Frequently Asked Questions


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Frequently Asked Questions

 

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I did not receive my TAD. Can you fax/mail a copy?

MCCS can send a copy of the TAD when requested.

Should claims returned on Form 017 or 017CI without processing be re-filed?

Yes. Once corrections are made, Medicaid claims should be re-billed using the CRCF-01 form for OSS and the DHHS 181 for NFs. Coinsurance claims can be submitted at any time of the month once corrections are made.

What happens if my DHHS Form 181, CRCF 01 or IPC form is not received on time or is not received at all?

No changes will be made regarding beneficiaries’ income, IPC/CRCF status, etc., for the current billing month if change forms are not received by MCCS. However, changes can be made during the next month’s billing process.

Will every Nursing Facility or Intermediate Care Facility (ICF) / Mental Retardation (MR) have the same rate?

No.

Is the date of discharge for Nursing Facilities or Intermediate Care Facility (ICF) / Mental Retardation (MR) room and board Medicaid reimbursable?

Nursing Facilities and ICFs/MR are not reimbursed for the date of discharge.

Nursing Facilities and ICFs/MR should not invoice hospice agencies for the date of discharge. The date of hospice discharge for a reason other than death or transfer to another facility is billed to Medicaid.

For example: If the person was in an NF or ICF/MR facility from Feb. 1 to Feb. 23, 2013, and was enrolled in hospice from Feb. 1 to Feb. 14, 2013, the hospice would pay NF or ICF/MR the room and board for Feb. 1 to Feb. 13, 2013. Medicaid would pay the NF or ICF/MR for dates of service from Feb. 14 to Feb. 22, 2013. 

Who is responsible for pharmaceutical costs as it relates to the terminal illness?

The hospice agency is responsible for pharmaceutical costs related to pain management and symptom control of the terminal illness.

What happens if the NF or ICF/MR* accepts a hospice resident while Medicaid eligibility is pending and it is later determined that the resident is not eligible? Who is responsible for room and board payment to the NF or ICF/MR?

The hospice is responsible for the room and board amount.

It is imperative that the hospice social worker continues to pursue eligibility for the resident to decrease the financial risk in the event the resident is ultimately not eligible for nursing facility benefits. 

*Nursing Facility (NF) or Intermediate Care Facility (ICF) / Mental Retardation (MR)

What happens if the Nursing Facility (NF) or Intermediate Care Facility (ICF) / Mental Retardation (MR) is paid in error for hospice dates of service?

The nursing facility must submit a request for an adjustment. The adjustment process must be completed before the hospice can be paid for room and board dates of service.

When are TADs available for providers to view on the Web Tool?

TADs are not yet available on the Web Tool. Medicaid will continue to send copies of the TADs to providers until the TADs are available on the Web Tool.

When are the DHHS Form 181, CRCF 01 and IPC forms due back to MCCS?

Nursing Home change forms are due to MCCS on the first working day of each month. OSS change forms are due no later than the 17th of each month. These dates are subject to change based on holidays, etc.


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