Tuesday, July 8, 2025, 3:44 AM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Frequently Asked Questions
What happens if you void the wrong claim?If it is voided, you can submit a new claim in. |
Can you submit two claims forms to void/replace a ten-line claim?Yes you can, as long as it is not a duplicate claim or void only; then, refile a 4-line and 6-line claim. |
Is an adjustment only done when you have been paid?Yes, only paid claims can receive an overpayment or underpayment. |
Will the system distinguish that a company has multiple provider numbers?Yes, make sure all their information is correct when completing the claim form. |
Do you file to another payer when you know services are not covered?Yes, this is considered a valid denial. |
What if you know any other office has a claim waiting to be filed that uses the same visit counts you will be using to file a claim for a member?You should also file right away. Area representatives can approve a few extra visits, but not every time. |
Do you have to ask MIVS to research TPL non-payment?No, they do this on their own to ensure payment. |
For HIPP referral, who should you contact?For HIPP referral, providers should contact the Medicaid Insurance Verification Services at 1-888-289-0709 option 5, option 4. The HIPP Fax is 803-462-2580. |
Can you accept a member as just a private pay patient even if they have Medicaid?Yes, you just have to let them know before they receive any services. |
Does the Medicaid card have all the information needed?No, you should further investigate eligibility using eligibility resources and the information provided on the card. |