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Dialysis Clinic

Dialysis Clinic

Provider Manuals

General Information for Providers 02/2017

Medicaid manual with general information for all provider types.

Dialysis Clinic Services 08.2016

This manual has information specific to your provider type.

Provider Manuals – Replacement Pages

General Information for Providers

02/06/2017 In summary, the Telemedicine Chapter was added as a new chapter.  And the Medically Needy section of the Member Responsibilities Chapter page 6.5 was updated.

08.02.2016

 

07.12.2016

 

General Information For Providers, July 2016

01.19.2016 General Information for Providers, January 2016: Introduction Regarding HELP Plan Information
01.15.2016 General Information for Providers, January 2016: Introduction Regarding HELP Plan Information
12.31.2015 General Information for Providers, January 2016: HELP Plan-Related Updates and Others
11.17.2015 General Information for Providers, November 2015: Billing Procedures, Revenue Codes 25X and 27X
07.31.2015 General Information for Providers, August 2015: Entire Manual
11.19.2014 General Information for Providers, November 2014: Billing Procedures
10.08.2014 General Information for Providers, September 2014: Billing Procedures
07.22.2014 General Information for Providers, June 2014: Member Eligibility and Responsibilities, Presumptive Eligibility
06.30.2014 General Information for Providers, June 2014: Entire Manual
If information is found on the website, it has been removed from the manual, and a link to the source is provided.
04.13.2012 General Information for Providers, April 2012: Medicaid Covered Services and Client Eligibility
04.29.2005 General Information for Providers, April 2005: Member Number a Billable Number and Key Contacts Updated
11.05.2004 General Information for Providers, November 2004: References to Medicaid Rules and Regulations Added
09.16.2004 General Information for Providers, September 2004: Team Care and Nurse First Information Added

Dialysis Clinic Services

08.08.2016

Dialysis Clinic August 2016: In Summary, the Cost Share Section of the Billing Procedure Chapter removed specific fees. The Cover Page was changed to reflect the current manual edition date

 

12.31.2015 Dialysis Clinic, January 2016, HELP Plan-Related Updates and Others
11.02.2015 Dialysis Clinic, October 2015: Covered Services and Billing Procedures
07.06.2015 Dialysis Clinic, June 2015: Entire Manual
03.25.2014 Dialysis Clinic, February 2014: Multiple Chapters
Key Contacts/Websites, Covered Services, Coordination of Benefits, Submitting a Claim, RAs and Adjustments, Forms
10.17.2013 Dialysis Clinic, October 2013: Multiple Chapters
Key Contacts/Websites, Introduction, Covered Services, Billing Procedures, Submitting a Claim, RAs and Adjustments, Payment, Forms, Definitions and Acronyms

Medicaid Rules and Regulations

Fee Schedules – Dialysis Clinic

Provider Notices 2010–

2017

04/06/2017 New EPSDT Request Form

2016

07.18.2016 Changes to Member Cost Share Update
05.19.2016 Changes to Member Cost Share
03.21.2016 NDC Required for Physician-Administered Drugs: Billing Instructions for Montana Medicaid Crossover Claims
02.22.2016 Hospital NDC Billing on Revenue Codes and Electronic Claim Submission Denials
02.01.2016 Basic Medicaid Benefit Increased to Standard Medicaid Benefit
01.25.2016 Hospital National Drug Code (NDC) Billing on Revenue Codes
01.15.2016 Standard Medicaid and HELP Plan Claims Processing Rev. 01.19.2016

2015

12.31.2015 Changes to Montana Medicaid
11.18.2015 Hospital National Drug Code (NDC) Billing on Revenue Codes Rev. 12.21.2015
11.03.2015 Services Exempt from Passport to Health Referral
10.09.2015 Changes to the Dialysis Clinic Services Provider Manual
10.01.2015 Changes to the Children's Mental Health Bureau Medicaid Services Provider Manual
08.03.2015 ICD-10 Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10)
07.31.2015 Adult and Pediatric Specialty Table of Services Available in Montana
02.11.2015 New HCPCS Modifiers – XE, XP, XS, and XU

2014

12.18.2014 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes Final Notice
09.16.2014 Adoption of the New Children's Mental Health Bureau's Medicaid Provider Manual into Administrative Rules of Montana
08.05.2014 Montana Prescription Drug Registry
06.12.2014 ICD-10 Delay
05.13.2014 PERM Provider Educational Webinars
03.18.2014 Information Regarding CMS-1500
01.29.2014 Centers for Medicare and Medicaid Services (CMS) ICD-10 Provider Readiness Assessment Update
01.09.2014 Using Medicaid Card ID Number When Billing and Checking Eligibility
01.09.2014 Reimbursement Changes for Covered Ancillary Services Provided to Youth in a PRTF and Additional Information Pertaining to PRTF Services

2013

12.23.2013 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes Update
11.26.2013 ICD-10 Readiness
09.11.2013 Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Changes
05.28.2013 DPHHS to Discontinue Temporary Hotline Number
02.19.2013 Montana Medicaid HIPAA Operating Rules Upgrade

2012

12.26.2012 Medicaid/HMK Plus Toll-Free Number
08.22.2012 Deleted ICD-9-CM Codes
01.06.2012 Psychiatric Residential Treatment Facility (PRTF) Prior Authorization Start Date Must Match Admission Date

2011

11.07.2011 Provider Information on HIPAA 5010 837 Health Care Claim Transactions
11.04.2011 Meeting the Requirements of HIPAA 5010 When Reporting National Drug Codes on Electronic 837I and 837P Transactions 11.16.2011
11.02.2011 End-Stage Renal Disease Revised Prospective Payment System
09.09.2011 HIPAA 5010.OCR Qualifier Changes Effective January 1, 2012
09.07.2011 Payment Error Rate Measurement (PERM)
07.18.2011 Reimbursement Changes for Covered Ancillary Services Provided to Youth in a PRTF and Additional Ancillary Services Are Covered
06.27.2011 HIPAA 5010.OCR Qualifier Changes Effective January 1, 2012
04.12.2011 Request: Claims Submission, Date of Payment by June 30, 2011
03.23.2011 Changes to Procedure Code Indicators

2010

10.05.2010 Changes to NCCI Edits
07.28.2010 Provider Record Update Procedures
06.23.2010 Cost Sharing Exemption Under ARRA
06.22.2010 Electronic Health Records Link
02.09.2010 United States 2010 Census

 

 

 

 

Provider Notices 2002–2009

2009

10.01.2009 Healthy Montana Kids Plan
09.22.2009 NDC Billing Tools
09.08.2009 Billing Procedures Regarding National Drug Code (NDC) When Using a UB-04 Rev. 09.21.2009
03.16.2009 Timely Filing for Medicare Crossovers
02.12.2009 Reimbursement Change for Psychiatric Residential Treatment Facilities and How It Affects Other Montana Medicaid Providers

2008

10.20.2008 Changes in Transplant Coverage 10.27.2008
08.12.2008 Federal Government May Request Medical Records 09.18.2008
07.22.2008 Billing Procedures Regarding Electronic Claims (837P and 837I)
05.29.2008 When to Submit an NDC (National Drug Code) If You Are Billing as a 340B Provider
05.22.2008 Frequently Asked Questions About NPI Reenrollment and Billing 06.17.2008
03.17.2008 Resubmission of Denied Claims 03.19.2008
03.11.2008 Billing Procedures Regarding National Drug Code (NDC) 10.15.2008
03.10.2008 NPI Reenrollment and Billing
01.18.2008 Possible Duplicate Claims Processed Through Electronic Data Interchange

2007

12.26.2007 WINASAP Upgrade Required for NDC Data Collection
12.17.2007 Enhanced Claims Editing – Assistant, Team, Co-Surgeon
12.17.2007 Enhanced Claims Editing – Multiple Evaluation and Management Services Provided on the Same Day
12.03.2007 NPI Requirement for Fee-for-Service Healthcare Provider Claims
12.03.2007 NPI Requirement for Fee-for-Service Healthcare Provider Claims
11.27.2007 Cost Share Changes
11.01.2007 Enhanced Claims Editing – Add-On Codes
11.01.2007 Enhanced Claims Editing – New Visit Evaluation and Management Codes
11.01.2007 Enhanced Claims Editing Bloodhound ClaimsGuard®
10.01.2007 Attending Provider
08.01.2007 Elimination of eSOR
06.25.2007 NPI on the Web Portal
06.11.2007 Ownership and Control Information Required for Reenrollment
06.06.2007 NPI Contingency Plan Implemented, Reenrollment Extended
05.31.2007 New CMS-1500 to Be Required Beginning July 2, 2007
01.18.2007 Admit Hour to Be Required for Institutional Claims

2002–2005

07.28.2005 Scales – Congestive Heart Failure
02.04.2005 Introduction to Preferred Drug List
06.10.2004 Team Care Program A New Component of the Passport to Health Program
10.17.2003 Q & A Regarding Reporting ICD-9-CM Procedure Codes
10.14.2003 Form Locator Update
08.29.2003 Passport to Health Implementation in Prairie County
08.29.2003 DMEPOS Advisory Workgroup Openings
08.20.2003 Submitting HIPAA Compliant Claims – Information for All Providers
02.03.2003 New Billing Requirements for UB-92 Billers
01.10.2003 New Provider Notification Procedure and Medicaid Changes
10.01.2002 Billing for Medicare Crossovers After Medicare's 45-Day Response Time
09.01.2002 Cost Sharing
07.01.2002 2.6% Reduction
02.14.2002 Weekly Payment Available

Other Resources

EOB R&R Crosswalk PDF and EOB R&R Crosswalk Excel 02.2011

With the implementation of HIPAA, Medicaid discontinued the use of Medicaid EOB codes and began using HIPAA standard reason and remark (R&R) codes. This document crosswalks the HIPAA standard R&R codes to the Medicaid EOB codes.

Rebateable Manufacturers 04.2016

SURS Provider Self-Audit Protocol 10.2015

The TPL Carrier Code List has been removed from this website, for questions or concerns related to the document please contact mttpl@xerox.com. Thank you.