Effective April 14, ICF/ID providers should follow the new process for requesting preadmission for members by entering an LTC case on the portal that does not contain admission/discharge dates. For complete instructions on this new preadmission process, refer to the TPA LTC Admission-Discharge User Guide.
There will be no impact to the ICD-10 test schedule despite the recent announcement that the ICD-10 compliance date will be delayed by 1 year. Molina and Medicaid will continue with the scheduled transition to ICD-10 by 10/1/2014. However, we will not begin accepting ICD-10 claims until the industry compliance date of 10/1/2015 or later as determined.
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:
CMS 1500 Instructions
The April Healthy Connections and Idaho Medicaid Health Home Member Rosters have been posted to your secure Trading Partner Account.
Registration for the 2014 Idaho Health Care Conference (IHCC) is now open. The dates of the conference are:
May 6 – Lewiston
May 7 – Coeur d’Alene
May 13 – Boise
May 20 – Idaho Falls
May 21 – Pocatello
May 22 – Burley
You can view the agenda for the conference online. Click here to register; registration is free for all Idaho health care providers.
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.
The Medicaid Bureau of Developmental Disability Services (BDDS) has updated its processes related to obtaining medical care information. Starting April 1, 2014, the Idaho Center for Disabilities Evaluation will begin including an Adult DD Medical Care Form with each eligibility scheduling letter sent to the participant. The participant will be asked to provide this form to their physician to complete. For more information on this updated process, please refer to the April 2014 MedicAide or call Jean Christensen at 1 (208) 334-0944 .
The April 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.
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.
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.