Claim Jumper Newsletters

Volume 40 Issue 2 - February 2025

SURS Revelations: Autograph Please!
Working to Improve the Healthcare for Healthcare Workers Initiative
Recent Website Posts
Top 15 Claims Denials



Volume 40 Issue 1 - January 2025

Big Sky Waiver - Level II Residential Habilitation Support Services
Legally Responsible Individuals as Caregivers in CFC
SURS Revelations: Periodic Orthodontic Treatment Visits
Recent Website Posts
Top 15 Claims Denials

Volume XXXIX Issue 12 - December 2024

Tips from Provider Relations: How to Add a CLIA to an Enrollment
SURS Revelations: Change is Inevitable
Recent Website Posts
Top 15 Claims Denials



Volume XXXIX Issue 11 - November 2024

Revalidation Deadline Approaching!
SURS Revelations: Diagnostic Evaluations, Psychotherapy, and Management Services
Tips from Provider Relations: Claim Adjustments
Free Virtual Provider Training Opportunity
Repeal ARM 37.85.1101-1125
Recent Website Posts
Top 15 Claims Denials

 
Volume XXXIX Issue 10 - October 2024

Tips from Provider Relations: Listing a License Number on Your Enrollment
SURS Revelations: Medicare Allowed Services Versus Coverage by Medicaid
Recent Website Posts
Top 15 Claims Denials



Volume XXXIX Issue 9 - September 2024

Personal Care Services Part 4 of 4: Consequences, Prevention, and Partnership
SURS Revelations: National Correct Coding Initiative (NCCI) Edits
Tips from Provider Relations: Billing Address on Enrollments and Claims
Recent Website Posts
Top 15 Claims Denials



Volume XXXIX Issue 8 - August 2024

Personal Care Services Part 3 of 4: Understanding Documentation, Eligibility, and Supervision
SURS Revelations: Remember the Order/Referral
Recent Website Posts
Top 15 Claims Denials



Volume XXXIX Issue 7 - July 2024

Personal Care Services Part 2 of 4: Navigating Medicaid Personal Care Services - Understanding Authorization, Settings, and Provider Requirements
House Bill 303
SURS Revelations: ABNs and No-Shows and Copays, Oh My!
Recent Website Posts
Top 15 Claims Denials



Volume XXXIX Issue 6 - June 2024

Personal Care Services Part 1 of 4: Navigating Medicaid Personal Care Services - A Provider's Guide
SURS Revelations: Tissue Conditioning for Dentures
Electronic Visit Verification Update
Recent Website Posts
Top 15 Claims Denials



Volume XXXIX Issue 5 - May 2024

The Provider Information Website - A Valuable Resource
SURS Revelations: Interactive Complexity in Mental Health
Recent Website Posts
Top 15 Claims Denials


Volume XXXIX Issue 4 - April 2024

EVV Implementation Update Extension
ASAM Services Refresher Training in April
SURS Revelations: Laboratory Documentation for Montana Medicaid
SURS Revelations: Documentation Matters
Recent Website Posts
Top 15 Claims Denials

Volume XXXIX Issue 3 - March 2024

SDMI Claim Submission and Timely Filing
The Importance of Effective Dates
Hospital Facility Utilization Fee 2023
Claim Adjustments
Recent Website Posts
Top 15 Claims Denials

Volume XXXIX Issue 2 - February 2024

Training for Caregivers of Those with Dementia
SURS Revelations: Unbundling Obstetrical Services on Bundles of Joy
EVV Implementation Update
Recent Website Posts
Top 15 Claims Denials

Volume XXXIX Issue 1 - January 2024

SURS Revelations: False Claims Act
SURS Revelations: Billing Outside the FQHC and RHC Prospective Payment System Rate
Recent Website Posts
Top 15 Claims Denials

 

Volume XXXVIII Issue 12 - December 2023

SURS Revelations: Appropriate Ambulance Billing
SDMI Waiver Serious Occurrence Reports
Money Follows the Person
Recent Website Posts
Top 15 Claims Denials
Provider Services Portal News: New Program for Crisis Services

Volume XXXVIII Issue 11 - November 2023

SURS Revelations: The More You Know
Recent Website Posts
Please Help Passport to Health Members Receive Care
House Bill 102 – An Act Revising Laws Related to Accrediting Agencies for Health Care Facilities
Top 15 Claim Denials
Severe Disabling Mental Illness (SDMI) Waiver Prior Authorizations (PAs)

Volume XXXVIII Issue 10 - October 2023

Durable Medical Equipment Rental Limits
Recent Website Posts
Top 15 Claim Denials
Nursing Facility Add-on Process
Usage Requirements of the Advanced Beneficiary Notice Form

Volume XXXVIII Issue 9 - September 2023

Provider Services Portal News: Provider Maintenance Update
Provider Services Portal News: Provider License Expiration Reminder Letters
Recent Website Posts
SURS Revelations: No More Tiers: Changes in IOP Services
Community Services Bureau Updates: Electronic Visit Verification
Community Services Bureau Updates: EVV Survey for Personal Care and Home Health Services
Top 15 Claim Denials

Volume XXXVIII Issue 8 - August 2023

Individual Provider Types
Recent Website Posts
PERM Medical Review Process
Top 15 Denial Reasons
Unlisted, Unspecified, Not Otherwise Classified Coding
CFC Development and Advisory Council
Provider Requirements for Residential Habilitation Adult Group Home Providers

Volume XXXVIII Issue 7 - July 2023

SURS Revelations: Creating a Successful Self-Audit Process
Recent Website Posts
SDMI Waiver Program: SDMI Claim Submission Issues
Top 15 Denial Reasons

Volume XXXVIII Issue 6 - June 2023

HMK: Discontinue Use of Healthy Montana Kids Application
Recent Website Posts
SURS Revelations: The Risks of Upcoding and Overbilling
SDMI Waiver Program: Provider Requirements for Residential Habilitation Assisted Living Providers
Top 15 Denial Reasons

Volume XXXVIII Issue 5 - May 2023

Provider Services: Location Addresses: When to Add
SURS Revelations: Sharing Is Not Always Caring
Recent Website Posts
SDMI Waiver Program: Life Coach Requirements
Top 15 Denial Reasons

Volume XXXVIII Issue 4 - April 2023

SURS Revelations: Billable FQHC & RHC Health Professionals
Recent Website Posts
Top 15 Denial Reasons

Volume XXXVIII Issue 3 - March 2023

PERM Medical Review Process and Common Findings
SURS Revelations: Records Maintenance for Physical Therapy, Occupational Therapy, or Speech Therapy.
Change to Youth Therapeutic Group Home Continued Stay Review Requirements. 
Recent Website Posts
Top 15 Denial Reasons

Volume XXXVIII Issue 2 - February 2023

OPA and Personal Resource/Patient Obligation Verification
Recent Website Posts
Top 15 Denial Reasons

Volume XXXVIII Issue 1 - January 2023

SURS Revelations: Provider Self Audits
Recent Website Posts
Top 15 Denial Reasons