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IHCP bulletin INDIANA HEALTH COVERAGE PROGRAMS BT201146 SEPTEMBER 13, 2011

2011 IHCP Annual Provider Seminar scheduled for October 25-27 in Indianapolis The Office of Medicaid Policy and Planning (OMPP) and HP Enterprise Services invite Indiana Health Coverage Programs

(IHCP) providers to attend the 2011 IHCP Provider Seminar October 25-27, 2011, in Indianapolis. There is no cost for the

seminar.

The seminar features three full days of important information. Topics include program overviews and specific program bill-

ing guidelines, as well as sessions about prior authorization. Sessions will be led by HP, ADVANTAGE Health SolutionsSM,

Anthem, Managed Health Services (MHS), and MDwise. See the following full seminar lineup to pick your “can’t-miss” ses-

sions.

Seminar registration

Providers may register online for the 2011 IHCP seminar. Go to indianamedicaid.com and select Provider Education from

the Quick Links column, then Workshop Registration, or go directly to the Workshop Registration page. The registration

page provides instructions, including the Workshop Registration Tool Quick Reference. Those who register online receive

immediate registration confirmation. When registering, you will be asked to select the classes you wish to attend. All regis-

tration is on a first-come, first-served basis, so sign up early for the best selection.

Walk-in registrations will be allowed. However, walk-in registration is not recommended, as the most popular sessions fill

up well before the start of the seminar, and walk-in registrants will be allowed to attend sessions only as space is available.

For comfort, business casual attire is recommended. Consider wearing layered clothing due to possible room temperature

variations. Continue

http://provider.indianamedicaid.com/ihcp/workshop/index.aspx

IHCP bulletin BT201146 SEPTEMBER 13, 2011

General location of Indianapolis Marriott East Hotel Specific location of Indianapolis Marriott East Hotel

Seminar location – Indianapolis Marriott East Hotel

The seminar will be at the following location:

Indianapolis Marriott East

7202 E. 21st Street

Indianapolis, IN 46219

1-800-228-9290 (for hotel reservations only)

(317) 352-1231 (for hotel information only)

Note: Please do not call the hotel to register for seminar sessions.

Guest room reservations are available at the special rate of $104 plus tax per night. When making reservations by tele-

phone, indicate you are attending the “Medicaid seminar” to secure the special rate. You may also reserve guest rooms

online at indianapolismarriotteast.com – enter group code “HPCHPCA” to secure the special room rate when making

reservations online. The special rate applies to reservations made by telephone and online on or before October 5,

2011.

Directions

The Indianapolis Marriott East hotel is located on the near northeast side of Indianapolis at 21st Street, east of Shade-

land Avenue, west of I-465, and south of I-70.

The maps on this page show the location of the Marriott East. For more specific directions from your location, please visit

a map-search website, such as mapquest.com.

Seminar sessions and descriptions

During online registration, you must specify the seminar classes you want to attend. Descriptions of seminar classes and

the class schedule are listed in the table starting on the next page. Continue

http://www.marriott.com/hotels/travel/inddt-indianapolis-marriott-east/

http://www.mapquest.com/


Table 1 – Session Descriptions

Session Name Description



Care Select 101 Presented by representatives from ADVANTAGE Health Solutions and MDwise

This session provides an overview of Indiana Care Select, including its goals and eligi-bility requirements, and the program’s focus on disease management and complex case management for specific chronic conditions. Other topics include general prior authori-zation, the Right Choices Program (RCP), and program quality measures. This session is ideal for primary medical providers (PMPs) and specialty care providers interested in participating in Indiana Care Select, as well as providers now participating in the pro-gram.

Claim Adjustment Process Presented by HP provider relations field consultants

This session, which provides step-by-step instructions for completing claim adjustments online using Web interChange, is necessary for anyone who corrects claims for resub-mission to HP. Instructions for completing the paper Adjustment Request Form and re-quirements for submitting adjustments via paper are also discussed.

CMS-1500 Billing Presented by HP provider relations field consultants

This session covers basic billing guidelines for various services, including anesthesia, injections, surgical services, therapies, evaluation and management codes, obstetrics, and more. Discussion also includes newly implemented code auditing guidelines affect-ing lab, bilateral, add-on, and component procedures. A review of the top claim denial reasons and resolutions is included. This session is ideal for new Medicaid billers.

CMS-1500 Billing and Prior Authorization from Managed Health Services Presented by representatives from Managed Health Ser-vices

This session is for providers that bill professional claims for both Managed Health Ser-

vices (MHS) – Hoosier Healthwise (HHW) and MHS – Healthy Indiana Plan (HIP). Pro-

viders learn about MHS claim processing guidelines and procedures, as well as the

most common reasons for claim rejections and claim denials, and how to correct and

prevent them. Providers also learn avenues for requesting prior authorization (PA) from

MHS and the top reasons for PA suspensions and denials. The appeals process for

claims and medical necessity is also reviewed.

CMS-1500 Billing and Prior Authorization from MDwise Presented by representatives from MDwise

This session is for providers that request prior authorization (PA) or bill professional

claims to MDwise. Providers learn about the most common reasons for MDwise claim

denials and discuss resolutions to prevent future claim denials. This session also helps

providers and medical staff obtain PA, including an overview of the new Universal PA

Form, services that require PA, and the appeals process. This session is vital for provid-

ers that interact with MDwise for Hoosier Healthwise (HHW) and HIP.

CMS-1500 Medicare Crossover Claim Billing Presented by HP provider relations field consultants

This session focuses on billing instructions for submitting Medicare crossover claims to

HP. Participants learn how to submit crossover claims electronically using Web inter-

Change and how to submit paper claim forms, as well.

CMS-1500 Medicare Replacement Plans Presented by HP provider relations field consultants

This helpful session contrasts Medicare replacement claims with Medicare crossover

claims. During this session, participants learn how to submit Medicare replacement

claims (also known as Medicare health maintenance organization, or HMO, claims) to

HP. Detailed instructions for submitting these claims electronically using Web inter-

Change and via a paper claim form are also presented.

Come Take a Ride with MHS Presented by representatives from LCP

This session, which is presented by LCP, the Managed Health Services (MHS) transpor-

tation vendor, includes an overview of transportation services, how members schedule

rides, and additional information.

Continue




Dental Billing Guidelines

Presented by HP provider relations field consultants

This session shows dental providers how to use Web interChange to facilitate dental billing. Having trouble with qualified Medicare beneficiary (QMB) members? This session will help. The session also discusses dental policy, billing the member, spend-down, and the $1,000 dental cap.

Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)

Presented by representa-tives from HP, Anthem, Managed Health Ser-vices, and MDwise

HP and the MCEs present a joint focus on EPSDT to familiarize primary care providers (pediatricians, family practice, internal medicine, and general practice) with the EPSDT pro-gram. This session provides a program overview, description of covered services and special-ties, billing guidelines, outreach strategies, strategies to maximize reimbursement and out-reach, and current trends. The presentation also covers the collaboration between the MCEs and the American Academy of Pediatrics (AAP), and the alignment of EPSDT programming with the Bright Futures Guidelines for Health Supervision of Infants, Children, and Adoles-cents. This session is ideal for clinical staff, billing staff, and primary medical provider office management staff.

Electronic Health Records


The American Recovery and Reinvestment Act (Recovery Act) of 2009 provides for incentive payments for eligible professionals (EPs) and eligible hospitals (EHs) that are meaningful us-ers of certified electronic health record technology. Come learn how to register your electronic health records (EHR) system to qualify for EHR payments.

Healthy Indiana Plan (HIP)

Presented by representa-tives from Anthem, Man-aged Health Services, and MDwise

The managed care entities (MCEs) present a comprehensive overview of the Healthy Indiana

Plan (HIP), and each MCE provides updates and information specific to its plan. The session

provides a description of covered services, prior authorization, claims filing, Personal Well-

ness Responsibility (POWER) Accounts, and provider enrollment. This session is ideal for all

HIP providers.

How to Read the Remittance Advice Presented by HP provider relations field consultants

Did you know you can control your office’s Medicaid accounts receivables (A/Rs) using the

Remittance Advice (RA)? This session provides an overview of how to use and understand

the RA. Providers also learn how to determine the reason for claim denials using the explana-

tion of benefits (EOB) codes, and how to recognize when a financial offset has occurred on

the weekly payment.

How Well Do You Know Your CMS-1500? Presented by representa-tives from Anthem

This session offers useful information to providers that bill professional claims to Anthem. Par-

ticipants learn about common reasons for claim denials, and how to correct and prevent them,

as well as how to access important information via the website and find out about upcoming

changes. Prior authorization (PA) is also discussed. This session is vital for providers that

interact with Anthem.

Introduction to the IHCP


This session describes the Indiana Medicaid program. Participants learn about Traditional

Medicaid, Care Select, Hoosier Healthwise (HHW), Healthy Indiana Plan (HIP), risk-based

managed care programs, and about the contractors involved with each program. This session

is ideal for those who are new to Medicaid.

Let’s Talk UB-04 Presented by representa-tives from Anthem

This session offers useful information to providers that bill institutional claims to Anthem. Par-

ticipants learn about common reasons for claim denials, and how to correct and prevent them,

as well as how to access important information via the website and find out about upcoming

changes. Prior authorization (PA) is also discussed. This session is vital for providers that

interact with Anthem.

Continue




Life of a Claim Presented by HP pro-vider relations field consultants

Have you wondered how your claims are processed? This session breaks down the steps that have an impact on all claims submitted to HP. Participants learn how prior authorization, system edits and audits, pricing, and medical policy suspensions affect how claims are processed. But it doesn’t end there – providers also learn how to correct claims through the online adjustments process. This session is ideal for those who are new to Medicaid.

MCE 2011 Performance Standards Presented by represen-tatives from Anthem, Managed Health Ser-vices, and MDwise

The managed care entities (MCEs) present a joint focus on Healthcare Effectiveness Data and Information Set (HEDIS)/Quality Measures as they relate to primary care providers (pediatricians, family practice providers, internal medicine providers, general practice providers, and obstetricians/gynecologists, or OB/GYNs) and specialty providers. This session provides information regarding documentation guidelines and time frames for each measure, billing guidelines, and resources available to providers. This session, which also includes how the measures are collected, analyzed, and presented to providers, is ideal for clinical and billing staff, as well as provider office management staff. The MCEs share this session, and each MCE delivers plan-specific information.

MCE and CMO Behavioral Health Presented by represen-tatives from Anthem, Managed Health Ser-vices, MDwise, and ADVANTAGE Health Solutions

The managed care entities (MCEs) and care management organizations (CMOs) are partnering together to present an overview of MCE/CMO plans’ approaches to behavioral health. The Of-fice of Medicaid Policy and Planning (OMPP) requires that members with certain chronic behav-ioral health diseases (for example, pervasive developmental disorders/autism, depression, and attention deficit hyperactivity disorder, or ADHD) receive assistance from their MCE or CMO, so members can manage their conditions and live fuller lives. In this session, participants learn about the strategies and techniques designed by MCEs and CMOs to promote better medica-tion adherence, manage behavioral health illnesses, reduce inpatient and emergency room vis-its, and improve lifestyles (for example, referrals to smoking cessation education) among their member populations. Providers also learn how to access resources and clients’ condition-specific information from the MCE or CMO to improve treatment outcomes for the members they serve.

Learn about the Right Choices Program (RCP), which is critical to the success of managing maladaptive behaviors that have led to poor health outcomes for members in the past. This ses-sion provides information about why members are placed in the RCP and describes the pro-gram’s components.

MCE and CMO Disease Management – Your Partner in Member Care Presented by represen-tatives from Anthem, Managed Health Ser-vices, MDwise and ADVANTAGE Health Solutions

The managed care entities (MCEs) and care management organizations (CMOs) present an

overview of each plan’s approach to disease management. The Office of Medicaid Policy and

Planning (OMPP) requires that members with certain chronic diseases (for example, diabetes,

depression, ADHD, and so on) receive assistance from their MCE or CMO, so members can

manage their chronic disease and live fuller lives. In this session, participants learn about the

strategies and techniques designed by the MCEs and CMOs to promote better medication ad-

herence, manage chronic illnesses, reduce inpatient and emergency room visits, and improve

lifestyles (for example, referrals to smoking cessation education) among their member popula-

tions. Providers also learn how to access resources and information from the MCE or CMO to

achieve better health outcomes for members on their managed care panels.

The Right Choices Program (RCP) is critical to the success of managing some types of behav-

ior while achieving better health outcomes for members in the program. This session provides

information about why members are placed in the RCP, and how MCEs and CMOs partner with

providers to manage RCP members’ behavior and ensure payment to providers that serve RCP

members.

Continue




MCE Coordination of Benefits Presented by representa-tives from Anthem, Managed Health Services, and MDwise

Medicaid is intended to be the payer of last resort. In most circumstances, other insurance resources must be billed first. In this session, the managed care entities (MCEs) – Anthem, MDwise, and Managed Health Services – provide an overview of Coordination of Benefits (COB), also known as third-party liability, and claim processing requirements.

MCE Roundtable Presented by representa-tives from Anthem, Managed Health Services, and MDwise

The MCE Roundtable allows providers to ask questions that were not answered during the day’s learning sessions. This question-and-answer session is valuable to those who desire to interact with the managed care entities (MCEs).

MCE Vision Services

Presented by representa-tives from Anthem, MDwise, and VSP

This session assists providers with billing guidelines for vision services, benefit limitations, prior authorization, common denials, and avenues of resolution from a managed care per-spective.

Medical Equipment Guidelines


Medical equipment providers will gain an understanding of durable medical equipment

(DME) guidelines including capped rental, repair versus replacement, preferred diabetic

supplies, and more. In addition, providers will learn the top reasons for DME claim denials

and how to resolve them.

Medical Equipment Roundtable

Presented by representa-tives from Anthem, Managed Health Services, and MDwise

This session allows providers of durable medical equipment (DME) to ask questions and

get answers regarding DME billing and prior authorization from a managed care perspec-

tive.

Medical Review Team Presented by HP provider relations field consultants

This session provides an overview of the billing requirements for Medical Review Team

(MRT) claims. The discussion reviews how the member eligibility process works, the types

of exams and service performed, and obtaining authorization for additional services. The

top reasons for MRT claim denials are discussed, along with methods of resolution.

Mental Health Presented by HP provider relations field consultants

This session, which provides an overview of mental health policy and billing guidelines

from a Traditional Medicaid perspective, includes topics such as outpatient mental health,

the Medicaid Rehabilitation Option (MRO) transformation, somatic treatment, assertive

community treatment, and psychiatric residential treatment facility services. Providers also

learn about the top reasons for claim denials and how to resolve them.

Mental Health Roundtable Presented by representa-tives from Anthem, Cen-patico, and MDwise

This question-and-answer forum allows providers to ask questions about the Medicaid

mental health benefit from a managed care perspective.

Continue




Need a Ride

Presented by represen-tatives from MTM and MDwise

This session, conducted by Medicaid transportation contractors, includes an overview of trans-portation services, such as trip limitations, how members schedule rides, and additional infor-mation.

Practice Optimization Strategies: Building Blocks of a Medical Home Presented by represen-tatives from Anthem

Anthem providers are invited to meet their local nurse practice consultant, and learn tips and tools to optimize providers’ practices and improve quality outcomes. This session reviews the basic concepts of a medical home and current initiatives promoting this model of care. To bet-ter enable Anthem to respond to providers’ evolving needs, a portion of the session elicits feedback from attendees to identify challenges and barriers facing providers as they try to meet their desired quality outcomes. Providers are also encouraged to bring and share exam-ples of changes or initiatives implemented in their offices that have resulted in improved out-comes and best practices. This “can’t-miss” interactive session allows Anthem providers to discuss recent trends and exchange recommendations for optimizing their practices.

Pre-Admission Screening Resident Review (PASRR)

Presented by HP pro-vider relations field con-sultants

This session provides an overview of Pre-Admission Screening Resident Review (PASRR) and discusses claim submission guidelines, including how to establish PASRR eligibility in the claims processing system, IndianaAIM. This session is ideal for community mental health cen-ters, diagnostic and evaluation teams, and representatives from the Area Agencies on Aging.

Presumptive Eligibility (PE) and Notification of Pregnancy (NOP) Presented by represen-tatives from HP, An-them, Managed Health Services, and MDwise

Since 2009, the Indiana Presumptive Eligibility (PE) Program for Pregnant Women has pro-

vided payment for initial ambulatory prenatal services furnished to pregnant women who have

not had Medicaid eligibility established at the time of the office visit. This program is having a

positive impact on prenatal care and birth outcomes for pregnant women in Indiana. Current

providers and all interested providers are encouraged to attend this session, which offers an

overview of the 2011 PE program, including updates and valuable tips.

Also included is valuable information regarding the Notification of Pregnancy (NOP), including

the designated high-risk stratification criteria for NOP documentation and billing guidelines to

maximize successful claim processing and reimbursement for high-risk patients.

Primary Care Well-Child Measures Presented by represen-tatives from Anthem, Managed Health Ser-vices, and MDwise

Managed care entities (MCEs) present a joint focus on the three well-child performance/

HEDIS measures to familiarize primary care providers – pediatricians, family practice provid-

ers, internal medicine providers, general practice providers, and obstetrician/gynecologists

(OB/GYNs) – with the three well-child measures, 0-15 months of life, 3-6 years of life, and

ages 12-21. The session describes the measures and the reasons for focusing on the meas-

ures for 2011, including billing guidelines for each measure, time frames and specifications

around each measure, tips and tools for how providers can outreach to members in each

measure, and how providers can reach targeted goals in each measure. Participants also

learn how the three performance measures are analyzed and presented to providers, how an

office can increase members’ quality of care, and how each performance measure can relate

to pay-for-performance initiatives. Providers receive tools and resources to help promote in-

creased performance in these three well-child measures. This session is ideal for clinical staff,

billing staff, and primary medical provider office management staff.

Continue




Prior Authorization 101 for Traditional Medicaid and Care Select Presented by repre-sentatives from AD-VANTAGE Health So-lutions and MDwise

This session provides an overview of current topics relevant to prior authorization (PA) for pro-viders participating in Indiana Care Select and Traditional Medicaid programs.

Topics include: PA Request Form and submission Medical necessity documentation General PA guidelines and processes for:

Elective inpatient admission

Medicaid Rehabilitation Option (MRO)

Behavioral health

Physical, occupational, and speech therapy

Durable medical equipment Administrative review and hearings overview

This session is ideal for primary medical providers (PMPs), specialty care providers, hospitals, community mental health centers, and ancillary providers rendering services to Care Select and Traditional Medicaid members.

Provider Enrollment – Impact of the Afford-

able Care Act

Presented by HP pro-vider relations field consultants

This session provides an overview of the changes to provider enrollment and update as a re-sult of the Affordable Care Act. Providers learn how enrollments, rendering provider changes, and profile updates will change in the near future. This session is ideal for credentialing per-sonnel and staff responsible for maintaining the accuracy of provider profile information.

Spend-down


This session shows how a member’s spend-down affects claims processing, including how spend-down is applied, how to collect spend-down dollars, and how to identify those who have spend-down requirements.

Third Party Liability Presented by HP pro-vider relations field consultants

This session shows how to tell when a member has coverage through a third-party insurer.

Participants learn how to update incorrect or missing third-party liability (TPL) information for

members and resolve TPL-related claim denials and billing procedures. This session is ideal

for all providers.

Transportation for Anthem Members and Providers Presented by repre-sentatives from LCP

This session includes an overview of transportation services, such as trip limitations and how

members schedule rides. Additional information about the new Medicaid requirements effec-

tive January 2011, such as required office hours, the change in Package C coverage, and non-

covered trips, is also covered.

Transportation Guidelines


This session provides an overview of transportation policy and billing.

Continue




UB-04 Billing and Prior Authorization from MHS

Presented by represen-tatives from Managed Health Services

This session offers useful information for providers that bill institutional claims for Managed Health Services (MHS) – Hoosier Healthwise (HHW) and MHS – Healthy Indiana Plan (HIP). Providers learn the most common reasons for claim rejections and denials, and how to correct and prevent them. Providers also learn about prior authorization (PA), the top reasons for PA suspensions and denials, and the appeals process in relation to claims and medical necessity.

UB-04 Billing and Prior Authorization from MDwise Presented by represen-tatives from MDwise

This session offers useful information for providers who bill institutional claims to MDwise. Par-ticipants learn about the most common reasons for MDwise claim denials and discuss resolu-tions to prevent future claim denials. This session also shows providers and medical staff how to obtain prior authorization (PA), including an overview of the new Universal PA Form, ser-vices that require PA, and the appeals process. This session is vital for providers who interact with MDwise for Hoosier Healthwise (HHW) and the Healthy Indiana Plan (HIP).

UB-04 Billing Medi-care Replacement Plans


This helpful session contrasts Medicare replacement claims with Medicare crossover claims. During this session, participants learn how to submit Medicare replacement claims (also known as Medicare HMO claims) to HP electronically using Web interChange and via the pa-per claim form.

UB-04 Institutional Claims Presented by HP pro-vider relations field con-sultants

This session shows how to complete the UB-04 claim form, and reviews both inpatient and

outpatient billing guidelines. Discussion includes newly implemented code auditing guidelines

that have an impact on outpatient claims.

UB-04 Medicare Crossover Claims


This session focuses on billing instructions for submitting Medicare crossover claims to HP

electronically using Web interChange and also via the paper claim form.

UB-04 Medicare Exhaust Claims Presented by HP pro-vider relations field con-sultants

Medicare exhaust claims can be confusing. During this session, institutional billers learn what

constitutes a Medicare exhaust claim, how to submit these claims via Web interChange and on

a paper claim form, including how to use the Notes and Attachments features of Web inter-

Change to send these claims. Providers also learn how to resolve claim denials common to

this type of claim. This session is for providers who bill on the UB-04 claim form.

Vision Services Presented by HP pro-vider relations field con-sultants

This session covers billing guidelines for vision claims submitted to HP. Also covered are vi-

sion policy, benefit limitations, prior authorization, third-party liability billing, spend-down, and

the impact of member assignment with the managed care organizations. Additional discussion

includes newly implemented code auditing guidelines.

Continue




Waiver Billing with Common Denials


This session for prospective and current Home and Community-Based Services (HCBS) waiver providers includes an overview of the Indiana waiver program. Topics include member eligibility, provider enrollment, billing, and common reasons for claim denials. This session is ideal for all waiver providers and case managers billing for waiver program services.

Web interChange


This session covers administrator and user functions, and instructs billers how to research claim status using Web interChange. In addition, providers learn how to use the Notes and Attachments functions and how to correct claim denials online. Provider profiles, prior authori-zation (PA), and Medicaid-secondary billing are also discussed.

Session times and room numbers appear on the next page.

QUESTIONS? QUESTIONS? QUESTIONS? QUESTIONS?

If you have questions about this bulletin, please contact Customer Assistance at (317) 655-3240 in the Indianapolis

local area or toll-free at 1-800-577-1278.







Continue


Salon A Salon 3 Salon 4 Time

UB-04 Institutional Claims (HP)

8:00 a.m. – 9:45 a.m. Care Select 101

(ADVANTAGE and MDwise) 8:15 a.m. – 9:45 a.m.

Web interChange (HP)

8:00 a.m. – 9:45 a.m.

Break Break Break

UB-04 Billing (MHS)

10:00 a.m. – 11:00 a.m.

Electronic Health Records (HP)

10:00 a.m. – 10:45 a.m.

Prior Authorization 101 (ADVANTAGE and MDwise)

10:00 a.m. – 11:30 a.m.

Break

Break

Break

Let’s Talk UB-04 (Anthem)

11:15 a.m. – 12:15 p.m.

Provider Enrollment – Impact of the Affordable Care Act

(HP) 11:00 a.m. – noon

Spend-down (HP)

11:45 a.m. – 12:45 p.m.

8:00 a.m.

9:00 a.m.

10:00 a.m.

11:00 a.m.

12:00 a.m.

1:00 p.m.

2:00 p.m.

3:00 p.m.

4:00 p.m.

5:00 p.m.

Break

Break

Break

UB-04 Billing (MDwise)

12:30 p.m. – 1:30 p.m. How to Read the

Remittance Advice (HP)

1:00 p.m. – 2:00 p.m.

Claim Adjustment Process (HP)

1:15 p.m. – 2:45 p.m.

Break

Break

Break

UB-04 Billing Medicare Replacement Plans

(HP) 1:45 p.m. – 2:30 p.m. Intro to the IHCP

(HP) 2:15 p.m. – 3:00 p.m.

Third Party Liability (HP)

3:00 p.m. – 4:30 p.m.

Break

Break

UB-04 Medicare Crossover Claims (HP)

2:45 p.m. – 3:30 p.m.

Life of a Claim (HP)

3:15 p.m. – 4:15 p.m. Break

UB-04 Medicare Exhaust Claims (HP)

3:45 p.m. – 4:30 p.m. Break

MCE Roundtable 4:30 p.m. – 5:00 p.m.

Table 2 – Session Schedule for Tuesday, October 25, 2011

Note: Registration and booths are open from 8 a.m. until 5 p.m.



Vision Services (HP)

8:00 a.m. – 9:00 a.m.

Dental Billing Guidelines (HP)

8:00 a.m. – 9:30 a.m. Healthy Indiana Plan

(MCEs) 8:15 a.m. – 9:45 a.m.

Break

Break

Break

MCE Vision Services (Combined MCEs and

Subcontractors) 9:15 a.m. – 10:00 a.m. Waiver Billing with Common Denials

(HP) 9:45 a.m. – 10:45 a.m.

Transportation Guidelines (HP)

10:00 a.m. – 11:00 a.m.

Break

Break

Break

Medical Equipment Guidelines (HP)

10:15 a.m. – 11:15 a.m.

Provider Enrollment – Impact of the Affordable Care Act

(HP) Noon – 1:00 p.m.

Transportation for Anthem Members and Providers

(LCP Subcontractor) 11:15 a.m. – 12:15 p.m.

8:00 a.m.

9:00 a.m.

10:00 a.m.

11:00 a.m.

12:00 a.m.

1:00 p.m.

2:00 p.m.

3:00 p.m.

4:00 p.m.

5:00 p.m.

5:30 p.m.

Break

Break

Third Party Liability (HP)

12:15 p.m. – 1:45 p.m.


1:15 p.m. – 2: 45 p.m.

Come Take a Ride with MHS (LCP Subcontractor)

12:30 p.m. – 1:15 p.m.

Break

Break

Break

MCE Coordination of Benefits (MCEs)

2:00 p.m. – 2:45 p.m.

Spend-down (HP)

3:00 p.m. – 4:00 p.m.

Need a Ride (MDwise)

1:30 p.m. – 2:15 p.m.

Break

Break

Medical Review Team (HP)

3:00 p.m. – 3:30 p.m.

MCE Roundtable (MCEs)

4:15 p.m. – 5: 00 p.m.

Break

Pre-Admission Screening Resident Review

(HP) 3:45 p.m. – 4:15 p.m.

How to Read the Remittance Advice (HP)

4:30 p.m. – 5:30 p.m.

Life of a Claim (HP)

4:30 p.m. – 5:30 p.m.

Table 3 – Session Schedule for Wednesday, October 26, 2011



2:30 p.m. – 4:15 p.m.


11:00 a.m. – 11:45 a.m.

Break

Medical Equipment Roundtable (MCEs)

11:15 a.m. – 11:55 a.m.

Break

Break

Break

Break



CMS-1500 Billing (HP)

8:00 a.m. – 9:45 p.m. Early and Periodic Screening,

Diagnosis, and Treatment (HP and MCEs)

8:15 a.m. – 10:00 a.m.


8:00 a.m. – 9:45 a.m.

Break

Break

Break

How Well Do You Know Your CMS-1500?

(Anthem) 10:00 a.m. – 11:15 a.m.

Primary Care Well-Child Measures (MCEs)

10:15 a.m. – 11:15 a.m.

Mental Health (HP)

10:00 a.m. – 11:00 a.m.

Break Break

Break

Presumptive Eligibility and Notification of Pregnancy

(HP and MCEs) 11:30 a.m. – 1:30 p.m.

MCE and CMO Behavioral Health (MCEs and CMOs)

11:15 a.m. – 12:45 p.m.

8:00 a.m.

9:00 a.m.

10:00 a.m.

11:00 a.m.

12:00 a.m.

1:00 p.m.

2:00 p.m.

3:00 p.m.

4:00 p.m.

5:00 p.m.

5:15 p.m.

Break Break

Break

CMS-1500 and Prior Authorization from MDwise

(MDwise) 1:00 p.m. – 2:15 p.m.

MCE 2011 Performance Standards (MCEs)

1:45 p.m. – 2:45 p.m.

Mental Health Roundtable (MCEs )

1:00 p.m. – 2:00 p.m.

Break

Break

Break


2:30 p.m. – 3:30 p.m. Practice Optimization Strategies – Building Blocks of a Medical Home

(Anthem) 3:00 p.m. – 4:00 p.m.

CMS-1500 Medicare Crossover Claim Billing

(HP) 2:15 p.m. – 3:00 p.m.

Break

Break

MCE and CMO Disease Management – Your Partner in Member Care

(MCEs/CMOs) 3:45 p.m. – 5:00 p.m.

How to Read the Remittance Advice (HP)

4:15 p.m. – 5:15 p.m.

Table 4 – Session Schedule for Thursday, October 27, 2011


CMS-1500 and Prior Authorization from MHS

(MHS) 11:30 a.m. – 12:45 p.m.

CMS-1500 Billing – Medicare Replacement Plans

(HP) 3:15 p.m. – 4:00 p.m.

Break


4:15 p.m. – 5:00 p.m.

Break

IHCP bulletinprovider.indianamedicaid.com/ihcp/Bulletins/BT201146.pdf · The Indianapolis Marriott...

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Transcript of IHCP bulletinprovider.indianamedicaid.com/ihcp/Bulletins/BT201146.pdf · The Indianapolis Marriott...