Can MIVS track down where other payer’s money goes if you are not paid?
Can the HIIRF form be faxed?
Can you accept a beneficiary as just a private pay patient even if they have Medicaid?
Do we need to send an EOB?
Do we send an EOB with claims?
Do you have to ask MIVS to research TPL non-payment?
Does the Medicaid card have all the information needed?
For HIPP referral, who should you contact?
How do patients learn updated information?
Patients learn of updates at their enrollment anniversary dates, or you may share information with them.
How long do you have to request a hearing for an appeal?
If a Health Insurance Information Referral Form (HIIRF) is completed with no documentation, will the beneficiary's TPL record be updated?
If a plan doesn’t cover family planning, do we bill to Medicaid and send the EOB?
If I have a difficult payer, do I need to complete a reasonable effort document?
If I send a HIIRF, will I see anything saying it was received?
If my third party has several addresses, which one do I choose?
If the beneficiary had Champus or Tri-Care and it paid 100%, why would I need to file to Medicaid?
You would need to file to Medicaid for reporting purposes and for seeing the claim through from beginning to end.
If you know a service isn’t covered, do you still file to the other carrier?
Yes, you still file to the other carrier to obtain a valid denial. Three denials should be kept on file each year.
What do you do if monies are sent to the patient?
What happens when Medicaid recoups for retro-health recovery and it is outside of the timely filing window?
What if a claim is created, but the beneficiary says that he/she no longer has the insurance on file?
If a beneficiary no longer has the insurance policy that is seen on the Web Tool, the provider can refer the beneficiary to their eligibility counselor/worker, or complete the Health Insurance Information Referral Form (HIIRF) to update the beneficiary’s third party payer information. Making a change to a policy that already exists in the Medicaid Management Information System (MMIS) takes five days. The HIIRF Form can be faxed to 803-252-0870.
Where are the specifics for pay and chase?