[Provider] Void Functionality Reminders -- Training Presentations posted to MaineCare web site

[Provider Notification]

ATTENTION:            All MaineCare Providers planning to use Void
Functionality

 

During the first two weeks of October, more than 800 providers attended
training on use of the void functionality in MeCMS.  The powerpoint
presentations used for the training have now been posted to the
MaineCare Services web site.  These can be accessed at the link here
under the "Void Functionality to be implemented in MeCMS" headline.

 

http://www.maine.gov/dhhs/bms/member/innerthird/mecms_portal_news.html

 

Providers can begin to submit voided claims not intended for re-billing
on Monday, October 22.

Providers can initiate voided claims intended for re-billing on Monday,
October 29.

Providers may submit re-bills once the voided claim appears on a
Remittance Advice (RA).

 

Reminders:

What providers CAN do with Void functionality:

* Void an original paid claim document or paid claim line for which a
void was not previously submitted and approved

 

   A general rule of thumb is that if claims are currently paying
correctly, a Void followed by a Re-bill should result in a proper
payment.  If a claim is NOT paying correctly due to a known issue, VOIDS
AND RE-BILLS SHOULD NOT BE SUBMITTED because the claim will encounter
the same issue.  Examples of these are limits, edits processing failures
(EPF) and co-pays.

 

  Nursing, Custodial Care and Residential Care Facilities cannot void
paid claim lines on documents with cost of care; spend downs, room and
board or TPL.  Please contact your Adjustment Specialist for
instructions on how to handle these.

 

 Hospitals and Psychiatric Hospitals cannot void paid claim lines on
documents that include spend downs or TPL, and cannot void a line that
has a revenue code of room and board unless the room and board line is
the only line in the entire claim document.  Please contact your
Adjustment Specialist for instructions to handle these.

*  Re-bill a Voided claim document or claim line once the Void appears
on an RA

*  Void multiple claim lines within a billing cycle

   Each claim line must be submitted as a separate Void document

 

 

What Providers CANNOT do:

*   . . .Void a DENIED claim document or claim line

*   . . .Void an ADJUSTMENT claim document or claim line

*   . . .Void a VOID claim document or claim line

*   . . . Void a mixed DENIED and PAID claim document (must VOID
individual paid claim lines)

*   . . . Void a SUSPENDED claim

*   . . . Void a claim held in Edits Processing Failure

*   . . . Void a claim held in Fund Allocation Failure 

*   . . . Resolve a current outstanding billing issue by voiding and
re-billing

*   . . . Adjust a claim document or claim line (using Submission
Reason/Frequency of 7)

 

Contacts for Questions:

 

Billing and Information 

1-800-321-5557, Option 8

 

Adjustment Unit Contacts

Providers Billing on CMS1500 or Dental Forms:

            Provider names

            beginning with:                        Contact Person:
Phone:

 

                  A-E                                    Debbie Ladd
207-287-1780

                  F-N                                    Jaime Hall
207-287-1778

                  O-Z                                    Debbie or Jaime


 

Providers Billing on UB Forms:

            Provider names

            beginning with:                        Contact Person:
Phone:

 

            A-E                                          Linda
Harrington                      207-287-1777

            F-L + All MR Waivers              Shavon Smith
207-287-6284

            M-Z                                          Nancy Haskell
207-287-1779

 

 

This is a one-way communication.  Please do not respond to this message.

 

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