Michigan Medicaid. REIMBURSEMENT UPDATES WINTER 2012/2013 Presenter-Catherine Caswell. Agenda . Hospital – edit changes for OPH/IPH Coding Updates Policy Clarifications New policy Review Proposed policy review CHAMPS Payment Schedule Posted Mass Claim Adjustment Schedule
Projected correction=4.6 release 02/15/2013
Future (not assigned to a release)
Projected (was 4.7-04/26/2013 ) ) now delayed due to budget constraints*
http://www.cms.gov/Medicare/Billing/TherapyServices/index.html?redirect=/TherapyServices need to use MPPR rate file (Multiple Procedure Payment Reduction)
(click the Medicaid Provider Training Sessions button in ‘Hot Topics’).
It is the providers responsibility to keep track of all TCN’s involved and to supply them when necessary to satisfy time limit requirements
Call Provider Support 800 292 2550 for billing information when your remittance advice denies claim with remark code N47-(Claim conflicts with another inpatient stay) and ask for other facility name and their from through dates. Investigate if PACER was or should be obtained etc.
WINTER 2012/2013 REIMBURSEMENT UPDATES