November 20, 2009 4:38 PM
(Press Ctrl-F5 to get the most current messages)
Current Issues:
The System is back online.
Session Time-Outs: We are looking at ways to implement session timeouts. Users may see a message telling them that their session has 'timed-out' after 30 minutes of inactivity. This will require users to log back into the system.
How to Contact the Data System Help Desk: Please use Jobtrack for ALL Requests. If you must email us, please use our new group e-mail account: peds-mch-earlysteps@peds.ufl.edu.
Q1 Data Pick Up: Data was picked up November 16th. We will be working on the Q1 data products (reports on the web-site, matrix, etc.) and notify everyone when they are ready.
Billing for IPDEFs by ITDS that were Denied (4257s):
- The Agency for Healthcare Administration has also informed us that claims with denial code 4257(re: procedure code T1024TS – Follow up Psychosocial and Developmental Evaluation – IPDEF – rendered by an ITDS) that are beyond the one-year limitation will need to be resubmitted on paper - sent to Debbie Warfel in Medicaid Contract Management, who will override the error. Any claims less than one year old should be re-submitted to EDS. Ms. Warfel's phone number is 922-2720; warfeld@ahca.myflorida.com; 2562 Executive Center Circle East, Montgomery Building, Suite 100, Tallahassee, FL 32301.
- Rebilling for these services began on 10/27/09. Based on the results from that billing, there is a problem with claims that are 4 Medicaid units (2.0 hours in the data system). 4 Medicaid units are being submitted for $111, but EDS/Medicaid is only reimbursing $83.25 and shows an “error” code of 6032 on the RA report indicating that the service is limited to 3 per calendar year. Per the Medicaid Handbook for Early Intervention services, IPDEFs should be limited to three service dates per calendar year, not three units. ESSO’s Medicaid liaison, Gail Underwood, is aware of the problem and is working with EDS/Medicaid to correct the problem. Until this is resolved:
- Per the weekly memo, please send copies of any payments or claims that have been inappropriately denied with error code 6032 to Renee Jenkins at ESSO – renee_jenkins@doh.state.fl.us or Fax # (850) (850) 921-8138. They will be forwarded to AHCA staff to ensure the issue is corrected.
- LES Centers should NOT submit any more IPDEF claims by ITDS (CPT Code T1024 TS) for 4 units (2.0 hours) through the data system or by hand claim.
- LES Centers may wish to change the payer code from MED to PEND for all IPDEF claims with CPT Code T1024 TS that have more than 4 Medicaid units (2.0 hours in the data system) that have not been submitted for reimbursement. This strategy will prevent accidental billing or re-billing of these claims since PEND will not allow an “R” bill flag.
- For IPDEF T1024 TS claims for 4 Medicaid units (2.0 hours in the data system) that have already been submitted and have incorrectly paid at $83.25 instead of $111, LES Centers should enter the actual amount paid ($83.25) in the “Paid amount” box, the paid date, and a bill flag of P. This will be enough information to collect these and re-flag them once the problem has been cleared.
- Claims for less than 4 units (2.0 hours in the data system) may be submitted via the data system or hand claim and are paying correctly.
- The UF Data Center will assist LES Centers with identifying and changing flags and/or payer codes if needed. Also, please call us if you spot any other billing/payment problems.
Data Clean-up Issues:
- All reports in your directory that were run prior to 10/01/09 will be removed today.
|
