Frequently Asked Questions


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Frequently Asked Questions

 

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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.


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