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  • 18,653 complaints received
  • 3,664 Field Investigations
  • $12,924,678 saved

    • May 1, 2012 - April 30, 2013

    Quick Tips
     
    Below are links to the PA Provider Quick Tips. These documents contain helpful tips for Medical Assistance providers and their staff.
     
    150 - Provider Enrollment Application Requirement effective January 21, 2013
     
    148 - CAQH/CORE Changes to 270/271 Eligibility Transactions
    146 - Statewide Obstetrical Needs Assessment Form (ONAF) Update
    145 - The ACCESS Card is not Going Away
    144 - Eligibility Verification System (EVS) Search Enhancement
    143 - Medical Assistance (MA) Providers and Managed Care Organizations (MCOs) Must Ensure Continuity of Care During HealthChoices (HC) New East Zone Expansion
    142 - HealthChoices Physical Health Expansion to the New East Zone March 2013
    141 - Delaying the Copay for Alternative Cost Sharing for Families of Children with Disabilities with Incomes Over 200% of the Federal Poverty Income Guidelines
     
    139 - Attention Medical Assistance (MA) Dental Providers
    138 - Medical Assistance (MA) Providers and Managed Care Organizations (MCOs) Must Ensure Continuity of Care During HealthChoices (HC) Expansion
    137 - Billing of Multiple Surgical Services
    136 - Billing Primary Procedure Code with Add-on Code(s)
    135 - HealthChoices Physical Health Expansion to the New West Zone
    134 - Low-Cost Outlier Implementation and High-Cost Outlier Threshold Adjustment
    133 - Emergency Supply of a Prescription That Requires Prior Authorization (PA) or a Benefit Limit Exception (BLE)
    132 - Updates to the Medical Assistance (MA) Program Fee Schedule for Hospital Based Clinic Services
    131 - Miscellaneous Healthcare Common Procedure Coding System (HCPCS) Procedure Codes B9998, E1399 and K0108 with Specific Modifiers Are Assigned to Distinct Items on the Medical Assistance (MA) Program Fee Schedule
    130 - The ANSI X12 v5010/D.0 Certification Help Desk will be Discontinued as of March 30, 2012
     
    129 - Payment Error Rate Measurement (PERM) Initiative for Federal Fiscal Year (FFY) 2012
    128 - Non-Emergency Ambulance Transportation – Appropriate Use of Place of Service (POS) and Modifier for Nursing Facility Recipients
    127 - Provider Electronic Solutions (PES) Software v3.59 replaces v3.58
    126 - HealthChoices is Expanding to your County in 2012
    125 - Reporting Ambulance Pick-up/Drop-Off Point of Service
    123 - Medical Assistance (MA) Claims for Ambulance Transport to Inpatient Hospital Facilities
    122 - Medical Assistance (MA) Outpatient Online Fee Schedule
    121 - Certification Renewal Required for Medical Assistance (MA) Providers Dispensing Hearing Aid Supplies (revised January 2013)
    120 - Waiving of the Certification Requirements for ANSI X12 v5010 and NCPDP D.0 for current electronic claim submitters
     
    119 - PROMISe™ Internet Adjustments, Voids and Resubmissions Beginning January 1, 2012
    117 - Medical Assistance (MA) Phone Number Changes
    116 - Compliance Date for ANSI X12 v5010/NCPDP vD.0 IS January 1, 2012; Pennsylvania will Implement January 1, 2012
    115 - Medical Assistance Inpatient Hospital Claims Secondary to Medicare Include 3 Day (72 hour) Payment Rule
    114 - Fee-For-Service Relative Weight Adjustment
    113 - Changes to Diagnosis Code Edits
    112 - Reprocessing Procedure Code 90999 Claims
    111 - Discontinued Mailing of Medical Assistance Bulletins
    110 - Medical Assistance Dental Benefit Changes
     
    109 - Is it Necessary to Certify for X12 v5010 Transactions?
    108 - Pediatric Palliative and Hospice Care Task Force
    107 - Medical Assistance Health Information Technology Initiative Electronic Health Record Incentive Program
    106 - PES Software Upgrade
    105 - APR-DRG Implementation to Begin on 3-4-11
    104 - 2-25-11 APR-DRG Implementation DELAYED
    103 - 1099-MISC - Information for Providers
    102 - As DPW Moves from DRG to APR DRG
    100 - ANSI v5010/NCPDP D.0 Recertification
     
    98 - Providing Services for Recipients who are Locked-In to a Physician, Pharmacy or Hospital
    96 - New Web Site Coming in October!
    95 - Clarification on the Change in Protocol for Certain Provider Appeals
    94 - Pennsylvania PROMISe ANSI X12 v5010 Companion Guides
    91 - PROMISe Certification for ANSI 5010 and NCPDP D.0
     
    89 - HIPAA Upgrades to ANSI X12 v5010 & NCPDP D.0 are coming! Get Ready!
    87 - Medical Assistance (MA) Providers are reminded to make sure MA contact information is up to date
    85 - Department of Public Welfare (DPW) Breast and Cervical Cancer Prevention and Treatment Program (updated February 2013)
    84 - HCBP 15 SelectPlan for Women Provides Limited Coverage
    82 - Reminder to Medical Assistance (MA) Providers Filing National Provider Identifier (NPI) Electronic Claims
    81 - Copayment Desk Reference Clarification
    80 - Attention: All Healthy Beginnings Plus Providers
     
    79 - ICD-9 Codes E849.0 - E849.9 (Place of Occurrence)
    77 - Medicaid Integrity Contractor (MIC) Audits
    76 - Reporting Diagnosis Codes for Immunization Administration
    75 - Pennsylvania PROMISe - 835 Remittance Advice Companion Guide
    74 - Diagnosis Codes are Required on Most Medical Assistance Claims
    72 - National Provider Identifier (NPI) Requirements For Electronic Claims
    71 - The Department of Public Welfare (DPW) Encourages Providers to go Electronic and Support the Go Green Initiative!
     
    69 - Medical Assistance (MA) Claims for Advanced Radiologic Imaging Services
    68 - Using the 50 Modifier on Medical Assistance Claims
    67 - Prior Auth. Requirements for Effective Non-Fee Schedule Surgical Procedures Effective Aug. 1, 2008
    66 - Early Periodic Screening, Diagnosis & Treatment (EPSDT) & Error Status Code 771
    65 - Early & Periodic Screening, Diagnosis & Treatment (EPSDT) Billing Assistance for FQHCs
    64 - For Medical Assistance (MA) Providers Submitting MA Claims For Prior Authorized Services
    63 - Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Billing Assistance
    62 - NPI and Paper Claim forms: CMS-1500 (Professional)& UB-04 (Institutional)
    61 - FFS Reminder: Prior Auth. Requirements for Advanced Radiologic Imaging Services Effective Sept. 1, 2008
    60 - Place of Service Review (PSR) requests for Short Procedure Units (SPUs)
     
    59 - Information For Healthy Beginnings Providers
    58 - Prior Authorization Requirements for Advanced Radiologic Imaging Services
    56 - Most Common Errors Made On the Prior Authorization / MA 97 Form
    55 - Federal Requirements for Outpatient Drug Prescriptions for MA Recipients
    53 - Electronic Funds Transfer (EFT) Sign Up Today!!
    52 - MA Recipient Drug Prescriptions Must be Written on Tamper-Resistant Prescription Pads
    51 - Dental Behavior Management Billing Reminders 
     
    47 - Attention: DME Suppliers, Independent Labs, and Mobile X-Ray Providers
    46 - Attention, New Healthcare Providers Requesting Medical Assistance (MA) Enrollment
    45 - National Provider Identifier (NPI) Legacy Dual Strategy
    44 - Correctly Reporting Value Codes on the UB-04 Claim Form to Ensure Smooth Claims Processing
    43 - Now Receive Medical Assistance (MA) Bulletin Notifications Via Email!
    42 - Eligibility Verification System (EVS) Reminder
    41 - Medical Assistance Desk Reference Guide (Updated February 2013)
    40 - New Downloadable Outpatient Fee Schedule
     
    39 - Provider Data Elements Expected on HIPAA-Covered Transactions
    38 - Attention, All Healthcare Providers: You MUST Register an NPI Number with DPW
    36 - Use EVS Instead of Paper Vouchers to Verify Visit Limits
    35 - The PROMISe Outpatient Fee Schedule is Online
    32 - Atypical Providers
    31 - New Option on ePeap!
     
    27 - National Provider Identifier (NPI) Taxonomy Codes
    26 - Securing National Provider Identifier (NPI) Numbers for Subparts
    25 - Access Plus Referral Requirements Effective November 1, 2006
    24 - NPI and Paper Claim Forms
    23 - Federal Medicaid Citizenship and Identity Eligibility Requirements
    21 - You Can Stop Receiving Paper Remittance AS (RAs)
     
    17 - Scope of Coverage of Pharmacy Services: Medical Assistance Dual Eligibles
    15 - Copayments for Prescription Drugs
    14 - AccessPlus - PA's Enhanced Primary Care Case Management Program
    12 - Do You Need to Send an Attachment for an Electronic Claim?
    11 - The Eligibility Verification System (EVS)
    10 - ePEAP (electronic Provider Enrollment Automation Project)
     
    07 - Are You Puzzled by Your Remittance Advice Statement?
     
    Long Term Living Providers: 
     
    01 - General Information
    02 - UB-04 Questions & Answers
    03 - Billing Questions and Answers
    04 - Medicare Questions and Answers
    05 - PES (Provider Electronic Solutions Software)

     

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