Medicaid alerts button

 

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

May 24, 2017: Attention Outpatient Hospital Providers: MDHHS has identified an issue that began with claims received on and after 5/13/2017. Any “new” claim that came in was affected as well as any suspended claim that was processed on and after 5/13/2017. It appears within the latest quarter’s OPPS release there were some  procedure codes that were loaded incorrectly and are causing an incorrect status indicator to set making service lines or in many cases making the entire claim reject with A8.   

Please do not take any action until the system has been updated, rebilling prior to the system being corrected will cause additional denials. Once the system has been corrected providers will be notified.  

Providers with further questions can contact Provider Support by email ProviderSupport@Michigan.gov.  Please include in the subject: Attention OPPS Claim Question.

May 23, 2017: Attention Home Health Providers:  Michigan Department of Health and Human Services (MDHHS) reminds provider of current Michigan Medicaid Policy within the Medicaid Provider Manual, Home Health Chapter, section 8 “Home health aide services are covered only when ordered by the attending physician and performed in conjunction with direct, ongoing skilled nursing care and / or PT”.

MDHHS will void identified claims received on or after January 2011 which were paid in error.  Provider’s will see these recoveries beginning with June 2017 pay cycle dates. The voided claims can be identified by the claim note “aide service billed without skilled nursing or PT”. 

Providers with further questions can contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@Michigan.gov

May 23, 2017: Attention All Providers: Update to message posted on April 25, 2017: There will be a delay in the implementation of enhanced pharmacy claim processing edits to deny prescriptions or refills written by a prescriber NPI that is not actively enrolled with Michigan Medicaid. The Michigan Department of Health and Human Services (MDHHS) does not want to create access to care issues for Medicaid beneficiaries. In the future, to ensure there is not a lack of payment due to claim denials prescribers need to enroll with MDHHS via CHAMPS as soon as possible.

Please refer to policy bulletin MSA 13-17 for further details. Enrolled pharmacies can verify whether a prescriber is enrolled with Michigan Medicaid by using the CHAMPS provider verification tool.

To enroll with Michigan Medicaid, prescribers can review provider enrollment information on the Provider Enrollment MDHHS website or contact Provider Enrollment at 1-800-292-2550. 

May 18, 2017: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, May 21, 2017, from 8:00 AM to 9:00 AM. We apologize for any inconvenience this may cause.

May 17,2017: Attention Hospice Providers: Michigan Department of Health and Human Services (MDHHS) is aware of incorrect reimbursement rates for routine care (revenue code 0651) for dates of service on and after October 1, 2016.  MDHHS is working to resolve this issue. An update will be posted when the issue has been resolved. We apologize for any inconvenience.

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

May 12, 2017: Attention ALL Providers: The File Transfer Service (FTS) portal will be unavailable on Saturday, May 13, 2017 from 10:00 AM to 2:00 PM. 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. 

May 11, 2017: Attention All Providers:  Effective June 1, 2017 Provider Support will no longer give beneficiary eligibility information to providers. Providers may verify eligibility information through a variety of resources.  Please refer to the Michigan Medicaid Provider Manual, Beneficiary Eligibility Chapter, Section 3 for further information and exceptions.  In addition, MDHHS has created Virtual Training Resources and Provider Tips to aid providers in learning how to verify beneficiary eligibility. Providers will receive assistance from Provider Support to learn how to verify beneficiary eligibility within CHAMPS. 

For CHAMPS navigational support, please contact us at 1-800-292-2550 or email providersupport@Michigan.gov   

May 8, 2017: System Outage:  Due to CHAMPS system release, the CHAMPS system will be down between 6:00 PM Saturday May 13, 2017 through 9:00 AM Sunday May 14, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

May 4, 2017: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, May 7, 2017, from 8:00 AM to 12:00 PM. We apologize for any inconvenience this may cause.

April 28, 2017:Attention ALL Providers: Due to a system issue the Document Management Portal (DMP) was down yesterday, Thursday April 27, 2017 from 6:00PM through Friday April 28, 2017 at 7:48AM . If any documentation was faxed through DMP during this time frame the information was not received by MDHHS. The issue has been resolved, please resubmit any documentation submitted during this outage to ensure it is received by MDHHS.  

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

April 27, 2017: Attention ALL Providers: The File Transfer Service (FTS) portal will be unavailable on Sunday, April 30, 2017 from 10:00AM to 2:00PM. 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. 

April 25, 2017:Attention All Providers: Pharmacy claims adjudicated on or after June 1, 2017, Michigan Department of Health and Human Services (MDHHS) will be enforcing enhanced claim processing edits to deny prescriptions or refills submitted through Medicaid’s Pharmacy Benefit Manager (Magellan) when the prescription is submitted with a type 2(Group NPI) or any non-enrolled NPI as the prescribing provider. This editing will affect all pharmacy claims paid under the Fee For Service (FFS) Medicaid Program, including Medicaid Health Plan carve out drugs. Claims billed with a Type 2 NPI or an NPI that is inactive or non-enrolled in CHAMPS in the NCPDP Field: #411-DB Prescriber ID will deny.

It is the prescribing physicians responsibility to ensure they are actively enrolled within CHAMPS to in order to prevent beneficiary access to care issues.

Further technical questions regarding this requirement please contact Magellan Technical Helpdesk at: 1-877-624-5204  . Questions regarding enrollment should be directed to Provider Enrollment at 1-800-292-2550

April 25, 2017: Attention Hospital Providers:Pharmacy claims adjudicated on or after June 1, 2017, Michigan Department of Health and Human Services (MDHHS) will be enforcing enhanced claim processing edits to deny prescriptions or refills submitted through Medicaid’s Pharmacy Benefit Manager (Magellan) when the prescription is submitted with a type 2 (Group NPI) or any non-enrolled NPI as the prescribing provider. Hospital interns, residents or students should not prescribe hospital discharge medications for Medicaid or other MDHHS pharmacy program beneficiaries unless they are actively enrolled in CHAMPS. MDHHS encourages participating hospital providers to review their internal protocols to ensure the attending physician’s NPI and name are identified on discharge prescriptions in order to prevent access to care issues. Claims billed with a Type 2 NPI or an NPI that is inactive or non-enrolled in CHAMPS in the NCPDP Field: #411-DB Prescriber ID will deny.

It is the prescribing physicians responsibility to ensure they are actively enrolled within CHAMPS.

Further technical questions regarding this requirement please contact Magellan Technical Helpdesk at 1-877-624-5204  . Questions regarding enrollment should be directed to Provider Enrollment at 1-800-292-2550

April 21, 2017: System Outage:  Due to system maintenance, the CHAMPS system will be down between 7:00 PM and 10:00 PM Friday, April 21 , 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

April 20, 2017:Attention Outpatient Hospital Providers: This is an update to the message posted on February 23, 2017.  The January 2017 quarterly APC/OPPS software and wrap around codes list were successfully uploaded to CHAMPS as of March 24, 2017, and all claims adjudicated with dates of service January 1, 2017 through March 24, 2017 for outpatient hospitals are currently being reprocessed.  The next software update for the April 2017 quarter is scheduled to be loaded to CHAMPS on May 13, 2017.

Providers with further questions can contact Provider Support by email at ProviderSupport@Michigan.gov. Please include in the subject area: Attention OPPS Claim Question.

April 18, 2017:Attention Clinic Providers: MDHHS would like to encourage Clinic providers review MSA policy bulletin 17-10 regarding Clinic billing changes to the Institutional claim format. MDHHS Provider Relations is currently working on training materials, and would appreciate provider input. Please email ProviderOutreach@Michigan.gov with topics or questions and refer often to the Medicaid Provider training page for upcoming informational and billing specific training sessions. 

April 13, 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 .

April 13, 2017: Attention ALL Providers: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, April 16, 2017, from 8:00 AM to 10:00 AM. We apologize for any inconvenience this may cause.

April 13, 2017: Attention ALL Providers: Effective April 3, 2017 the name of Fidelis SecureCare of Michigan Integrated Care Organization (ICO) will be known as Michigan Complete Health (MCH) ICO. Providers may notice this name change when verifying eligibility and the beneficiary is enrolled with this ICO-MC plan.

MCH provider IDs and customer number phone numbers will remain the same.

Updated website address: https://mmp.michigancompletehealth.com/2017.html

Providers with further questions should contact Michigan Complete Health at 844-239-7387

April 12, 2017: Attention ALL Providers: MDHHS Provider Relations would like to remind providers of the opportunity to register your email-address or update your ListServ subscriber preferences to access newly added topics for immediate updates.

This is a great way to receive direct, immediate communication, including information specific to your provider specialty. Common updates include: training opportunities, CHAMPS system updates and outages, policy changes, and other important specialty specific alerts.

Click here to subscribe or update your listserv subscription and receive updates and announcements delivered to your registered email address. You may unsubscribe at any time.

April 11, 2017:  Attention All Providers and Trading Partners:  Due to system response times the batch 271 response may be delayed by one business day.  Providers or Trading Partners with further questions can contact AutomatedBilling@Michigan.gov.

April 4, 2017: System Outage:  Due to system maintenance, the CHAMPS system will be down between 6:00 PM Saturday, April 8, 2017 through 9:00 AM Sunday, April 9, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

March 30, 2017: Attention Clinic Providers: Professional Claims submitted by a clinic provider type on or after April 1, 2017 must include the Rendering Provider NPI for proper adjudication. Failure to comply will result in claim denials and could cause lack of payment in the future.

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

March 30, 2017:Attention ALL Providers: For dates of service on or after April 1, 2017, co-pays for certain Healthy Michigan Plan beneficiaries are going up.  MSA Policy 17-02 includes the revised co-pay amounts and describes how this change will impact Healthy Michigan Plan beneficiaries and providers.

Beginning April 1, 2017, the eligibility response within CHAMPS will provide the tiered co-pay amounts applicable to the beneficiary.  Beneficiaries have been notified of these changes by MDHHS.

The Healthy Michigan Plan list of chronic health conditions that are exempt from beneficiary co-pay requirements has also been updated for dates of service on or after April 1, 2017.  It is located at www.michigan.gov/healthymichiganplan.

Finally, consistent with MSA letter L 14-52, the handout “Information on HMP Co-pays” has been updated to reflect the revised co-pay structure. It is located at http://www.michigan.gov/healthymichiganplan under the Healthy Michigan Plan Provider information page.

March 30, 2017: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, April 2, 2017, from 8:00 AM to 12:00 PM. We apologize for any inconvenience this may cause.

March 24, 2017: Attention ALL Providers: Effective Sunday April 2, 2017 the MI Login for Third Party link will receive an update which will change the look and feel for Providers and advocates. Overall functions and access to applications will remain the same.

Further MI Login instructions can be found on the CHAMPS webpage

March 23, 2017: System Outage: Due to system maintenance, MILogin will be unavailable on Sunday, March 26, 2017, from 8:00 AM to 12:00 PM. This outage will impact all system functionality. We apologize for any inconvenience this may cause.

March 22, 2017: System Outage:  Due to system release, the CHAMPS system will be down between 7:00 PM Friday, March 24, 2017 through 2:00 AM Saturday, March 25, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

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

March 1, 2017: Attention ALL Providers: Due to administrative error, fees for procedure codes 99381-99387 and 99391-99397 were altered within CHAMPS. This caused claims billed with dates of service January 1, 2017 to February 23, 2017 to process incorrectly within CHAMPS. MDHHS has corrected the error and will be adjusting the affected claims. 

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

February 28, 2017: Attention Dental Providers: MDHHS has identified a system error, Dental Providers were sent out a Third Party Liability (TPL) void letter for claims with dates of services prior to May 1, 2016. Please disregard the void letters for these claims as the take backs will not be processed. We have a resolution in place to eliminate this system error from occurring in the future. For dates of service on or after May 1, 2016 TPL will process take backs.

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

February 23, 2017:  Attention Outpatient Hospital Providers: Providers may notice an increase of claim adjustment reason code A8 denials as the MDHHS CHAMPS system is processing current claims with the December 2016 quarterly APC/OPPS software and wrap around codes list.  The implementation the software for the January 2017 quarter is planned for March 24, 2017, and will resolve this issue.

MDHHS asks that providers continue to bill for the services rendered using National Coding Guidelines for the date of service the charges were incurred on.  Any claims affected by this software update will be processed in April and may be identified by the claim note:  APC January 2017 quarterly updates.

Providers with further questions can contact Provider Support by email at ProviderSupport@Michigan.gov. Please include in the subject area: Attention OPPS Claim Question.

February 22, 2017Attention ALL Providers: MDHHS no longer accepts the paper MSA-1380 835-Electronic Remittance Advice Request for Billing Agent Change/Update. Providers wanting to change their billing agent information need to submit a provider enrollment modification within CHAMPS. Please refer to Associate new billing agent and authorize 835 instructions.  

Providers needing CHAMPS navigational assistance can contact Provider Enrollment at 1-800-292-2550 or email providerenrollment@Michigan.gov or providersupport@Michigan.gov

February 22, 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, February 26, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

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.

            2016

 2015

 2014

 

2013

2010 2011 2012 BBA

 

 

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

May 15, 2017: Pharmacist Medication Therapy Management (MTM) Virtual Training

March 7, 2017: Determining Eligibility Virtual Training 

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): 


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

 

May 25, 2017: Clinic Institutional FAQ 

 

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

 

May 16, 2017: Spend-Down Billing Tip

 

May 16, 2017: Medicare Buy-in Requests

 

April 10, 2017: Outpatient Hospital Compound Drug Billing Tip

 

March 29, 2017: Reporting HSA/FSA/HRA Payments to MDHHS Tip

 

February 22, 2017: Incarceration Benefit Plan Billing Tips

 

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

  

March 22, 2017: Nursing Facility Virtual Training

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
 

Click here for Nursing Facility Historical Provider Tips

 

Pharmacy/DME

 

May 15, 2017: Pharmacist Medication Therapy Management (MTM) Virtual Training 

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