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 ‭(Hidden)‬ Welcome to Health PAS OnLine

 

 
 

 Welcome to Health PAS-OnLine Announcements

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Bariatric Policy ChangeUse SHIFT+ENTER to open the menu (new window).

After recent review of our bariatric surgery policy, effective for date of service April 1, 2015, bariatric procedures may now be performed in any Idaho Medicaid enrolled hospital which is also Medicare certified.

  • Hospital practices should be in keeping with national medical standards for weight loss surgery (IDAPA 16.03.09.434) to promote positive outcomes.
  • Procedures must be prior authorized by Qualis Health. If approval is granted, Qualis Health will issue the authorization number and conduct any necessary length-of-stay reviews.  For more information, contact Qualis Health at 1 (800) 783-9207 or see http://www.qualishealth.org/healthcare-professionals/idaho-medicaid.

 

Medicaid ICD-10 Compliant!Use SHIFT+ENTER to open the menu (new window).
We have completed successful validation of ICD-10 updates to our Molina claims processing system (MMIS) for ICD-10 compliance with an effective date of 10/1/2015. ICD-9 coded claims are required for dates of service through 9/30/2015. Starting 10/1/2015, all claims with a date of service of 10/1/2015 and later are required to be billed with ICD-10 codes.
March MedicAide Newsletter Now OnlineUse SHIFT+ENTER to open the menu (new window).
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 must receive the MedicAide by mail, please dial 1 (866) 686-4272 and select option 3.
Idaho Health Care Conference - Save the DateUse SHIFT+ENTER to open the menu (new window).

The dates have been announced for the 2015 Idaho Health Care Conference.  Look for more details soon on www.idmedicaid.com.

  • Clarkston – May 5, 2015
  • Coeur d’Alene – May 6, 2015
  • Idaho Falls – May 12, 2015
  • Pocatello – May 13, 2015
  • Twin Falls – May 14, 2015
  • Boise – May 21, 2015
Attention PCPs and PHA Weight Management ProvidersUse SHIFT+ENTER to open the menu (new window).

Preventive Health Assistance (PHA) has been added as section 2.8 of the General Provider and Participant Information handbook.  Eligibility and billing information for weight management services has changed.

Health Acquired Conditions (HAC)/Present on Admission (POA) Use SHIFT+ENTER to open the menu (new window).

Beginning January 1, 2015 Medicaid will implement an edit in the claims processing system that will look at inpatient claims for Health Acquired Conditions (HAC).  The system will use the combination of the Present on Admission (POA) indicator, procedure codes, and diagnosis codes.  The POA indicator is required for all claims involving Medicaid inpatient admissions.

 

POA is defined as present at the time the order for inpatient admission occurs — conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered POA.  The POA indicator is assigned to principal and secondary diagnoses.

 

For details and proper billing, refer to the Provider Handbook – Hospital (https://www.idmedicaid.com/Provider%20Guidelines/Hospital.pdf) Section 4.4 – 4.4.2.

 

Any claim that is not properly billed will be denied.

FQHC/RHC Crossover and Third Party BillingUse SHIFT+ENTER to open the menu (new window).
In order to be paid up to the Encounter Rate for claims with a third party payment, specific instructions must be followed. Click here for the instructions.
Trading Partner Registration Tip SheetUse SHIFT+ENTER to open the menu (new window).

We have posted a trading partner registration ‘Tip Sheet’ to answer questions you may have concerning which entity type to select. You can find it under the ‘User Guides’ link to your left.

 

Dial 1 When You Call!Use SHIFT+ENTER to open the menu (new window).
It is very important that you dial a 1 when calling us. Please call 1 (866) 686-4272.
Thank you!
 
 
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