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September 19, 2017: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, September 24, 2017, from 7:00 AM EST to 1:00 PM EST. We apologize for any inconvenience this may cause.

September 18, 2017: Attention All Providers: This serves as a reminder of current Medicaid Policy as outlined in the Medicaid Provider Manual, in both the Billing & Reimbursement for Professionals and Billing & Reimbursement for Institutional Providers, Section Remittance Advice:

A Remittance Advice (RA) is produced to inform providers about the status of their claims. RAs are available in paper and electronic formats, and utilize the HIPAA-compliant national standard claim adjustment group codes, claim adjustment reason codes, and remarks codes, as well as adjustment reason codes, to report claim status. Code definitions are available from the Washington Publishing Company.”

It is a provider’s responsibility to review the claim adjustment reason codes (CARC) and remittance advice remark codes (RARC) on their RA to determine why a claim(s) denied or paid.

A complete listing of the CARC and RARC Codes can be found on the Washington Publishing Company website at http://www.wpc-edi.com/reference/ .

Claim status and paper RA navigation steps within CHAMPS.  

If you need assistance in navigating your RA or CHAMPS to locate the information please call 1-800-292-2550 or email ProviderSupport@Michigan.gov.

September 15, 2017: Attention Trading Partners and Billing Agents: The File Transfer Service (FTS) portal will be unavailable on Sunday, September 17, 2017 from 8:00 AM EST to 2:00 PM EST. 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. 

September 13,2017: Attention Inpatient Hospital Providers: MDHHS is aware that there is a system issue causing claims to deny for newborns that are born in one hospital and subsequently transferred to another hospital the same day. NUBC rules state that only the initial hospital claim should have the newborn admit type reported, and the subsequent claim should be reported with the “true” admit source 5- Transfer. The CHAMPS system is currently incorrectly denying the second admission if the admit date and the date of birth are the same and the admit type is anything other than 4-Newborn. Until the system is updated, it is advised that providers report admit type 4- Newborn and notate within the remarks “Newborn Admit Type Defect”.

There is currently no projected fix date for this issue. Another notification will be sent to providers after the system fix with instructions for identifying and adjusting affected claims.  

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

September 12, 2017: Attention ALL Providers: In January 2018 the Michigan Department of Health and Human Services (MDHHS) will implement the first phase of the Community Health Automated Medicaid Processing System (CHAMPS) Modernizing Continuum of Care (MCC) project. 

Features of the MCC project include:

  • Admissions, Enrollments, Discharges, and Dis-enrollments will be completed within CHAMPS (only required for certain provider types).
  • Level of Care (LOC) codes will be replaced with Program Enrollment Type (PET) codes.
  • Patient Pay Amounts (PPA) will be displayed separately in a new ‘Patient Pay’ section at the bottom of the CHAMPS Eligibility response page. 
  • Managed care entities will move from multiple CHAMPS provider identification numbers (CHAMPS provider IDs) to a single provider ID per contract.

An LOC to PET crosswalk table can be found on our Provider Tips webpage. 

For a list of MCC training dates and to register, please visit our Medicaid Provider Training webpage.

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

September 12, 2017: Attention Billing Agents and Trading Partners: As part of the SIGMA transition the electronic HIPAA Remittance Advice (835) will display the Vendor ID in existing loop 1000B – Payee Identification, REF02 Additional Payee Identifier segment.

Example 835, vendor ID outlined in red box:

*Please note the vendor ID is not required to be reported on the 837 file.

        

For more information on SIGMA’s major improvements, visit Michigan.gov/SIGMAVSS  

Additional SIGMA resources and Provider information can be found at Michigan.gov/MedicaidProviders

Additional Billing Agent and Trading Partner resources can be found at Michigan.gov/MedicaidProviders>>Billing and Reimbursement >>Electronic Billing

For questions please contact Automatedbilling@Michigan.gov

September 5, 2017: System Outage: Due to system maintenance, the CHAMPS system will be down from 6:00 PM EST Saturday September 9, 2017 through 9:00 AM EST Sunday, September 10, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

September 5, 2017: Attention Outpatient Hospitals: The July 2017 Quarterly APC & ASC software was loaded into CHAMPS August 12, 2017 and MDHHS will begin to adjust claims that were processed under the previous quarter’s software.

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

August 28, 2017: Attention All Providers: This serves as a reminder to all providers that bill for emergency room charges. Per Medicaid Policy Bulletin 04-03 and Section 1.2 of the Practitioner Chapter, effective for dates of service on or after January 1, 2004, the two-tiered fee screen for emergency department (ED) attending physician services is based on whether the beneficiary is treated and released from the ED or treated and admitted to the hospital/transferred to another hospital.

Treated and Released: 

When billing for the attending ED physician E/M service, the modifier UD must be used with the appropriate E/M procedure code to designate that the beneficiary was released (discharged) from the ED. This modifier must be placed in the first modifier position on the claim line to ensure correct processing. The UD modifier indicates the physician billing for the ED E/M service was the attending ED physician and allows the appropriate fee screen to be used. E/M services provided by other physicians in the ED must not use the UD modifier. Services billed in addition to the E/M service by the attending ED physician must not use the UD modifier.

Treated and Admitted/Transferred:

When billing for the attending ED physician E/M service, the modifier UA must be used with the appropriate E/M procedure code to designate that the beneficiary was admitted to the hospital or transferred to another hospital from the ED. This modifier must be placed in the first modifier position on the claim line to ensure correct processing. The UA modifier indicates the physician billing for the ED E/M service was the attending ED physician and allows the appropriate fee screen to be used. E/M services provided by other physicians in the ED must not use the UA modifier. Services billed in addition to the E/M service by the attending ED physician must not use the UA modifier.

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

August 23, 2017: Attention Outpatient Hospital Providers: This is an update to the Biller “B” Aware posted on July 19, 2017. MDHHS identified a system issue that was causing services on MDHHS wrap around list with status indicator A8-Healthy Michigan Plan only to incorrectly pay $0.00. The affected procedure codes were; G0104, G0105, G0121, G0297 and G0328. MDHHS has updated the system effective August 12, 2017. MDHHS will identify and reprocess the affected claims.

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

August 17, 2017: System Outage: Due to scheduled MILogin maintenance, the CHAMPS system will not be accessible from 7:00 AM EST until 1:00 PM EST on Sunday, August 20th, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

August 17, 2017: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, August 20, 2017, from 8:00 AM to 10:00 AM. We apologize for any inconvenience this may cause.

August 14, 2017:Attention ALL Providers: In January 2018 the Michigan Department of Health and Human Services (MDHHS) will implement the first phase of the Community Health Automated Medicaid Processing System (CHAMPS) Modernizing Continuum of Care (MCC) project. 

Features of the MCC project include:

  • Admissions, Enrollments, Discharges, and Dis-enrollments will be completed within CHAMPS (only required for certain provider types).
  • Level of Care (LOC) codes will be replaced with Program Enrollment Type (PET) codes.
  • Patient Pay Amounts (PPA) will be displayed separately in a new ‘Patient Pay’ section at the bottom of the CHAMPS Eligibility response page. 
  • Managed care entities will move from multiple CHAMPS provider identification numbers (CHAMPS provider IDs) to a single provider ID per contract.

Additional information and details to follow.

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

August 14, 2017: Attention ALL Providers: The File Transfer Service (FTS) portal will be unavailable on Sunday, August 20, 2017 from 6:00AM 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. 

August 11, 2017: Attention ALL Providers: Effective September 3, 2017, coverage that is received from McLaren Health Advantage will be loaded directly into the CHAMPS TPL Coverage File. MDHHS Third Party Liability (TPL) will no longer update these records unless changes are available in McLaren Health Advantage’s web portal after the last load date of eligibility from the National Roster File. Providers are asked to please contact McLaren Health Advantage for any questions related to loaded coverage.

August 10, 2017: System Outage: Due to maintenance, the CHAMPS system will be down between 6:00 PM EST Saturday, August 12,2017 through 9:00 AM EST Sunday August 13, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience this may cause.

August 3,2017: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, August 6, 2017, from 8:00 AM to 12:00 PM. We apologize for any inconvenience this may cause. 

August 2, 2017: Attention ALL Providers: The File Transfer Service (FTS) portal will be unavailable on Sunday, August 6, 2017 from 6:00AM 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. 

July 28, 2017: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, July 30, 2017, from 8:00 AM to 4:00 PM. We apologize for any inconvenience this may cause.

July 19, 2017: Attention Outpatient Hospital Providers: This is an update to the Biller B Aware posted on June 29, 2017. MDHHS recognizes that claims continue to be denied with CARC A8-ungroupable incorrectly. The affected claims have services that are assigned a payment status indicator G or K on Medicare’s Addendum B and the supporting payable procedure is on the MDHHS wrap around list with an assigned MDHHS status indicator. MDHHS is working to correct the system, there is no projected fix date at this time. A subsequent Biller B Aware will be posted once the issue is resolved with information for rebilling affected claims.

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

July 19, 2017 Attention Outpatient Hospital Providers: MDHHS has identified a system issue that is causing services on MDHHS wrap around list with status indicator A8-Healthy Michigan Plan only to incorrectly pay $0.00. The affected procedure codes are; G0104, G0105, G0121, G0297 and G0328. MDHHS is working to update the system, there is no projected fix date at this time. A subsequent Biller B Aware will be posted once the issue is resolved with information for rebilling affected claims.

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

July 19, 2017: Attention ALL Providers: The File Transfer Service (FTS) portal will be unavailable on Sunday, July 23, 2017 from 6:00AM to 9:00AM. 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. 

July 18, 2017: System Outage: Due to system maintenance, the CHAMPS system will be down between 2:00 PM until 6:00 PM EST on Saturday, July 22, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

July 12, 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 phone 1-800-292-2550 or email ProviderSupport@Michigan.gov .

July 11,2017: Attention ALL Providers: Please be advised: As part of the transition from the current State of Michigan (SOM) financial system, Michigan Administrative Information Network (MAIN), to Statewide Integrated Governmental Management Application (SIGMA), there will be a delay in payment and Remittance Advices (RA), i.e. HIPAA Electronic 835 transactions & paper, from the Michigan Department of Health and Human Services (MDHHS).

CHAMPS Pay cycle 40 payments (pay date 10/5/2017) and RAs will be delayed and pushed into pay cycle 41 (pay date 10/12/2017). Please be mindful as there will be no payments and RAs generated on 10/5/2017; pay 40 and 41 payments and RAs  from CHAMPS will be combined on pay date 10/12/2017.

In the event issues may arise given the transition from MAIN to SIGMA, MDHHS will immediately notify providers. 

SIGMA Key Dates: 

  • July 31, 2017: Providers converted to SIGMA VSS  
  • September 22, 2017: C&PE no longer available for update
  • October 3, 2017: SIGMA Go Live 
  • October 5, 2017: No Payments and RAs from CHAMPS
  • October 12, 2017: Combined 40 & 41 pay cycles from CHAMPS

Benefits Include: 

  • Manage account information, view invoice and payment information for checks and EFTs 24 hours a day, 7 days a week!
  • Improved communication through automated e-mails 
  • Unique Vendor/Customer ID improves privacy 
  • Provides more detailed spending analysis and robust report options

For more information on SIGMA’s major improvements, visit Michigan.gov/SIGMAVSS  

Additional SIGMA resources and Provider information can be found at Michigan.gov/MedicaidProviders

For questions please contact the SIGMA Vendor Customer Support Center (VCSC) at SIGMA-Vendor@Michigan.gov 

July 11, 2017: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, July 16, 2017, from 7:00 AM to 1:00 PM. We apologize for any inconvenience this may cause.

June 29, 2017System Outage:  Due to monthly maintenance, the CHAMPS system will be down between 6:00 PM Saturday July 8, 2017 through 9:00 AM Saturday July 9, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

June 29, 2017: Attention Outpatient Hospital Providers:  This message is an update to the Biller “B” Aware posted on May 24, 2017, alerting providers of erroneous claim rejections.  The CHAMPS system was updated on June 24, 2017, and MDHHS will begin resurrecting and reprocessing any of the affected claims.

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

June 27, 2017: Attention Clinic Providers (FQHC, RHC, THC): Michigan Department of Health and Human Services (MDHHS) will be delaying implementation of policy Bulletin MSA 17-10.  The bulletin indicated the change was effective for dates of service on or after July 1, 2017, the change has been delayed until August 1, 2017.  A bulletin announcing the delay in implementation of the institutional billing format will be forthcoming. 

Providers with further questions can contact provider support by email ProviderSupport@Michigan.gov .

June 23, 2017:Attention Clinic Providers: Please note the Clinic Revenue Codes for FQHC/RHC/THC’s  have now been added to the Medicaid Provider Webpage, which can be accessed by going to www.michigan.gov/medicaidproviders >> Provider Specific Information >> Inpatient Hospital >> Revenue Code Requirement Table.

Providers with further questions can contact provider support by email ProviderSupport@Michigan.gov .

June 23, 2017: Attention ALL Providers: The File Transfer Service (FTS) portal will be unavailable on Saturday, June 24, 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. 

June 22, 2017: Attention Skilled Nursing Facility Providers: When emailing Provider Support regarding LOCD issues the applicable documents must be uploaded to Document Management Portal (DMP) instead of sending as a PDF attachment. Please visit our Medicaid Provider Training page for guidance in using DMP – See Recorded Medicaid CHAMPS Trainings 2016 Document Management Portal (DMP). 

June 19, 2017System Outage:  Due to CHAMPS system release, the CHAMPS system will be down between 7:00 PM Friday June 23, 2017 through 2:00 AM Saturday June 24, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

June 14, 2017: Attention Private Duty Nursing Agencies:  Michigan Department of Health and Human Services (MDHHS) reminds providers of current Michigan Medicaid Policy within the Provider Manual, Billing and Reimbursement for Institutional Providers, section 10-Private Duty Nursing Agency Claim Submission/Completion.  Service Dates “Each date of service must be reported on a separate service line”.  In the instance two nurses provide services on the same day to the same beneficiary, the services must be combined and reported on one claim service line.  Providers will no longer be able to bill each nurse service on a separate claim line as this will result in a denial of the second service as an exact duplicate (CARC 18 and RARC N522).

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

June 14, 2017: System Outage: Due to MILogin maintenance, CHAMPS will be unavailable on Sunday, June 18, 2017, from 7:00 AM to 1:00 PM. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience this may cause.

June 14, 2017: Attention All Providers: As we approach the one year mark of MILogin implementation users may be prompted to update their MILogin password. Current MILogin password requirements call for users to reset their password every 365 days. For instructions on how to reset your MILogin password please refer to MILogin instructions.

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

June 13, 2017: Attention Outpatient Hospital Providers: Providers may have noticed an increase in claims denied with Claim Adjustment Reason Code 23 “The impact of prior payers adjudication including payments/and or adjustments”. If the other insurance information is reported at the header of the claim and there is a CARC reported from the other payer that is considered a denial (example: CARC  50) or would cause the claim to suspend (example: CARC 16) the claim is denied by CHAMPS. Claims will need to be rebilled with the other insurance information reported at each service line level for correct processing or providers will need to contact the primary payer to further resolve the primary payers actions.

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

June 13, 2017: Attention All Providers and Trading Partners:  CHAMPS has noticed intermittent delays in returning 271 transactions. This delay is due to the volume of requests being submitted with 5,000 or more transaction sets in a single group header and each transaction set only containing one beneficiary. To help avoid the delay MDHHS would like to remind trading partners that 270 transactions can be submitted with multiple group headers and multiple transaction sets within those headers and each transaction set can contain up to 1,000 beneficiaries.

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

June 7, 2017: Attention Clinic Providers: Please note the Clinic codes for FQHC/RHC/THC’s have now been added to the Medicaid Provider Webpage, which can be accessed by going to www.michigan.gov/medicaidproviders >> Provider Specific Information >> Clinic Institutional Billing. Please save this webpage as a favorite as additional information is posted here.These codes are not related to the OPPS Hospital defect. 

Please email ProviderSupport@Michigan.gov if you have any questions. 

June 7, 2017System Outage:  Due to CHAMPS system release, the CHAMPS system will be down between 6:00 PM Saturday June 10, 2017 through 9:00 AM Sunday June 11, 2017. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

June 7, 2017: Attention ALL Providers: The State of Michigan is upgrading its financial and business systems to a new system, SIGMA.

SIGMA, Statewide Integrated Governmental Management Application, will improve the way Michigan performs all financial activities, including budgeting, accounting, payments, and business and grant opportunities. SIGMA Vendor Self-Service (VSS) improves how we work with vendors, payees and grantees, replacing Contract & Payment Express (C&PE) and Buy4Michigan.

If you have an active account in the C&PE system on June 30, 2017, you will be converted to the user-friendly SIGMA VSS.

Key Dates:

  • July 31, 2017: Claim your account and verify information       
  • October 2, 2017: C&PE no longer available for update

Benefits Include:

  • Manage account information, view invoice and payment information for checks and EFTs 24 hours a day, 7 days a week!
  • Improved communication through automated e-mails
  • Unique Vendor/Customer ID improves privacy

For more information on SIGMA’s major improvements, visit Michigan.gov/SIGMAVSS

For questions please contact the SIGMA Vendor Customer Support Center (VCSC) at SIGMA-Vendor@Michigan.gov

 

June 2, 2017: MILogin Outage: Due to system maintenance, MILogin will be unavailable on Sunday, June 4, 2017, from 8:30 AM to 9:30 AM. We apologize for any inconvenience this may cause.

 

2017 Biller B Aware Archive

2009-2016 Biller B Aware Archive       


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Ambulance

 

Home Health  Hospital

 

 Nursing Facility

Pharmacy and DME Physician

 

Professional

   

 

All Providers

September 18, 2017: CHAMPS claim status instructions

August 15, 2017: LOC to PET Crosswalk Table

June 13, 2017: How to verify associated and authorized billing agents within a provider's enrollment information

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

March 7, 2017: Determining Eligibility Virtual Training 
Q&A from 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, 2015CHAMPS Navigation 

April 08, 2015CSHCS Provider Information Page

March 19, 2015ICD-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

 

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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).

 

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Clinics

August 10, 2017: Clinic Revenue Codes 

May 25, 2017: Clinic Institutional FAQ 

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

February 24, 2015: Clinic Billing Tips 

 

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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.

 

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Home Health

August 10, 2017: 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.
When submitting claims and reporting aide services along with skilled nursing care or physical therapy, it’s recommended to report the services in the following sequential order to allow for proper processing. The nursing and/or PT HCPCS code on the first claim line, followed by the Aide HCPCS codes. 
CHAMPS logic looks for a PAID nursing or physical therapy HCPCS service line during the same calendar month. Therefore when billing both services on the same claim, aide services could be denied if the service line is billed out of order. 

 

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Hospital

August 10, 2017: Attending Provider Tip
 

July 17, 2017: Inpatient Hospital A8 Claim denial Tip
 

June 5, 2017: Billing the Medicaid beneficiary Tips
 

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, 2017Incarceration Benefit Plan Billing Tips
 

February 17, 2017Self-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  *updated as of July 19,2017
 

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, 2015How 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 *updated as of March 31,2017
 

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). 

 

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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, 2017Instructions 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

 

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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

 

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Physician

 

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

 

 

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Professional

September 5, 2017: Billing Tip-Common Denials

August 22, 2016: Provider Verification Tool Guide

August 16, 2016: Professional Updates

February 26, 2016: Billing Tips-Vaccine for Children (VFC)

 

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