Yes, as long as the provider is not designated as an ordering/referring provider exclusively. Future edits will prevent claims payment if an ordering/referring-only provider submits their NPI as a billing provider.

No. The only information that the provider service center has is if a provider revalidation application has been completed and submitted. The provider service center cannot see if a provider has started the application process but not completed it. If you have the revalidation reference number, NPI and Medicaid ID of the provider in question, you can access the application to see if there is any work in progress. Revalidation FAQs PDF

Yes, providers can be reassigned from the “limited” or “moderate” categories due to:

• Imposition of a payment suspension within the previous 10 years
• A provider or supplier has been terminated or is otherwise precluded from billing Medicaid
• Exclusion by the OIG
• A provider or supplier has been excluded from any federal health care program
• A provider or supplier has had billing privileges revoked by a Medicaid contractor within the previous 10 years
• A provider or supplier has been subjected to a final adverse action (as defined in 42 CFR 424.502) within the past 10 years
• Instances in which CMS lifts a temporary moratorium for a particular provider or supplier type and a provider or supplier that was prevented from enrolling based on the moratorium, applies for enrollment as a Medicaid provider or supplier at any time within 6 months from the date the moratorium was lifted.

No. Batches cannot be deleted at this time.

You must have authorized signed documentation in order to add a member to your TAD. You should not add a member before the DHHS 181 is forwarded to DHHS Medicaid Eligibility for approval. Contact your Eligibility office if additional information is needed.

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

Yes. You can check on the status of your provider revalidation application by calling the Provider Service Center at (888) 289-0709, option 4. You will need your revalidation reference number in order to check on the status of your provider revalidation application. Revalidation FAQs PDF

Yes, by entering in information in the to and from fields.

Extensions will not be granted due to the stringent timelines mandated by Federal Regulation 455.104 (b), (c), and 455450 (e). Revalidation FAQs PDF

Yes. There are certain points that are clearly defined in the provider revalidation application process where you can save your work and exit the application. An incomplete application will be deleted and unable to be recovered 30 days from the day the application was created. Revalidation FAQs PDF

The HIIRF can be faxed to Medicaid Insurance Verification Services at (803) 252-0870.

No, however the edit code listing is found in Appendix 1 of your provider manual.

Not at this time. The Lists can be sorted by who created them. 

Users in the same organization based on the provider’s NPI number will be able to see claim information entered by other users.

No, MCCS staff cannot add any information to the TAD. You can only make changes via DHHS Form 181, CRCF 01 and IPC change forms.

An authorized SNF 181 along with a separate Medicare-to-Medicaid bed hold billing 181 is required.

Yes, you can copy batches and delete selected claims.

Yes; this can be done by submitting a new claim. 

No. MCCS staff cannot make corrections to the DHHS Form 181 or CRCF 01 form.

Yes, providers must file to all other payers and then input that information (received money) on the claim form on the Web Tool. There is a place to identify the hierarchy.

Yes. Copy the claim, correct it, and submit it.

Yes, if you submit a new claim, you will get a new CCN.

Copies of Remittance Advice statements can be retrieved online via the Web Tool.

If the remittance advice date is not available, complete a Duplicate Remittance Advice Request Form in the Forms Section of all provider manuals. There is a processing fee of $20 plus 20 cents per page copied. The charges will be deducted from a future Remittance Advice, appearing as a debit adjustment. The duplicate RA policy was enacted in December 2010.

Yes, you may submit an adjustment through the Web Tool, even if the original claim was filed using a clearinghouse – as long as it is within 15-18 months. However, UB-04 (Institutional) billers must file adjustments in the same medium as the original claim.