 2017 Attention Skilled Nursing Facility Providers: Instructions on Inactive Level of Care Determination (LOCD) Completed waiting for LOC/MA

January 19, 2017 Attention Private Duty Nursing Providers:  MDHHS has identified a processing issue.  Claims that were submitted with dates of service for December 25, 2016 and/or December 26, 2016 were paid at the incorrect rate.  MDHHS is working on a resolution. Once resolved, MDHHS will adjust the effected claims. 

Providers with further questions can contact provider support by phone1-800-292-2550 or by email ProviderSupport@michigan.gov .

January 19, 2017: Attention ALL Providers: The File Transfer Service (FTS) portal will be unavailable on Sunday, January 22, 2017 from 10:00AM to 12:00PM. Please refrain from submitting files during this maintenance period. We apologize for any inconvenience this may cause.

Please contact AutomatedBilling@michigan.gov if you require further assistance.

January 17, 2017: Attention ALL Providers: The latest batch of MDHHS Quarterly Newborn Recoveries is currently being processed. This batch includes fee for service claims for newborns that were retroactively enrolled into a Medicaid Health Plan. Please note, as with previous quarterly newborn take backs, claims must be submitted to the Medicaid Health Plans within 60 days from the Medicaid Remittance Advice date. Please review the following for information on how to verify the Adjustment Source of your claim. 

Providers with further questions can contact provider support by phone1-800-292-2550 or by email ProviderSupport@michigan.gov .

January 9, 2017: System Outage:  Due to system maintenance, the CHAMPS system will be down between 6:00 PM Saturday, January 14, 2017 through 9:00 AM Sunday, January 15, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

January 6, 2017: System Outage:  Due to MILogin system maintenance, users may experience intermittent outages while accessing the CHAMPS system between 7:00 AM and 1:00 PM on Sunday, January 8, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

January 5, 2017:  Attention All Physical and Occupational Therapy Providers: Effective January 1, 2017, the Centers for Medicare and Medicaid Services (CMS) has issued updated physical and occupational therapy evaluation codes.

  • PT code 97001 is now replaced by one of the following codes:  97161, 97162 or 97163

  • PT code of 97002 is now replaced with 97164

  • OT code 97003 is now replaced by one of the following codes: 97165, 97166 or 971637

  • OT code 97004 is now replaced by 97168

Please refer to this CMS resource for additional information.

        

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Provider Tips

 

Description: All Providers

Description: Description: Ambulance

Description: Description: Clinics

Description: Description: Dental

Description: Description: Hospice

Description: Description: Hospital

Description: Description: Nursing Facility

Description: Description: Pharmacy and DME

Description: Description: Physician

 Professional

 

 

All Providers

January 26, 2017: CHAMPS Claim Statusing

August 01, 2016:  Document Management Portal (DMP) for Children’s Special Health Care Services

July 19, 2016: Documental Management Portal (DMP) Messaging Function for Predictive Modeling

April 21, 2016: Hearing Providers: Audiologists individual NPI must be associated to a Hearing Aid Dealer or Hearing Center billing NPI; for claim adjudication.

March 02, 2016: Billing Newborn Services when mother is enrolled in a Medicaid Health Plan (MHP)

If the mother is enrolled in a Medicaid Health Plan (MHP) at the time of delivery, the newborn's services are also the responsibility of the MHP unless the child is placed in foster care. Providers are encouraged to review MSA L-Letter 15-66 for current policy information. Providers are advised to validate the mother's enrollment in a MHP when rendering services for newborns to ensure services are billed appropriately to the correct payer. All newborn charges must be billed to the MHP using the newborn’s ID.

June 04, 2015: How to use the CHAMPS Claim Limit List

May 04, 2015: CHAMPS Navigation 

April 08, 2015: CSHCS Provider Information Page

March 19, 2015: ICD-10 Virtual Presentation

 

March 10, 2015: How to Adjust a claim with OTHER INSURANCE

March 10, 2015: Refund of Payment
 

March 10, 2015: Benefits Monitoring Program (BMP):

Benefits Monitoring Program

Verifying BMP Eligibility

Beneficiary Notification Letter Example

Beneficiary Final Notification Letter Example

 

MSA 1302 for Specialty Referrals

Click here for archived Provider Tips and Presentations

 

Ambulance

 

April 20, 2016: Billing two Separate Runs on the same DOS

 

March 24, 2016: Tips for Requesting Prior Authorization

 

March 24, 2016: Non-emergent Ambulance Services Denials on Medicare Primary Crossover Claims:       

Providers are encouraged to report the referring physician field when sending claims to Medicare in order to avoid claim denials with CARC 208, N286, and N290 on the crossover claim. Medicaid requires an enrolled ordering/referring/attending physician to be on all non-emergent ambulance services billed. For professional ambulance claims, this is Loop 2310A or 2420F (Referring) or Loop 2420E (Ordering). For institutional claims, this is Loop 2310A (Attending) or Loop 2310F or 2420D (Referring).

 

Clinics

 

March 23, 2016: Billing Tips-Vaccine for Children (VFC)


February 24, 2015: Clinic Billing Tips 

 

Dental

 

April 26, 2016: Verifying Dental Eligibility: For beneficiaries that are Medicare eligible and are not Medicare enrolled, the other insurance field will appear with Medicare and all 11111111 or 22222222. Even though Medicare does not pay for dental services, beneficiaries must obtain Medicare before the system can process and by-pass dental claims. The only exception is if the beneficiary is an alien and has not been in this country for 5 years. The date and port of entry must be reflected in the claim remarks. 

January 29, 2016: Claims being submitted for beneficiaries residing in a Nursing Home, a referring NPI is mandatory on the claim. The referring NPI can be obtained from the Nursing Home.

 

Hospice

 

The Hospice section is in the process of being updated. Please email ProviderOutreach@michigan.gov if you have suggestions! Thank you for your patience. 

 

Hospital

 

February 17, 2017: Self-Administered Drugs Billing Tip

 

February 16, 2017: Outpatient Hospital Drug Carveout information

 

February 02, 2017: Hospital Fee for Service (FFS) Claim Appeal first step instructions

 

January 26, 2017: New Timely Filing (CARC 29) Policy effective January 1, 2017

 

January 12, 2017:  Predictive Modeling/Document Management Portal (DMP) Billing Tips

 

January 11, 2017:  Inpatient Hospital Psychiatric Admissions Billing Tip

 

November 01, 2016: Inpatient ICD-10 Surgical Codes with Documentation Requirements

 

November 01, 2016: ICD-10 Surgical Procedure Codes Requiring Prior Authorization

 

September 27, 2016: PACER Requirements Billing Tip

 

August 11, 2016: Hospital Claim Newborn Coverage Tips

 

May 04, 2016: A8 Outpatient Hospital Claim Denials

 

April 20, 2016: Re-Billing Hospital Claims

 

April 20, 2016: Three Day Window Billing Tip

 

April 20, 2016: Pricing Outpatient Hospital Claims
 

March 23, 2016: IPH Pricing Billing Tip
 

March 22, 2016: Diagnosis Inconsistent with Procedure Billing Tip
 

February 18, 2016: Credit Balance Billing Tip

 

February 18, 2016: Timely Filing Billing Tip
 

June 04, 2015: How to use the CHAMPS Claim Limit List

March 10, 2015: Inpatient Surgical/ ICD 9 Procedure code documentation requirements

April 08, 2013: How to Find Professional REV Codes
 

  

June 20, 2011: Hysterectomy- When billing for a hysterectomy performed during a beneficiary's period of retroactive eligibility, please indicate in the Remarks section: "No consent not eligible on DOS, Retro MA. PT told prior to HYST unable to reproduce." 

  

June 2, 2011: Inpatient Hospital Rehab- Providers should report appropriate taxonomy code 273Y00000X, 283X00000X, or 283XC2000X ( not 282N00000X). 

 

Nursing Facility

  

January 26, 2017: How to filter Level of Care Determination (LOCD) within CHAMPS

January 26, 2017: Locating Provider ID within CHAMPS

January 26, 2017: Instructions on Inactive Level of Care Determination (LOCD) Completed waiting for LOC/MA

August 11, 2016: Denials for LOCD Not Complete

November 06, 2015: Level of Care Determination (LOCD) Tool within CHAMPS
 

Nursing Facility Historical Provider Tips

 

Pharmacy/DME

 

April 26, 2016: DME Provider Verification Tool

April 20, 2016: Blood Glucose Monitoring Equipment and Supplies

 

Physician

 

March 10, 2015: Immunizations Administration and Preventive Medicine Services. 

 

Professional

 

 
August 16, 2016: Professional Updates