Oct 9, 2010 | Medical billing basics
Patient 1st Patient 1st is a statewide Primary Care Case Management (PCCM) system. Medicaid recipients eligible for this program are assigned to a Primary Medical Provider (PMP) who is responsible for primary care services and authorization of referrals. The...
Oct 7, 2010 | Medical billing basics
QMB-only Medicare recipients QMB-only Medicare recipients are identified as QMB ONLY by using the Provider Electronic Solutions software, AVRS (Automated Voice Response System) or the Provider Assistance Center. These recipients are eligible only for crossover...
Oct 7, 2010 | Medical billing basics
How will I know if I have successfully submitted my enrollment application? Once the Internet application has been electronically submitted, the “Submission Receipt” page appears. This page informs the physician or non-physician practitioner that the...
Oct 7, 2010 | Medical billing basics
Maternity Care Program The Maternity Care Program is a statewide program that covers maternity services. The state is divided into 14 districts with a Maternity Care Primary Contractor in each district. The primary contractor is responsible for the coordination of...
Oct 7, 2010 | Medical billing basics
Provider Signatures This section discusses the various requirements for provider signatures when filing electronic or hard copy claims. Medical Claims The provider’s signature on a claim form/medical submission agreement certifies that the services filed were...
Oct 7, 2010 | Medical billing basics
Providers may submit paid and partially paid third party claims to Medicaid using theapproved paper or online filing methods as described in Chapter 5, Filing Claims. The following third party-related information is required on the claim, in addition to the other...
