Description: Medicaid Alerts

 

 

 


 

 

 

Description: Description: Biller B Aware

Description: Description: Provider Tips

Description: Description: Medicaid Providers

 

 

 

Description: Description: Provider Manual

Description: Description: Provider Fee Schedule

Description: Description: Forms

 

 

 

 Description: Description: CHAMPS

Description: Description: Policy Bulletins

Description: Description: ICD10

 

 

 

Description: Description: Email Provider Support

 

Description: Description: Phone Menu for Provider Support

 

 

 

 

 

 

 

 

 


 

 

 

Description: Description: Biller B Aware

 

 

 

 

 

 

 

 

 

July 28, 2015Attention Managed Care (MC) Inpatient and Outpatient Hospital Providers:  Due to a system issue, the April FD622 MC (for Managed Care Encounter Data) reports will be purged and reloaded for April 5, 12, 19, and 26th, 2015 pay cycle dates. These reports will be completed by August 4th, 2015. 

Providers with further questions can contact Provider Support by email ProviderSupport@michigan.gov or by phone 1-800-292-2550.

July 27, 2015:
System Outage: Due to a CHAMPS interim release deployment, the CHAMPS system will be down between 7:00 PM and 11:00 PM Friday, July 31st 2015. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience this causes.

July 16, 2015
: Attention ALL Providers:
Based on provider feedback, MDHHS is implementing improved changes to our Provider Support Services automated phone options. Effective July 20, 2015, the phone options are changing as follows:

Main Menu:
Option 1:  Medicaid Beneficiaries Only
Option 2:  Adult Foster Care and Home Help (Chore) Services
Option 3:  All claims status and payment related questions
Option 4:  All non-claims questions including assistance with Provider Enrollment

Providers with further questions may contact Provider Support by phone at 1-800-292-2550 or email ProviderSupport@michigan.gov

July 13, 2015:
Attention ALL Providers:
The latest batch of MDCH Quarterly Newborn Recoveries is currently being processed. This batch includes fee for service claims for newborns that were retroactively enrolled into a Medicaid Health Plan. Please note, as with previous quarterly newborn take backs, claims must be submitted to the Medicaid Health Plans within 60 days from the Medicaid Remittance Advice date. Please review the following for information on how to verify the Adjustment Source of your claim.

Providers with further questions can contact Provider Support by phone 1-800-292-2550 or by email ProviderSupport@michigan.gov

July 07, 2015:
Attention ALL Providers: Based on provider feedback, MDHHS is implementing improved changes to our Provider Support Services automated phone options. Effective July 20, 2015, the phone options are changing as follows:


Main Menu:
Option 1:  Medicaid Beneficiaries Only
Option 2:  Adult Foster Care and Home Help (Chore) Services
Option 3:  All claims status and payment related questions
Option 4:  All non-claims questions including assistance with Provider Enrollment

Providers with further questions may contact Provider Support by phone at 1-800-292-2550 or email ProviderSupport@michigan.gov

July 07, 2015
: System Outage: Due to a CHAMPS major release deployment and CHAMPS monthly maintenance activities, the CHAMPS system will be down between 2:00 PM Saturday, July 11th 2015 and 6:00 AM Sunday, July 12th 2015. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.


July 01, 2015:
 Attention ALL Providers: As part of the Document Management Portal (DMP) update on June 26, 2015, DMP is now compatible with different browsers and versions including: IE 8-11, Mozilla Firefox and Google Chrome. If you are experiencing issues with these changes in DMP, please follow these instructions to delete your browser’s cache: DELETING CACHE INSTRUCTIONS.  

Providers with further questions can contact provider support by phone 1-800-292-2550 or by email ProviderSupport@michigan.gov

June 23, 2015:
Attention Inpatient and Outpatient Hospital Providers: MDHHS misidentified Title XIX as Title XVIII claims on the FD-622 reports for both Fee for Service (FFS) and Managed Care (MC). MDHHS will be re-running FD-622 reports beginning June 22, 2015 until completed for both the CVS and PDF versions beginning with the May 7, 2015 pay cycle date up to the current pay cycle date.

Providers with further questions can contact Provider Support by email ProviderSupport@michigan.gov or by phone 1-800-292-2550.

June 23, 2015:
System Outage: Due to a CHAMPS major release deployment, the CHAMPS system will be down between 7:00 PM Friday, June 26th 2015 and 2:00 AM Saturday, June 27th 2015. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

June 03, 2015
: System Outage: Due to system maintenance, the CHAMPS system will be down between 6:00 PM Saturday, June 13th through 6:00 AM Sunday, June 14, 2015. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

May 28, 2015
Attention Inpatient Hospital Providers: As part of the CHAMPS update on April 24, 2015, inpatient hospital claims processed and denied with RARC N47 (15 day readmission). Providers can now view the paid inpatient claim that is causing their current claim to deny if the paid claim was to a different or the same facility by utilizing the claim limit list function within CHAMPS.

To find the paid claim, locate the current denied claim within CHAMPS claim inquire and select the TCN number and the service line ending in ‘01’ of the denied claim and choose claim limit list from the show drop-down box. The current claim displayed will be the current denied claim and the history claim displayed will be the paid claim. For further instructions follow the Claim Limit List tutorial.

Providers with further questions may contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@michigan.gov.

May 28, 2015:
Attention ALL Providers: Effective June 1, 2015 MDHHS Third Party Liability (TPL) has updated the Pending TPL Void Letter and Report. The content of the letter and report remains the same, only the view has changed. As part of the update, one report will now be generated for BCBS, Commercial and Medicare primary beneficiaries. These were previously separate generated reports. Providers can still access the Pending TPL Void Letter and Report within CHAMPS archived documents. For further instructions on finding the information within CHAMPS please visit: http://www.michigan.gov/mdch/0,4612,7-132-2943-343541--,00.html.

Providers with further questions may contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@michigan.gov

May 28, 2015
:
Attention ALL Providers: The Data Exchange Gateway (DEG) will be unavailable on Saturday, May 30, 2015 from 10:00 AM to 4:00 PM EST. Please refrain from submitting files during this maintenance period.

Please contact AutomatedBilling@michigan.gov if you require further assistance.

We apologize for any inconvenience this may cause.

May 21, 2015
:
Attention ALL Providers: MDHHS would like to remind providers of current Medicaid policy for newborn billing. Medicaid Provider Manual, Beneficiary Eligibility Chapter, Section 7: Newborn Child Eligibility: If the mother is enrolled in a Medicaid Health Plan (MHP) at the time of delivery, the newborn's services are also the responsibility of the MHP unless the child is placed in foster care. Providers are encouraged to check the MHP of the mother when rendering services for newborns in order to ensure services are being billed to the correct and appropriate payer.

Providers with further questions can contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@michigan.gov

May 19, 2015
:
Attention ALL Providers: As part of the June 26 update within CHAMPS, starting with Remittance Advice July 2: To comply with ACA guidelines, MDHHS will change the way the Claim Adjustment Reason Code (CARC) is reported on the 835 and Paper Remittance Advice.  CARC 22 will be replaced with CARC 23 - the impact of prior payer(s) payments and/or adjustments.  CARC 22 will continue to be reported for when a claim denies for Other Insurance that was not reported on the claim. Providers are encouraged to review their internal systems to see if changes are needed for automatic posting of remittance advices.

Providers with further questions can contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@michigan.gov

May 19, 2015
: Attention Vision Providers:
MDHHS would like to remind providers of current Medicaid policy for vision frames and lenses. Medicaid Provider Manual, Vision Chapter, Section 1:  Vision providers (e.g., opticians, dispensing ophthalmologists, optometrists) must order frames and lenses from the contractor. A list of lenses is available on the MDHHS Vision Services Fee Schedule located on the MDHHS website. A list of available frames is available from the contractor which is currently Classic Optical Laboratories. This policy applies to beneficiaries that do not have current primary insurance coverage from either Medicare and/or other commercial insurance and are not enrolled in a Medicaid Managed Care Plan.

May 14, 2015
:
Attention Inpatient & Outpatient Hospital Providers: MDHHS will void Outpatient Hospital claims for 2012 dates of service to recover paid claims which were not processed in compliance with MSA policy bulletin 10-60 and L-letter 14-25. Beginning on pay cycle 21 (05/28/2015), the voided claims can be identified by the claim note “OPH 72 hrs rule, DOS 2012 void batch”. Providers wanting to adjust their paid Inpatient claim to add the Outpatient charges will need to include “72 hour rule and the Outpatient credited TCN” in the notes or remarks of the Inpatient adjustment in order to bypass timely filing.

Providers with further questions can contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@michigan.gov

May 05, 2015
: System Outage: Due to system maintenance, the CHAMPS system will be down between 6:00 PM Saturday, May 9th, 2015 thru 6:00 AM Sunday, May 10th, 2015. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience this may cause.

May 01, 2015
: System Outage: Due to system maintenance on the State of Michigan Single Sign On (SSO), the SSO and CHAMPS will be unavailable between 2:00 AM and 12:00 PM Sunday, May 3rd, 2015. This outage will affect CHAMPS system access for all functionality. We apologize for any inconvenience this may cause.

April 24, 2015
: Attention ALL Providers: Due to a system error, some providers who receive Electronic Funds Transfer (EFT) payments may have only received an 835 file and remittance advice (RA) showing denied claims for pay cycle 16 (4/23/15). Affected providers did receive their EFT payment but payment information was missing from the 835 file and RA. MDHHS has now completed 835 files and RAs for the paid claims information.

Providers with further questions can contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@michigan.gov

April 20, 2015
:
System Outage: Due to CHAMPS system maintenance, the CHAMPS system downtime will be down between 7:00 PM Friday, April 24, 2015 and 2:00 AM on Saturday, April 25, 2015. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience this may cause.

April 17, 2015:
  Attention Adult Home Help Services: MSA L-Letter 15-22 was inadvertently mailed to all Adult Home Help Services Providers. This L-Letter only pertains to Adult Home Help Services providers in the current MI Health Link demonstration counties:  Alger, Baraga, Barry, Berrien, Branch, Calhoun, Cass, Chippewa, Delta, Dickinson, Gogebic, Houghton, Iron, Kalamazoo, Keweenaw, Luce, Mackinac, Macomb, Marquette, Menominee, Ontonagon, Schoolcraft, St. Joseph, Van Buren and Wayne. If you are an Adult Home Help Services Provider not within one of these demonstration counties, please disregard this L-Letter as you are not affected by this change.

April 15, 2015
:
Attention ALL Providers: The latest batch of MDCH Quarterly Newborn Recoveries is currently being processed. This batch includes fee for service claims for newborns that were retroactively enrolled into a Medicaid Health Plan. Please note, as with previous quarterly newborn take backs, claims must be submitted to the Medicaid Health Plans within 60 days from the Medicaid Remittance Advice date. Please review the following for information on how to verify the Adjustment Source of your claim.

Providers with further questions can contact provider support by phone1-800-292-2550 or by email ProviderSupport@michigan.gov


April 07, 2015
: System Outage: Due to system maintenance, the CHAMPS system will be down between 6:00 PM Saturday, April 11th thru 6:00 AM Sunday, April 12th, 2015. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience.

March 31, 2015
: Attention Nursing Facility and Waiver Agency Providers: UPDATE: In regards to the message posted March 10, 2015 related to the Level of Care Determination (LOCD) tool, the CHAMPS system issue with adding the beneficiary identification number to a LOCD tool where the beneficiary’s active benefit plan was other than Medicaid Fee for Service (FFS) has been corrected. For those LOCD’s affected, providers are now able to go back into the LOCD and add the beneficiary ID number.

March 31, 2015
: Attention ALL Providers: As part of the April 24th update within CHAMPS, MDCH will no longer report Claim Adjustment Reason Codes (CARC) with a zero dollar amount on the electronic 835 and Remittance Advice. Claims denied for multiple CARC’s will only have one CARC reported at the line level but will have all Remittance Advice Remark Codes (RARC) reported. Providers are encouraged to review their internal systems to see if changes are needed for automatic posting of remittance advices.

Providers with further questions can contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@michigan.gov

March 27, 2015: Attention ALL Providers: Due to the State of Michigan network maintenance activities, the following periodic outages may cause a delay for electronic files:

Core 270/271 Real-time transactions:
Saturday March 28, 2015 5:00 PM - 9:00 pm EST
Sunday March 29, 2015  Beginning at 6:00 AM EST and ending Monday, March 30, 2015 at 2:00 AM EST

Batch 270/271: There may be a delay in receiving batch 271 response files for 270 files submitted after 7:00 PM EST, Friday March 27, 2015.

We apologize for this inconvenience. Please contact AutomatedBilling@michigan.gov with questions or concerns.


March 24, 2015
: Attention Outpatient Hospital Providers:
 All Outpatient Hospital claims with dates of service on or after 1/01/2015 will be adjusted or resurrected to process using the newly loaded January APC software updates and will begin to appear on pay cycle 13 (4/02/15 remittance advice). Adjusted claims can be identified by the claim note “APC Jan 2015 quarterly updates.” For further information, providers can review how to verify the Adjustment Source of your claim.

Providers with further questions can contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@michigan.gov

March 16, 2015:
Attention Professional Providers: MDCH would like to remind providers of current Medicaid policy as outlined within the Medicaid Provider Manual, Billing & Reimbursement for Professionals Chapter, Section 6.4 Ancillary Medical Services, “Immunizations must be reported using the administration fee code(s) and the code identifying the type of vaccine given”. In April 2015, MDCH will begin voiding paid claims that reported the administration code without the corresponding immunization code. Medicare primary claims will not be included in these voids.

Providers with further questions can contact Provider Support by phone 1-800-292-2550 or email ProviderSupport@michigan.gov

March 10, 2015
: System Outage: Due to system maintenance, CHAMPS will be down between 6:00 PM Saturday, March 14, 2015 thru 6:00 AM Sunday, March 15, 2015.  This outage will affect CHAMPS system access for all functionality. We apologize for any inconvenience this may cause.

March 10, 2015:
Attention Nursing Facility and Waiver Agency Providers UPDATE: When attempting to add the beneficiary identification number to a Level of Care Determination (LOCD) tool where there is eligibility other than MA, MA-HMP or Spend-down, the following error code is once again being displayed: “LOCD may not be conducted for private pay individual; MA not active as of the date of this LOCD.” Until the issue is corrected, MDCH asks providers to continue to conduct LOCD as outlined in current policy.

March 05, 2015
:
System Outage: Due to CHAMPS interim release deployment, the CHAMPS system will be down between 7:00 PM and 11:00 PM on Friday, March 6th, 2015. This outage will affect the CHAMPS system access for all functionality. We apologize for any inconvenience this may cause.

 

 

 

 

 

 

 

 2014

2013 

2012 

 

 

 

Description: Description: 2011

Description: Description: 2010

 

 

 


 

 

 

Description: Description: Provider Tips

 

 

 

 

 

 

 

 

 


 

 

 

Description: All Providers

Description: Description: Ambulance

Description: Description: Clinics

 

 

 

Description: Description: Dental

Description: Description: Home Health

Description: Description: Hospice

 

 

 

Description: Description: Hospital

Description: Description: Nursing Facility

Description: Description: Pharmacy and DME

 

 

 

Description: Description: Physician 

Description: Description: Private Duty Nursing

 

 

 

 


 

 

 

All Providers

 

 

 

June 04, 2015: How to use the CHAMPS Claim Limit List

May 04, 2015
: CHAMPS Navigation  *NEW

April 08, 2015: CSHCS Provider Information Page

March 19, 2015
: ICD-10 Virtual Presentation

March 10, 2015: How to Adjust a claim with OTHER INSURANCE *UPDATED


March 10, 2015:
Refund of Payment

March 10, 2015: Benefits Monitoring Program (BMP):

Benefits Monitoring Program

Verifying BMP Eligibility

Beneficiary Notification Letter Example

Beneficiary Final Notification Letter Example

 

MSA 1302 for Specialty Referrals


October 01, 2013:
MDCH-ICD10 Virtual Training

June 14, 2013: Upper Peninsula Professional Presentation 

 

March 22, 2013: Medicaid 101 Training Sessions PowerPoint Presentation 

 

March 07, 2013ICD-10 Virtual Training 

 

December 11, 2012: ICD-10 Presentation 

 

December 3, 2012: Medicare Part D Coverage of Benzodiazepines and Barbiturates 1/1/2013.

As of January 1, 2013, Medicare Part D plans will begin covering benzodiazepines and barbiturates (i.e. barbiturates used in the treatment of epilepsy, cancer, or a chronic mental health disorder). For additional information on the Part D coverage changes, please visit the Michigan Medicaid website https://michigan.fhsc.com 

 


April 16, 2012:
  CHAMPS Navigational Presentation 

March 21, 2012:  CHAMPS Navigational Presentation (billing/claims specific)

 

October 26, 2011:  5010 Professional DDE

October 26, 2011:  5010 Institutional DDE

October 3, 2011:  Local CSHCS Office Contact Info

January 15, 2010:  PERM Audit Information


August 27, 2008:
  CMS 1500 Claim Completion Instructions 

June 14, 2005:  Listserv Instructions- Updated 09.22.2009 

 

 

 


 

 

 

 

Ambulance

 

 

 

 

The Ambulance section is in the process of being updated. Please email ProviderOutreach@michigan.gov if you have suggestions! Thank you for your patience.  

 

 

 

 

 

 

 

 

 


 

 

 

 

Clinics

 

 

 

 

February 24, 2015: Clinic Billing Tips 

 

 

 

 

 

 

 

 

 


 

 

 

 

Dental

 

 

 

 

The Dental section is in the process of being updated. Please email ProviderOutreach@michigan.gov if you have suggestions! Thank you for your patience. 

 

 

 

 

 

 

 

 

 


 

 

 

 

Home Health

 

 

 

 

The Home Health section is in the process of being updated. Please email ProviderOutreach@michigan.gov if you have suggestions! Thank you for your patience. 

 

 

 

 

 

 

 

 

 


 

 

 

 

Hospice

 

 

 

 

The Hospice section is in the process of being updated. Please email ProviderOutreach@michigan.gov if you have suggestions! Thank you for your patience. 

 

 

 


 

 

 

 

Hospital

 

 

 

 

June 04, 2015: How to use the CHAMPS Claim Limit List

March 10, 2015
:
Inpatient Surgical/ ICD 9 Procedure code documentation requirements

April 08, 2013
: How to Find Professional REV Codes
 

  

June 20, 2011: Hysterectomy- When billing for a hysterectomy performed during a beneficiary's period of retroactive eligibility, please indicate in the Remarks section: "No consent not eligible on DOS, Retro MA. PT told prior to HYST unable to reproduce." 

  

June 2, 2011: Inpatient Hospital Rehab- Providers should report appropriate taxonomy code 273Y00000X, 283X00000X, or 283XC2000X ( not 282N00000X). 

 

 

 


 

 

 

 

Nursing Facility

 

 

 

 

Nursing Facility Historical Provider Tips

 

 

 


 

 

 

 

Pharmacy/DME

 

 

 

 

The Pharmacy/DME section is in the process of being updated. Please email ProviderOutreach@michigan.gov if you have suggestions! Thank you for your patience. 

 

 

 


 

 

 

 

Physician

 

 

 

 

March 10, 2015Immunizations Administration and Preventive Medicine Services. 

 

 

 


 

 

 

 

Private Duty Nursing

 

 

 

 

The PDN section is in the process of being updated. Please email ProviderOutreach@michigan.gov if you have suggestions! Thank you for your patience.