Claims Filing Guide For HCBS Providers - Keystone First Community .
Claims Filing InstructionsHome- and Community-Based Services (HCBS) ProvidersApril 2022April 2022www.keystonefirstchc.com
Home- and Community-Based Services Provider SpecialtiesAdult Day CareJob CoachingArchitectural ModificationLicensed Practical NurseAdult Day Services-EnhancedAssistive TechnologiesAttendant Care/Personal AssistanceBehavioral TherapyJob FindingNon-Medical CounselingOccupational TherapistPer-Monthly MaintenanceCareer AssessmentPersonal Care - AgencyCommunity IntegrationPersonal Emergency Response SystemCognitive TherapistCommunity Transition ServicesDME / Medical SuppliesEmployment - Benefit CounselingEmployment - Skills DevelopmentEnrollmentEnvironmental Accessibility AdaptationsHome and Community HabilitationHome Delivered MealsHome Health ServicesISO - Fiscal/Employer AgentApril 2022Personal Care - IndividualPest EradicationPhysical TherapistRegistered NurseRegistered NutritionistRespite Care - Home BasedService CoordinationSpeech/Hearing TherapistStructured Day ProgramTelecare ServicesVehicle Modificationwww.keystonefirstchc.com
Table of ContentsHome- and Community-Based Services Provider Specialties . 2Claim Filing . 4Claim Mailing Instructions . 5Claim Filing Deadlines . 6Exceptions . 6Refunds for Claims Overpayments or Errors. 8Claim Form Field Requirements . 10Required Fields (CMS 1500 Claim Form): . 10Special Instructions and Examples for CMS 1500, UB-04 and EDI Claims Submissions . 24Common Causes of Claim Processing Delays, Rejections or Denials . 26Electronic Claims Submission (EDI) . 32Hardware/Software Requirements . 32Contracting with Change Healthcare and Other Electronic Vendors. 32Contacting the EDI Technical Support Group . 32Specific Data Record Requirements . 33Electronic Claim Flow Description . 33Invalid Electronic Claim Record Rejections/Denials . 34Plan Specific Electronic Edit Requirements . 34Exclusions . 34Common Rejections . 36Resubmitted Professional Corrected Claims . 36Electronic Billing Inquiries . 40Tips for Accurate Diagnosis Coding: How to Minimize Retrospective Chart Review . 40What is the Risk Score Adjustment Model? . 40Why are retrospective chart reviews necessary? . 40What is the significance of the ICD-10-CM Diagnosis code? . 41Have you coded for all chronic conditions for the Participant?. 41Physician Communication Tips . 42Supplemental Information: . 42Ambulance . 42Durable Medical Equipment . 43Miscellaneous codes will not be used if an appropriate code is on the Plan’s First DME feeschedule. Home Health Care (HHC) . 43Most Common Claims Errors . 44April 2022www.keystonefirstchc.com
HCBS Provider Claims Filing Instructions2022Keystone First Community Health Choices, hereafter referred to as the Plan (whereappropriate), is required by state and federal regulations to capture specific data regarding servicesrendered to its Participants. All billing requirements must be adhered to by the provider in order toensure timely processing of claims.Section 6401 of the Affordable Care Act (ACA) requires that all providers must be enrolled inMedicaid in order to be paid by Medicaid. This means all providers must enroll and meet allrequirements of the Pennsylvania Department of Human Services (DHS) which then issues aMedicaid identification number called Promise Provider Identification (PPID). The enrollmentrequirements include registering every service location with the state and having a different servicelocation extension for each location.Additionally, DHS has implemented the requirement that all providers must revalidate theirMedical Assistance enrollment every five (5) years. (ACA) (§42 CFR 455.414). Claims fromProviders who have not accurately updated their enrollment information cannot be paid.Providers should log into PROMISe to check the revalidation dates of each service location andsubmit revalidation applications at least 60 days prior to the revalidation dates. Enrollment(revalidation) applications may be found ntinformation/S 001994.Reimbursement for all rendering network providers for claims subject to theordering/referring/prescribing (ORP) requirement is determined by validating that participatingordering/referring/prescribing practitioners have a valid PPID. Claims subject to the ORPrequirement will be denied when billed with the NPI of a network ordering/referring/prescribingprovider that is not enrolled in Medicaid.Claim FilingKeystone First Community Health Choices (Keystone First CHC) is required by state and federalregulations to capture specific data regarding services rendered to its Participants. All billingrequirements must be adhered to by the provider in order to ensure timely processing of claims.Important: To comply with provisions of the Affordable Care Act (ACA) regarding enrollment andscreening of providers (Code of Federal Regulations: 42CFR, §455.410), Providers participatingwith Keystone First CHC must participate in the Pennsylvania Medical Assistance Program.All providers must be enrolled in the Pennsylvania State Medicaid program before a payment of aMedicaid claim can be made.Important note: This applies to non-participating out-of-state providers as well.This means all providers must enroll and meet applicable Medical Assistance providerrequirements of DHS and receive a Pennsylvania Promise ID (PPID). The enrollment requirementsfor facilities, physicians and practitioners include registering every service location with DHS andhaving a different service location extension for each location.4DHS fully intends to terminate Medical Assistance enrollment of all non-compliant providers.Keystone First CHC will comply with DHS’s expectation that non-compliant providers will also beterminated from out network, since medical assistance enrollment is a requirement forApril 2022www.keystonefirstchc.com
2022HCBS Provider Claims Filing Instructionsparticipation with Keystone First CHC. Enroll by rollmentinformation/S 001994.For providers other than Type 59, DHS also requires that Providers obtain an NPI and share it withthem. Further information on DHS's requirements can be found /NPI.aspx.When required data elements are missing or are invalid, claims will be rejected by the Plan forcorrection and re-submission.Claims for billable and capitated services provided to Plan Participants must be submitted by theprovider who performed the services.Claims filed with the Plan are subject to the following procedures: Verification that all required fields are completed on the CMS 1500 form.Verification that all Diagnosis and Procedure Codes are valid for the date of service.Verification for electronic claims against 837 edits at Change Healthcare .Verification of Participant eligibility for services under the Plan during the time period in whichservices were provided.Verification that the services were provided by a participating provider or that the “out of plan”provider has received authorization to provide services to the eligible Participant.Verification that the provider participated with the Medical Assistance program at the time ofservice.Verification that an authorization has been given for services that require prior authorizationby the Plan.Verification of whether there is Medicare coverage or any other third party resources and, if so,verification that the Plan is the “payer of last resort” on all claims submitted to the Plan.Important: Rejected claims are defined as claims with invalid or required missing data elements,such as the provider tax identification number, Provider PPID number, Participant ID number, thatare returned to the provider or EDI source without registration in the claim processing system. Rejected claims are not registered in the claim processing system and can be resubmitted as anew claim.Rejected claims are considered original claims and timely filing limits must be followed.Important: Denied claims are registered in the claim processing system but do not meetrequirements for payment under Plan guidelines. They should be resubmitted as a corrected claim. Denied claims must be re-submitted as corrected claims within 365 calendar days from thedate of service.Set claim frequency code correctly and send the original claim number.Note: These requirements apply to claims submitted on paper or electronically.Claim Mailing InstructionsSubmit claims to the Plan at the following address:5Claim Processing Department Keystone First CHC (no Medicare):Keystone First CHCP.O. Box 7146April 2022www.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsLondon, KY 40742-7146Claim Processing Department Keystone First CHC (with aligned Keystone First VIP Choice)*:Keystone First CHCP.O. Box 7143London, KY 40742-7143The Plan encourages all providers to submit claims electronically. For those interested in electronicclaim filing, contact your EDI software vendor or Change Healthcare’s Provider Support Line at1-800-845-6592 to arrange transmission.Any additional questions may be directed to the EDI Technical Support Hotline at 1-877-234-2460or by email at edi.kfchc@keystonefirstchc.com.Claim Filing DeadlinesOriginal invoices must be submitted to the Plan within 180 calendar days from the date serviceswere rendered or compensable items were provided.Re-submission of previously denied claims with corrections and requests for adjustments must besubmitted within 365 calendar days from the date services were rendered or compensable itemswere provided.Please allow for normal processing time before re-submitting a claim either through the EDI orpaper process. This will reduce the possibility of your claim being rejected as a duplicate claim.Claims are not considered as received under timely filing guidelines if rejected for missing orinvalid provider or Participant data.Note: Claims must be received by the EDI vendor by 9:00 p.m. in order to be transmitted to the Planthe next business day.ExceptionsClaims with Explanation of Benefits (EOBs) from primary insurers must be submitted within 60days of the date of the primary insurer’s EOB (claim adjudication).Important: Claims originally rejected for missing or invalid data elements must be correctedand re-submitted within 180 calendar days from the date of service. Rejected claims are notregistered as received in the claim processing system.Important: Requests for adjustments may be submitted by telephone to Provider Claims Servicesat 1-800-521-6007.(Select the prompts for the correct Plan, and then, select the prompt for claim issues.) If submittingvia paper or EDI, please include the original claim number.If you prefer to resubmit claims by mail or by EDI, please refer to instructions under“Resubmitted Professional Corrected Claims”.If you prefer to write, please be sure to stamp each claim submitted “corrected” or“resubmission” and address the letter to:6April 2022www.keystonefirstchc.com
HCBS Provider Claims Filing Instructions2022Claim Processing DepartmentKeystone First CHC (no Medicare):Keystone First CHCP.O. Box 7146London, KY 40742-7146Claim Processing DepartmentKeystone First CHC (with aligned Keystone First VIP Choice Medicare):Keystone First CHCP.O. Box 7143London, KY 40742-7143Electronically:Mark claim frequency code “7” and use CLM05-3 to report claims adjustments electronically.Include the original claim number.A Dispute is a verbal or written expression of dissatisfaction by a Network Provider regarding aPlan decision that directly impacts the Network Provider. Disputes are generally administrative innature and do not include decisions concerning medical necessity.An appeal is a written request from a Health Care Provider for the reversal of a denial by KeystoneFirst, through its Formal Provider Appeals Process, with regard to two (2) major types of issues.The two (2) types of issues that may be addressed through the Plan’s Formal Provider AppealsProcess are: Disputes involving medical necessity and not resolved to the Network Provider’ssatisfaction through the Plan’s Informal Provider Dispute ProcessDenials for services already rendered by the Health Care Provider to a Participant including,denials that do not clearly state the Health Care Provider is filing a Participant Complaint orGrievance on behalf of a Participant (even if the materials submitted with the Appealcontain a Participant consent)Outpatient medical appeals must be submitted in writing to:Provider Appeals DepartmentKeystone First CHCP.O. Box 80113London, KY 40742-0113Inpatient medical appeals must be submitted in writing to:Provider Appeals DepartmentKeystone First CHCP.O. Box 80111London, KY 40742-0111Written Disputes should be mailed to:7Informal Practitioner DisputeKeystone First CHCATTN: Claims DisputesApril 2022www.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsP.O. Box 7146London, KY 40742-7146Refer to the Provider Manual for complete instructions on submitting appeals.Note: Keystone First CHC’s EDI Payer ID # is 42344Refunds for Claims Overpayments or ErrorsThe Plan and the Pennsylvania Department of Human Services encourage providers to conductregular self-audits to ensure accurate payment.Medicaid program funds that were improperly paid or overpaid must be returned. If the provider’spractice determines that it has received overpayments or improper payments, the provider isrequired to make immediate arrangements to return the funds to the Plan or follow the DHSprotocols for returning improper payments or overpayment.A. Contact Provider Claim Services at 1-800-521-6007 to arrange the repayment. There are twoways to return overpayments to the Plan:1. Have the Plan deduct the overpayment/improper payment amount from future claimspayments.2. Submit a check for the overpayment/improper amount directly to:Claim Processing DepartmentKeystone First CHC (no Medicare):Keystone First CHCP.O. Box 7146London, KY 40742-7146Claim Processing DepartmentKeystone First CHC (with aligned Keystone First VIP Choice Medicare):Keystone First CHCP.O. Box 7143London, KY 40742-7143Note: Please include the Participant’s name and ID, date of service, and Claim ID.B. Providers may follow the “Pennsylvania Medical Assistance (MA) Provider Self-audit Protocol”to return improper payments or overpayments. Access the DHS voluntary protocol process viathe following link: /MA-Provider-SelfAudit-Protocol.aspx.8April 2022www.keystonefirstchc.com
HCBS Provider Claims Filing Instructions9April 20222022www.keystonefirstchc.com
HCBS Provider Claims Filing Instructions2022Claim Form Field RequirementsThe following charts describe the required fields that must be completed for the standard Centersfor Medicare & Medicaid Services (CMS) CMS 1500 or UB-04 claim forms. If the field is requiredwithout exception, an “R” (Required) is noted in the “Required or Conditional” box. If completingthe field is dependent upon certain circumstances, the requirement is listed as “C” (Conditional)and the relevant conditions are explained in the “Instructions and Comments” box.The CMS 1500 claim form must be completed for all professional medical services, and the UB-04claim form must be completed for all facility claims. All claims must be submitted within therequired filing deadline of 180 days from the date of service.Although the following examples of claim filing requirements refer to paper claim forms, claim datarequirements apply to all claim submissions, regardless of the method of submission (electronic orpaper).Required Fields (CMS 1500 Claim Form):*Required [R] fields must be completed on all claims. Conditional [C] fields must be completed if theinformation applies to the situation or the service provided. Refer to the NUCC or NUBC ReferenceManuals for additional information.CMS-1500 Claim FormPaper Claim - CMS 1500 FieldField FieldInstructions and Comments#DescriptionN/A11a210X12 837P Claim FieldRequired or Loop ID Segment NotesConditional*Carrier Block2010BB NM103N301N302N401N402N403InsuranceCheck only the type of healthR2000B SBR09Title ClaimProgramcoverage applicable to the claim.FilingIndicator inIdentification This field indicates the payer towhom the claim is being filed.837P.Insured I.D.Health Plan’s ParticipantR2010BA NM109 TitledNumberidentification number. If submittingSubscribera claim for a newborn that does notPrimaryhave an identification number, enterIdentifier Inthe mother’s ID number. Enter thethe 837P.Participant’s ID number exactly theway it appears on their Plan-issuedID card.Patient’sEnter the patient’s name as itR2010CA NM103Name (Last, appears on the Participant’s HealthorNM1042010BA NM105First, Middle Plan I.D. card. If submitting a claimInitial)for a newborn that does not have anNM107April 2022www.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsCMS-1500 Claim FormPaper Claim - CMS 1500 FieldField FieldInstructions and Comments#Description345678911X12 837P Claim FieldRequired or Loop ID Segment NotesConditional*identification number, enter “BabyGirl” or “Baby Boy” and last name.MMDDYY / M or FRIf submitting a claim for a newborn,enter “newborn” and DOB/SexEnter the patient’s name as itRappears on the Participant’s HealthPlan I.D. card, or Enter the newborn’sname when the patient is a newborn.Enter the patient’s complete address Rand telephone number. (Do notpunctuate the address or phonenumber.)Patient’sBirth Date /SexInsured’sName (Last,First, MiddleInitial)Patient’sAddress(Number,Street, City,State, Zip)Telephone(include areacode)PatientAlways indicate self unless covered by RRelationship someone else’s insurance.To Insured2010CA DMG02orDMG032010BA2010BA NM103NM104NM105NM1072010CA N301N401N402N403N404Titled Genderin 837P.2000B2000CInsured’sAddress(Number,Street, City,State, ZipCode)Telephone(Include AreaCode)Reserved forNUCC useOtherInsured'sName (Last,First, MiddleInitial)Titleindividualrelationshipcode in 837P.SBR02PAT01If same as the patient, enter “Same”.Otherwise, enter insured’sinformation.C2010BA N301N302N401N402N403N/ANotRequiredCN/ARefers to someone other than thepatient. Completion of fields 9athrough 9d is Required if patient iscovered by another insurance plan.Enter the complete name of theinsured. Note: "COB claims thatrequire attached EOBs must besubmitted on paper.”April 20222330AN/ANM103NM104NM105NM107TitledSubscriber in837P.Titlesubscriberaddress in837P.N/AIf patient canbe uniquelyidentified tothe otherprovider inthis loop bythe uniqueParticipant IDthen thepatient is thesubscriberwww.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsCMS-1500 Claim FormPaper Claim - CMS 1500 FieldField FieldInstructions and Comments#Description9a9b9c9dOtherInsured'sPolicy OrGroup #Reserved forNUCC useReserved forNUCC useInsurancePlan Name OrProgramName10a,b, cIs Patient'sConditionRelated To:10dClaim Codes(Designatedby NUCC)Required if # 9 is /A2320SBR04N/ARequired if # 9 is completed. Listname of other health plan, ifapplicable. Required when otherinsurance is available. Complete ifmore than one other Medicalinsurance is available, or if 9acompleted.Indicate Yes or No for each category. RIs condition related to:a) Employmentb) Auto Accidentc) Other AccidentEnter new Condition Codes asCappropriate. Available 2-digitCondition Codes includes nine codesfor abortion services and four codesfor worker’s compensation. Pleaserefer to NUCC for the complete list ofcodes. Examples include: AD – Abortion Performed dueto a Life EndangeringPhysical Condition Caused by,Arising from or Exacerbatedby the Pregnancy Itself 12X12 837P Claim FieldRequired or Loop ID Segment NotesConditional*and identifiedin this loop.W3 – Level 1 AppealApril 2022N/AN/ATitled OtherSubscriberName in 837P.Titled Groupor PolicyNumber in837P.Does not existin 837P.Does not existin 837P.Titled otherinsurancegroup in 837P.2300CLM11Titled relatedcauses code in873P.2300NTENTE 01position –input “ADD”Upper case/capitalformat).NTE 02position – firstsix characterinput“EPSDT ”(uppercase/capitalformat wherethe sixthcharacter willthe sign.www.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsCMS-1500 Claim FormPaper Claim - CMS 1500 FieldField FieldInstructions and Comments#Description1111a11b11c13X12 837P Claim FieldRequired or Loop ID Segment NotesConditional*Inputapplicablereferraldirectly after“ ”Insured'sRequired when other insurance isCPolicy Group available. Complete if more than oneother Medical insurance is available,Or FECA #or if “yes” to 10a, b, and c. Enter thepolicy group or FECA number.Insured'sSame as # 3. Required if 11 isCBirth Date / completed.Sex2000BOther ClaimID2010BA REF01REF02Enter the following qualifier andCaccompanying identifier to report theclaim number assigned by the payerfor worker’s compensation orproperty and casualty: Y4 – Property Casualty ClaimNumberEnter qualifier to the left of thevertical, dotted line; identifier to theright of the vertical, dotted line.InsuranceEnter name of Health Plan. Required CPlan Name Or if 11 is completed.ProgramNameApril 2022SBR032010BA DMG02DMG032000BFor multiplecode entries:Use(underscore)to separate asfollows:NTE*ADD*EPSDT YD YM YO Subscribergroup orpolicy # in837P.TitleSubscriberDOB andGender on837P.Titled OtherClaim ID in837P.SBR04www.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsCMS-1500 Claim FormPaper Claim - CMS 1500 FieldField FieldInstructions and Comments#Description11dIs ThereY or N by check box.AnotherIf yes, indicate Y for yes.If yes, complete # 9 a-d.HealthBenefit Plan?X12 837P Claim FieldRequired or Loop ID Segment NotesConditional*R2320TitledSubscriberGroup Name in837P.Presence ofLoop 2320indicates Y(yes) to thequestion on837P.12Patient's OrAuthorizedPerson'sSignature13Insured's OrAuthorizedPerson'sSignatureDate OfCurrentIllness Injury,Pregnancy(LMP)14On the 837, the following values areaddressed as follows at ChangeHealthcare:“A”, “Y”, “M”, “O” or “R”, then changeto “Y”, else send “I” (for “N” or “I”).R2300CLM09Titled Releaseof informationcode in 837P.C2300CLM08MMDDYY or MMDDYYYYC2300DTP01DTP03Titled BenefitAssignmentIndicator in837P.Titled in the837P:Enter applicable 3-digit qualifier toright of vertical dotted line.Qualifiers include: 431 – Onset of CurrentSymptoms or Illness 439 – Accident Date 484 – Last Menstrual Period(LMP)Date – LastMenstrualPeriodUse the LMP for pregnancy.Example:1514Other DateMMDDYY or MMDDYYYYEnter applicable 3-digit qualifierbetween the left-hand set of verticaldotted lines. Qualifiers include: 454 – Initial TreatmentApril 2022Date - Onset ofCurrent Illnessor SymptomC2300DTP01DTP03Titled in the837P:www.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsCMS-1500 Claim FormPaper Claim - CMS 1500 FieldField FieldInstructions and Comments#Description 304 – Latest Visit orConsultation 453 – Acute Manifestation ofa Chronic Condition 439 – Accident 455 – Last X-Ray 471 – Prescription 090 – Report Start (AssumedCare Date) 091 – Report End(Relinquished Care Date) 444 – First Visit orConsultationExample:X12 837P Claim FieldRequired or Loop ID Segment NotesConditional*Date – InitialTreatmentDateDate – LastSeen DateDate – AcuteManifestationDate –Accident Date– Last X-rayDateDate – Hearingand VisionPrescriptionDateDate –Assumed andRelinquishedCare DatesDate –Property andCasualty Dateof FirstContact161715Dates PatientCUnable ToWork InCurrentOccupationName OfRequired if a provider other thanCReferringthe Participant’s primary carephysician rendered invoiced services.April 20222300DTP032310A NM101(Referri NM103ng)NM104If Patient HasHad Same orSimilar Illnessdoes not existin 837P.TitledDisabilityfrom Date andWork ReturnDate in 837P.www.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsCMS-1500 Claim FormPaper Claim - CMS 1500 FieldField FieldInstructions and Comments#DescriptionX12 837P Claim FieldRequired or Loop ID Segment NotesConditional*Physician Or Enter applicable 2-digit qualifier toNM105Other Source left of vertical dotted line. If multiple2310D NM107providers are involved, enter one(Superprovider using the following priorityvising)order:1. Referring Provider24202. Ordering Provider(Orderi3. Supervising Providerng)Note: Claims subject to theORP requirement will bedenied when billed withthe NPI of a networkordering/referring/prescribing provider that is notenrolled in Medicaid.Qualifiers include: DN – Referring Provider DK – Ordering Provider DQ – Supervising ProviderExample:17aOther I.D.Number OfReferringPhysicianEnter the Health Plan providerCnumber for the referring physician.The qualifier indicating what thenumber represents is reported in thequalifier field to the immediate rightof 17a. If the Other ID number is theHealth Plan ID number, enter G2. Ifthe Other ID number is anotherunique identifier, refer to the NUCCguidelines for the appropriatequalifier.The NUCC defines the followingqualifiers:0B State License Number1G Provider UPIN Number2310A REF01(Referri erSecondaryIdentifier, andOrderingProviderSecondaryIdentifier in837P.G2 Provider Commercial Number16LU Location Number (This qualifieris used for Supervising Provideronly.)April 2022www.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsCMS-1500 Claim FormPaper Claim - CMS 1500 FieldField FieldInstructions and Comments#DescriptionRequired if # 17 is completed.X12 837P Claim FieldRequired or Loop ID Segment )Enter the NPI number of theRreferring provider, ordering provideror other source.Required if #17 is completed.2310DNM10918Hospitalization DatesRelated atedby NUCC)Required when place of service is in- Cpatient. MMDDYY (indicate fromand to date)2300DTP01DTP03Enter additional claim informationwith identifying qualifiers asappropriate. For multiple items,enter three blank spaces beforeentering the next qualifier and datacombination.2300NTEPWK1917The NUCC defines the followingqualifiers: 0B State License Number 1G Provider UPIN NumberApril ntifier,SupervisingProviderIdentifier, andOrderingProviderIdentifier in837P.Titled RelatedHospitalization Admissionand DischargeDate in 837P.www.keystonefirstchc.com
2022HCBS Provider Claims Filing InstructionsCMS-1500 Claim FormPaper Claim - CMS 1500 FieldField FieldInstructions and Comments#Description 20Outside Lab21Diagnosis OrNature OfIllness OrInjury.(Relate To24E)22G2 Provider CommercialNumberLU Location Number (Thisqualifier is used forSupervising Provider only)N5 Provider Plan NetworkIdentification NumberSY Social Security NumberX5 State Industrial AccidentProvider NumberZZ Provider TaxonomyCEnter the codes to identify theRpatient’s diagnosis and/or condition.List no more than 12 ICD diagnosiscodes. Relate lines A – L to the linesof service in 24E by the letter of theline. Use the highest level ofspecificity. Do not provide narrativedescription in this field.Note: Claims with
Claim Processing Department Keystone First CHC (with aligned Keystone First VIP Choice)*: Keystone First CHC . P.O. Box . 7143. London, KY 40742-7143 . The Plan encourages all providers to submit claims electronically. For those interested in electronic claim filing, contact your EDI software vendor or . Change Healthcare's Provider Support .
c) HCBS Eligibility Assessments must be entered, signed, and locked in UAS-NY to be considered complete. d) After the HCBS Eligibility Assessment has been completed: iii. If HCBS Eligibility Results indicate that the Member is eligible for Tier 1 or Tier 2 HCBS, and the Member chooses to receive HCBS services, the CHN must complete the following:
1 Adult Behavioral Health Home and Community Based Services (BH HCBS) Questions and Answers As of January 14, 2016 BH HCBS QUESTIONS: 1. Q: Can you receive BH HCBS without being HARP eligible? A: As of 1/1/16, BH HCBS are available to individuals in NYC enrolled in HARPs or who are enrolled in HIV SNPs and are HARP eligible, who reach a qualifying score on
Bruksanvisning för bilstereo . Bruksanvisning for bilstereo . Instrukcja obsługi samochodowego odtwarzacza stereo . Operating Instructions for Car Stereo . 610-104 . SV . Bruksanvisning i original
10 tips och tricks för att lyckas med ert sap-projekt 20 SAPSANYTT 2/2015 De flesta projektledare känner säkert till Cobb’s paradox. Martin Cobb verkade som CIO för sekretariatet för Treasury Board of Canada 1995 då han ställde frågan
service i Norge och Finland drivs inom ramen för ett enskilt företag (NRK. 1 och Yleisradio), fin ns det i Sverige tre: Ett för tv (Sveriges Television , SVT ), ett för radio (Sveriges Radio , SR ) och ett för utbildnings program (Sveriges Utbildningsradio, UR, vilket till följd av sin begränsade storlek inte återfinns bland de 25 största
Hotell För hotell anges de tre klasserna A/B, C och D. Det betyder att den "normala" standarden C är acceptabel men att motiven för en högre standard är starka. Ljudklass C motsvarar de tidigare normkraven för hotell, ljudklass A/B motsvarar kraven för moderna hotell med hög standard och ljudklass D kan användas vid
LÄS NOGGRANT FÖLJANDE VILLKOR FÖR APPLE DEVELOPER PROGRAM LICENCE . Apple Developer Program License Agreement Syfte Du vill använda Apple-mjukvara (enligt definitionen nedan) för att utveckla en eller flera Applikationer (enligt definitionen nedan) för Apple-märkta produkter. . Applikationer som utvecklas för iOS-produkter, Apple .
the interRAI HC and the requested care plan to be completed via paper in the participant’s home (i.e., no internet connectivity or no portable computer device). This will require data entry of the information into the HCBS Web Tool
