Frequently Asked Questions


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Frequently Asked Questions

 

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D

Do we send an EOB with claims?

You do not send an EOB with claims, unless it is requested.

Do you file to another payer when you know services are not covered?

Yes, this is considered a valid denial.

Do you have to ask MIVS to research TPL non-payment?

No, they do this on their own to ensure payment.

Do you have to put in diagnosis codes?

If the service you are providing requires the use of a diagnosis code, then you must enter the diagnosis code with your claim information. 


Do you have to put the last 4 digits of the zip code for Claims Entry?

Yes; you can find zip codes on the US Postal Services website: www.usps.com.  Click on Look Up a Zip Code


Do you have to submit claims through Web Tool?

No, you may use other options like hard copy or vendor/clearing house.


Does a beneficiary have to be on Medicaid to qualify for HIPP?

No, but they must be Medicaid eligible.

Does Suspended mean processing?

No; Suspended means that the claim is in review. 


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.

Does the Nursing Facility (NF), Intermediate Care Facility (ICF) / Mental Retardation (MR) or Swing Bed facility have to wait for a denial from DHHS before submitting an invoice to the hospice agency?

Yes. The denial must be attached.



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