Frequently Asked Questions

Currently sorted By last update ascending Sort chronologically: By last update | By creation date

Page: (Previous) 1 ... 14 15 16 17 18 19 20 21 22 23
ALL

What is the Web Tool’s Non-Contractual box?

The Non-Contractual box is to be selected/entered when the provider is not contracted with the member’s third party payer.

Why would a Nursing Facility provider receive a 951 rejection if the member had always been eligible for NF Medicaid since entering the facility?

A 951 Edit Code means the member was not eligible for Medicaid on the date of service. The member and/or responsible party for the member might not have completed the annual Medicaid eligibility review. Inform the nursing facility caller to contact the member’s eligibility caseworker.

Can I check claim status on the Web Tool?

Yes. Key in the NPI or provider ID number and the member ID number and press submit.

If you are checking a new person’s eligibility, can you add them to your member list from that screen? Yes, there is a button to do that.

Yes, there is a button to do that.

Page: (Previous) 1 ... 14 15 16 17 18 19 20 21 22 23
ALL

Learning Resources