review of pcs billing nc division of medical assistance january 2013

Review of PCS Billing

NC Division of Medical AssistanceJanuary 2013

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NCECSWeb Tool Next slides will present Screen Shots of actual

form on Web Tool Web Tool

https://webclaims.ncmedicaid.com/ncecs Must have a HP login and password Don’t have a login?

Contact HP ECS for login 1-800-688-6696, menu option 1

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https://webclaims.ncmedicaid.com/ncecs

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https://webclaims.ncmedicaid.com/ncecs

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https://webclaims.ncmedicaid.com/ncecs

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Do not provide history of

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Use the modifier listed inDecision Notice Provider receivesfrom CCME

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What Billing Questions are directed to HP? Denials Incorrect or Missing Carolina Access Number Incorrect CPT code Assistance with the Web Tool Request for on site visit

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RESOURCES

HP Enterprise Services (HPES) – Provider Services

Toll Free Number: 1-800-688-6696

Division of Medical Assistance (DMA) - http://www.ncdhhs.gov/dma/index.htm Basic Medicaid and NC Health Choice Billing

Guide - http://www.ncdhhs.gov/dma/basicmed

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RESOURCES

The Carolina Center for Medical Excellence (CCME) - www.thecarolinascenter.org

CCME’s Call Center is available Monday through Friday from 8:00 a.m. – 5:00 p.m. Toll Free Number: 800-228-3365

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RESOURCES Special Bulletin Dec 2011

http://www.ncdhhs.gov/dma/bulletin/NCECSWebGuide.pdf

North Carolina Electronic Claims Submission/Recipient Eligibility Verification Web Tool https://webclaims.ncmedicaid.com/ncecs

www.nucc.org Provides a crosswalk of paper CMS 1500 fields

to electronic form equivalent fields

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RESOURCES

Place of Service Codes General Bulletin Dec 2005 http://www.ncdhhs.gov/dma/bulletin/pdfbulletin/

1205bulletin.pdf

PCS Limitations or Requirements 5.4.1 Place of Service http://www.ncdhhs.gov/dma/mp/3L.pdf

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RESOURCES

www.cms.gov

http://www.cms.gov/medicare-coverage-database/staticpages/icd-9-code-lookup.aspx

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QUESTIONS?