Saturday, April 20, 2024, 3:11 AM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Frequently Asked Questions
For ambulatory care, are children under 19 exempt from copay?Children under 19 are exempt from all copays. |
Can you only see a certain amount of beneficiaries?Yes, but you must have a visible sign stating so. |
Can you export data from Web Tool?Not at this time, however you can print screen and save it as a file. |
Will recertification dates be listed on Web Tool?No, it would violate HIPPA. |
If the beneficiary doesn’t have an ID number for the MCO, how do we obtain it?Contact the MCO. |
What should I do if one line does not pay on your claim?Correct and refile that one line. |
Can I handwrite on the claim forms?Yes you can, or you use a printing service. |
How does Medicaid know what the provider is receiving from another carrier/third party payer?There are spaces/sections on the claim form that identify what you receive from the other carrier. |
Do we need to send an EOB?An Explanation of Benefits from a third party payer should be kept on file in the provider’s office, especially if the payer didn’t submit payment. |
How are MCO plans chosen for a beneficiary if they are auto-enrolled?The plan is chosen based on the beneficiary’s needs, service area, and any needed specialists. |