The March Healthy Connections and Idaho Medicaid Health Home Member Rosters have been posted to your secure Trading Partner Account.
Updates have been made to the Provider Handbook. You may find the link on the left navigation panel of this website. Changes are noted at the beginning of each document. The updated documents are:
- Allopathic and Osteopathic Physicians
- Eye and Vision Services
- Remittance Advice Analysis
A new section has been added to your RA. The Adjustment section will appear at the end of the claim detail portion of the RA and will list claims that have been adjusted based on third party and overpayment recoveries. Claims will be listed with a claim status of Adjustment: PAID or Adjustment: REVERSED. Please note: These adjustments do not impact your payment and are for informational purposes only.
The numerical fee schedule has been updated and is available online. Click Medicaid Fee Schedules in the menu on the left to view the most current ones. The numeric fee schedule is applicable to most providers. Additional custom fee schedules are updated as needed.
When entering a discharge for an LTC case on the Molina Medicaid website, it is important that you do not use any special characters in the discharge-to address (commas, periods, etc.). Entering special characters in the address will prevent the system from discharging the patient properly.
Please remember to perform timely admissions and discharges for all LTC cases.
January and February share of cost (SOC) decreases are currently being updated. Letters are sent to notify providers of SOC decreases. The letters are sent to the address on the provider record or on the provider’s claims. If you are not receiving these letters, contact your regional Provider Relations Consultant. Once the decreases have been updated, the new SOC can be found by viewing Eligibility. When verifying SOC, remember to use the first day of the month as the effective date. Members with $0 SOC will now be reflected going forward in Eligibility Verification.
The March edition of the MedicAide Newsletter is now available online. Please click here for the latest news and information affecting Idaho Medicaid providers. If you prefer to receive the MedicAide by mail, please dial 1 (866) 686-4272 and select option 3.
Providers were recently notified that prior authorization (PA) numbers on claims would be required beginning April 1, 2014. This date has changed, and PA numbers will be required on claims as of May 1, 2014. Claims submitted on or after May 1, 2014, for services that require a prior authorization, will be denied if the PA number is not included on the appropriate claim line. If your claim does not process as expected, please contact your local Provider Relations Consultant (PRC) so the claim processing record can be reviewed.
Reminder: Idaho Medicaid is now accepting the revised CMS-1500 claim form. The old version of the form will no longer be accepted beginning April 5, 2014. For more information, see the article published in the December 2013 MedicAide newsletter.