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General Information for Providers Manual

General Information for Providers Manual

This manual is a DRAFT and IS NOT IN EFFECT.
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General Information for Providers Manual

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General Information for Providers Manual

Updated 04/25/2017

This manual was updated 04/25/2017

Update Log

Update Log

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
The Introduction contains updated links in the HELP section.
Cost Share was updated in the Billings Procedure.
A duplicate word was removed in the RA chapter.
The Cover Page was changed to reflect the current date of the new General Manual revision.

07.12.2016
General Information For Providers, July 2016
Table of Contents was amended by changing the title of “Basic Medicaid Waiver” to  “Waiver for Additional Services and Populations (formerly Basic Medicaid Waiver)”.
Index was amended by changing the title of “Basic Medicaid Waiver” to  “Waiver for Additional Services and Populations (formerly Basic Medicaid Waiver)”.
Page 1.3 changed the title “Basic Medicaid Waiver for Additional Services and Populations” to “Waiver for Additional Services and Populations (formerly Basic Medicaid Waiver)”

 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, July 2014: Member Eligibility and Responsibilities

06.30.2014
General Information for Providers, June 2014: General Information for Providers
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

Table of Contents

 

Introduction

 

Provider Requirements

 

EPSDT Well-Child

 

Prior Authorization

 

Telemedicine

 

Member Eligibility and Responsibilities

 

Surveillance and Utilization Review

 

Billing Procedures

 

Remittance Advices and Adjustments

 

Appendix A: Forms

 

Appendix B: Place of Service Codes

 

Appendix C: Local Offices of Public Assistance

 

Definitions and Acronyms

 

Index

 

Complete General Information for Poviders Manual