review of pcs billing nc division of medical assistance january 2013
DESCRIPTION
3 https://webclaims.ncmedicaid.com/ncecsTRANSCRIPT
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?