0 hbbd``b`j~@q3`WAM \b K D\w3Ho$6 b 5L3Ao~0 ( - March 2023 Provider Training Calendar. This article provides general claim filing information for online and paper claim submissions, proof of loss, and timely filing guidelines, and related links to additional resources and troubleshooting for claims and provider systems. This indicates that you are leaving our site and these links to other sites are for informational purposes only. (800) 888-1965, TTY 711 Sign In | Optum Products & Services Sign in or register Whether you're a patient, health care organization, employer or broker, find the site you want to sign into below. The next Provider Council Meeting will be held on Friday, October 14 at 10:00 am. Incedo Provider Portal (IPP): Utilizing Client-Level COVID-19 Vaccine Status Data Files. Stay up-to-date on upcoming Maryland mental health news, training and events. Sign in . Providers can choose any clearinghouse vender to submit claims using EDI. TheProvider Alertsare important updates from Optum and the Department. Optum Maryland FAQs 1 BH2567_01/2020 United Behavioral Health operating under the brand Optum Optum Maryland . Incedo Provider Portal Quick Reference Guide, The March Provider Council Meeting will be held onFriday, March 10th at 10:00 am EST. ` =3 endobj P.O. Skip to main content. O4 Text Component. After logging into Incedo Provider Portal, use the Incedo Provider Portal user Guide for instructions on entering a claim or for submitting an electronic file of claims. 2017 All rights reserved. 231 0 obj <>stream 04-30-21: Incedo Provider Portal - Authorization Entry Issue Resolved 04-09-21: Incedo Provider Portal Accessibility 2023 For services and providers covered by Medicare, submit claims directly to Medicare following Medicares timely filing guidelines. <> Check the website often as it continues to grow to better serve you! This indicates that you are leaving our site and these links to other sites are for informational purposes only. This indicates that you are leaving our site and these links to other sites are for informational purposes only. 159 0 obj <> endobj Participant Questions Call Toll-Free: <> May 2020 Training Schedule. If you are a person or a family member seeing a MDH/BHA provider, you can access relevant information with the touch of a finger: "Fiasco," "debacle," and "administrative nightmare" were among the words behavioral health providers and legislators used to describe the ongoing claims reconciliation process with the Maryland Department of Health (MDH) and its system vendor, Optum, at the House Health and Human Services Subcommittee meeting last week. We invite you to look through this site to see the many ways we can serve you. Data interchange between a practitioner, physician, psychologist, or a social worker and a payer. After enrollment in Maryland Medicaid, Providers register with Optum using Incedo provider portal. endstream The website has sections for participants and families as well as providers of mental health services. Contact us O4 Utility Nav Items. Optum Nondiscrimination Notice and Language Services, see here. Its performance in Maryland to date does not suggest that its demonstrated technology or project management limitations have been resolved. You may be trying to access this site from a secured browser on the server. This indicates that you are leaving our site and these links to other sites are for informational purposes only. March 2020 Training Schedule. 179 0 obj <>/Filter/FlateDecode/ID[<5B6A138A1EB17A4A9A613D6755F54D64>]/Index[159 73]/Info 158 0 R/Length 103/Prev 136342/Root 160 0 R/Size 232/Type/XRef/W[1 3 1]>>stream Leveraging Incedo's fully integrated medical management platform, Doctors continues to expand its footprint in highly a competitive market, having earned market distinction for offering innovative programs to . Please contact the Center's Program Director if you have any questions on this initiative or the Center's resources: Kristen Beall. hb```i L-N mXp_[!dd(v[g\E\`hG A1?7 r 2 FoX8fIL>kn&eWAzYP3( News /Events. 43 0 obj Please click. . Optum Maryland has provided a listing of Mental Health, Substance Use Disorder and other specific levels of care by fee schedules for Providers to use. O4 Utility Nav Items. Uninsured Eligibility: Provider Training Guide. Find out what that means for you! Optum Maryland requires the other carriers remittance advice as proof of timely filing. Privacy Policy | Terms of Use | Site Map | Accessibility Note:Adobe Acrobat Readeris required to view and print PDFs. Maryland Behavioral Health resources, information and more, Participant Questions Call Toll-Free: Click on either the Participants and Families or the Providers tab to see the information that applies to you. You have the right to get help and information in your language at no cost. EDI / Electronic claims: Electronic Data Interchange (EDI) is the exchange of information for routine business transactions in a standardized computer format. Uninsured Eligibility: Provider Training Guide. Please note that all access and activity on this site is monitored and by using this site you agree to the confidentiality provisions of both HIPAA and HITECH. ^U^P -NZY1#Xp*b "$L9I08"X.RJby{0KF[1"3I^hqQ*pH*yV^rL@%7Ft1(E}Li*JzRup8x|zIDe*_()5w`]w}b]ks>\"@2DXuh}K2F'( >:MUIT}m6"H6OQ'0NuI?1ORp>J5'Sj.5E%IRB~%bM *~#w(u{n5)|~zE.% WKWqY24x]"n=?1'~Hr%x}0}0EJBi&)&oa ~+gV]9n&6mc. Optum Maryland gives care to people served by the Maryland Department of Health (MDH), Behavioral Health Administration (BHA). November 2022 Provider Training Calendar. Authorizations are required for services not covered or exhausted by Medicare for those services that typically require an authorization (COMAR 10.09.36.06 B (2) a b). If you are a person or a family member seeing a MDH/BHA provider, you can access relevant information with the touch of a finger: Q.4 For corrected claims submission for DOS prior to date 12/29/19 submitted to Beacon, do (800) 888-1965, TTY 711 Optum Maryland has run an off-cycle payment process which was mailed on January 9, 2020. The provider may then register with Optum Incedo Provider Portal - Once approved, the provider may also complete the Provider Referral . On October 1, 2013, a . Reference the charts below to identify the acceptable proof of loss for claim submission based on the service type specifics. It is the responsibility of the facility to update MDH when a rate change occurs so that claims are paid at the correct amount. Effective January 1, 2020, Optum Maryland will replace Beacon as the Administrative Service Organization (ASO) for Maryland's Public Behavioral Health System. Monday - Friday: 8:00 AM to 6:00 PM EST, Outside of Business Hours (evenings, weekends, holidays), Maryland Suicide and Crisis Lifeline: News and Events:Stay up-to-date on upcoming Maryland mental health news, training and events. Box 30532 National Human Trafficking Hotline - 24/7 Confidential. It looks like your browser does not have JavaScript enabled. June 2020 Training Schedule. Top Optum Maryland gives care to people served by the Maryland Department of Health (MDH), Behavioral Health Administration (BHA). .e Privacy Policy | Terms of Use | Site Map | Accessibility Note:Adobe Acrobat Readeris required to view and print PDFs. Out-of-state psychiatric hospitals are paid at a Host State Medicaid Rate. Provider Resources - Optum. We welcome your continued commitment to the Maryland network and encourage new providers to join us in our mission to help people live their lives to the fullest potential. (800) 888-1965, TTY 711. The mailing address for completed claim forms and required attachments is: Optum MarylandP O Box 30531Salt Lake City, UT 84130. Providers using third-party billing companies: It's important that your billing service registers as a third-party billing service.Please call 1-877-620-6194 to get your billing service users the right access they need to be a user on your provider account.Frequently asked questions. Eligibility Criteria and Requirements for Uninsured Consumers, Psychiatric Rehabilitation Program - Adult, Psychiatric Rehabilitation Program Child and Adolescent, General Information and Resources Monkeypox, Physician for Emergency Room Evaluation Services, Emergency Vehicle / Peace Officer Transportation, Provider Type 50 Programs - Partial Hospitalization - ASAM Level 2.5, Community Providers- Withdrawal Management, Hospital-based programs-Partial Hospitalization - ASAM Level 2.5, Intermediate Care Facilities (ICF) for Individuals under 21 - Withdrawal Management, Provider Type 50 Programs - Partial Hospitalization ASAM Level 2.5, Hospital-based programs-Partial Hospitalization ASAM Level 2.5, Withdrawal Management -Acute General Hospital claims. Optum Nondiscrimination Notice and Language Services, see here. February 2020 Training Schedule. Thus, as you consider our request for the immediate replacement of Incedo and Optum's promises of future Incedo functionality, we invite you to consider these facts: Ohio. Optum generates both 999 and 277 files. All rights reserved. October 2022 Provider Training Calendar. Optum Maryland will accept paper CMS - 1500 forms for practitioner/professional services or Uniform Billing (UB)-04 forms for inpatient and outpatient facility claims. About Us:Learn more about the MDH/BHA and Optum Maryland partnership. Office: (667) 214-2123. <>stream (800) 888-1965, TTY 711 9-8-8 (Available 24/7), Optum Crisis Line Available 24/7: Below are a just a few of the important documents that will assist you as a behavioral health provider. Below is an anticipated schedule of releases. %%EOF We invite you to look through this site to see the many ways we can serve you. A registration link will be posted at the beginning of the month. Toll Free Phone Number : 1-800-888-1965, TTY 711 BHA Vaccine Hesitancy Webinar. News and Events:Stay up-to-date on the upcoming Maryland mental health news and training and events. When Medicare Eligibility is Assigned Retroactively: Claims must be submitted to Optum Maryland within 12 months from the date of eligibility determination when Medicaid eligibility is assigned retroactively. Maryland 2-1-1, Provider Questions Call Toll-Free: Note: Providers should press two and follow prompts. Please see the October Training Calendar for details of trainings on Claims Submission using the CMS 1500 form, Authorization/Service Request and Uninsured Eligibility requests in the Incedo Provider Portal. Eligibility Criteria and Requirements for Uninsured Consumers, Psychiatric Rehabilitation Program - Adult, Psychiatric Rehabilitation Program Child and Adolescent, General Information and Resources Monkeypox, Incedo Provider Portal Quick Reference Guide. To view the September Provider Council Meeting Presentation. Salt Lake City, UT 84130, Optum Maryland See the scenarios below for timely claim filing guidelines: Claims must be submitted and received within 12 months of the earliest date of service on the claim, or if the service was a hospital inpatient service, the date of discharge, or if the service was provided in a nursing or rehabilitation facility the month of service.Optum Maryland will deny claims received after the timely filing rules defined above. May 27, 2021, 5:02pm: Optum Maryland is aware that some users are experiencing issues accessing the Incedo Provider Portal, or are receiving Server Error messages. (866) 342-6892. . Example inquiry reasons for contacting this email address: When contacting this email address, please include the following information in the body of the email alongside your providerissue: *To obtain a token, please click hereto complete the provider survey. Learn how Doctors HealthCare Plans partnered with InfoMC just 45 days prior to their target go-live date, launched on time, and became the fastest growing MA plan two years in a row. Q.4 For corrected claims submission for DOS prior to date 12/29/19 submitted to Beacon, do MDH/BHA and Optum Maryland offer education and community events. Monday - Friday: 8:00 AM to 6:00 PM EST, Participant Help to Find a Provider: <>stream January 2023 Provider Training Calendar. Privacy Policy | Terms of Use | Site Map | Accessibility Note:Adobe Acrobat Readeris required to view and print PDFs. (800) 888-1965, TTY 711 (800) 888-1965, TTY 711 endobj TheProvider Manualis where you will find important information about the services offered in Maryland. If you are not authorized to use this website by the sponsoring health plan, or if this is not a user account that was designated specifically for your use; access is strictly prohibited. The ABA Fee Schedule can be viewed on the Autism Providers Information page, here PBHS Provider Billing Appendix.pdf State Fiscal Year 2023 (Effective October 1, 2022) We invite you to look through this site to see the many ways we can serve you. 1-855-427-4682. We are working to fix this issue as soon as possible. MDH/BHA and Optum Maryland offer education and community events. Incedo Provider Portal Brain Injury. Disclaimer: The contents of this website and any information contained herein are intended solely for the use by providers and care coordinators and may contain confidential and/or privileged information which is legally protected from disclosure pursuant to the HIPAA and HITECH laws and/or other applicable law. On this page you will find a wealth of information developed specifically for you, which includes ourIncedo Provider Portalplatform where you can enter authorization for services, claims and more. startxref Example inquiry reason for contacting this email address: *We recommend providers to only send inquires to the appropriate designated email address to ensure that Optum Maryland efficiently serves you. %%EOF Claims may be submitted online using Incedo Provider Portal, through a clearinghouse using Electronic Data Interchange (EDI) with 837batch files or by U.S. Mail. Copyright Maryland.gov. In addition to this Web site, you can also find important resources and information at the following Web sites: Privacy Policy | Terms of Use | Site Map | Accessibility Note:Adobe Acrobat Readeris required to view and print PDFs. Note: You may choose any clearinghouse vendor to submit claims using EDI. hb`````2a VY8!1&>sO{wxu50N[fII`Nj@ Login or register with Incedo Provider Portal, an online tool that allows you to submit and check claims status, check member eligibility, update your provider profile, request inpatient and outpatient authorizations and more. DORS Training 1.27.20. Optum Maryland FAQs 1 BH2567_01/2020 United Behavioral Health operating under the brand Optum Optum Maryland . To request an interpreter, call (800) 888-1965. espaol (Spanish); (Chinese); (Korean); hrvatski (Croatian); Vit (Vietnamese); (Arabic); Deutsch (German); Tagalog (Tagalog); (Russian); franais (French); (Japanese);romnete (Romanian); (Farsi) ; (Ukrainian); Kreyl ayisyen (Haitian Creole); (Hindi); portugus (Portuguese); Ikirundi (Bantu-Kirundi); (Nepali), Privacy Policy | Terms of Use | Site Map | Accessibility Note:Adobe Acrobat Readeris required to view and print PDFs. Please click the drop-down icon to view contact information. Additional information related to the registration process will be shared with you via provider alert on 12/9/2019. hbbd```b``U i&d/#` "l.>dqA$WX2$wE4ev=$Q x Box 30531 The provider must submit the claims to the primary carrier within the primary carriers timely filing limit. endobj Clinical Manager. Find out what that means for you! For current HSA, FSA and HRA account holders, find support at the link below or call us today. O4 Dynamic Alert Site Logo. Incedo Provider Portal is used verify eligibility, enter requests for authorizations and to submit claims. Please click here for full details. %PDF-1.5 % Hours: Monday - Friday, 8:00 a.m. to 6:00 p.m. An Optum Maryland dedicated line to assist with questions related to general information, eligibility, verification, and claim payment status. Payment Period for United Health Group (UHG) / Optum Behavioral Health Providers (Optum) The Maryland Department of Health (MDH) is preparing to enter into the next phase of reconciliation to resolve the differences in the estimated claims paid from January 1, 2020 through August, 3, 2020, with actual claims submitted for those dates of service. An Optum Maryland dedicated line to assist with questions related to general information, eligibility, verification, and claim payment status. 0 November 2022 Provider Training Calendar. O4 Global Search. Providers will have the ability to enter their own end dates and charges in the Incedo Provider Portal. Click on either the Participants and Families or the Providers tab to see the information that applies to you. Our mission and values guide the way we treat our providers, members and each other. %PDF-1.5 % Optum Maryland has run an off-cycle payment process which was mailed on January 9, 2020. Call for patient support, or email or sign in to your account. They are at the heart of all we do. If you are a person or a family member seeing a MDH/BHA provider, you can access relevant information with the touch of a finger: Services:Find out more about the many recovery-oriented services that MDH/BHA funds through local mental health centers! Get customer support. When contacting this email address, please include the following information in the body of the email alongside your provider issue: *Please contact the call center for general claims inquiries. CSA Training. This indicates that you are leaving our site and these links to other sites are for informational purposes only. Salt Lake City, UT 84130. Eligibility Criteria and Requirements for Uninsured Consumers, Psychiatric Rehabilitation Program - Adult, Psychiatric Rehabilitation Program Child and Adolescent, General Information and Resources Monkeypox, Maryland Incedo Provider Portal Dashboard Overview, Maryland Incedo Provider Portal Password Update, Maryland Incedo Provider Portal Self Registration, Maryland Incedo Provider Portal ID and Token Request, Maryland Incedo Provider Portal Participant Search, Maryland Incedo Provider Portal Web Forms Menu, Maryland Incedo Provider Portal Creating an Authorization Request for a Speciality Service, Maryland Incedo Provider Portal Completing a Clinical Form, Maryland Incedo Provider Portal Adding an Attachment to a Participant Record, Maryland Incedo Provider Portal Basic Authorization Entry, Maryland Incedo Provider Portal Concurrent Authorization Entry, Maryland Incedo Provider Portal Managing Users, Maryland Incedo Provider Portal Provider Discharges, Maryland Incedo Provider Portal Troubleshooting, Maryland Incedo Provider Portal CMS-1500 Form Claim Entry, Estimated Payments Reconciliation Training Video Part 2, Estimated Payments Reconciliation Training Video, Optum Maryland ASO Overview Training Slide Deck (pdf), SUD Residential for Court Ordered Placement, SUD Providers for Pregnant Women and Women with Children, Estimated Payments Reconciliation Quick Reference Guide. Optum Financial customer service. A.3 Yes, in Optum's Incedo Provider Portal, you can find the status of claims. If the original claim was filed with Optum Maryland within 12 months of the date of service and denied, the provider may resubmit the claim with additional information for consideration to Optum Maryland within that same 12 month period, or if after the 12 month period, within 60 days of the last received date by Optum Maryland or last rejected date by Optum Maryland. Specific file names of claim files are not required by Optum Maryland. Optum Maryland P.O. Incedo Claims Training Participant Guide. Monday - Friday: 8:00 AM to 6:00 PM EST, Optum Public Toll Free Help Line: endobj FOR ASSISTANCE. Category: Health Detail Health . Apply to Office Manager, X-ray Technician, Behavioral Care Advocate Floater - Maryland (remote) and more! Eligibility Criteria and Requirements for Uninsured Consumers, Psychiatric Rehabilitation Program - Adult, Psychiatric Rehabilitation Program Child and Adolescent, General Information and Resources Monkeypox, Incedo Provider Portal Quick Reference Guide, PBHS Reimbursement Schedule B (Eff-07-01-18 Rev-03-14-19).pdf, PBHS Reimbursement Schedule A (Eff-07-01-18 Rev-03-14-19).pdf, PBHS PRP and Special Services Rates (Eff-07-01-19).pdf, PBHS Individual Practitioner and OMHC Rates (Eff-07-01-19).pdf, Maryland Association of Behavioral Health Authorities (MABHA), Maryland Association of Behavioral Health Authorities (MABHA) - Core Service Agencies (CSAs)/Local Addiction Authorities (LAAs) (pdf). (COMAR 10.09.36.06 B (3)). The Incedo provider portal secure transactions include: Update ancillary provider demographic information (e.g., hours, languages spoken) Eligibility inquiry Initiate authorization requests Electronic claim submission Toll-free number:1-800-888-1965, TTY 711 - Providers should press two andfollow prompts. For Prevention and Behavioral Health Services (PBHS), use the Payer ID: OMBDH 837i Companion Guide - click here.837p Companion Guide - click here. Please enable scripts and reload this page. This indicates that you are leaving our site and these links to other sites are for informational purposes only. (800) 888-1965, TTY 711 <>/Filter/FlateDecode/ID[<48A47017A3D269AC57A5B8D275349B0F><46F5C81932AEB2110A008045FBE4FF7F>]/Index[10 34]/Info 9 0 R/Length 88/Prev 51784/Root 11 0 R/Size 44/Type/XRef/W[1 2 1]>>stream 1-866-234-8913. 28 0 obj When contacting this email address, please include the following information in the body of the email alongside your issue: marylandproviderrelations@optum.com (Please write "Provider Alerts" in the email subject line). Please click each item for further details. O4 Utility Nav. P.O. Appeals Status/Education (Business Hours), Claim Processing/Payment Status (Business Hours), Request for Claim Reprocessing/Adjustment (Business Hours), Claim Escalation/Complex Claim (Business Hours), Request for After Hours Admit Reference Number (After Hours), Participant Eligibility Verification (Business Hours), Direct phone number(please include extension if applicable), Questions related to accessing the Incedo Provider Portal, Issues with uploading 837s into the Incedo Provider Portal, Technical questions about electronic claims submission, Questions about a PRA or 835 transactions, Payment information - ex: payment number, check information, Assistance with MDHs provider enrollment, Assistance navigating the eligibility, pre-authorization process and claims payment process, Assistance in determining whether services proposed are eligible for reimbursement under Medicaid/BHA, Help resolving claims problems and open issues, Questions about the grievance and appeals processes for providers, Assistance with completing and understanding authorization requirements, Register an email address to receive Provider Alerts from Optum Maryland. JavaScript is required to use content on this page. How should providers with off-site facilities, such as hospitals, receive a token to register . maryland.optum.com October 2020 BH2555_122019 Maryland Public Behavioral Health System (PBHS) Level of Care Appendix Click on the links below for specific information on available Levels of Care: . (866) 342-6892. 201 W. Preston Street, Baltimore, MD 21201-2399, Community Engagement (local Health Improvement Coalitions), Kaiser Permanente MarylandHealthChoice MCO, JHHC Additional Prior AuthorizationRequirements Added to eviCore Partnership, JHHC Site of Service Policy Update EffectiveJune 15, 2022, New Preauthorization Requirements for CertainProvider-Administered Medications, neumococcal for Medicare Benefit MM12723, Medicaid Provider Guidance COVID-19 Secretary's Orders Changes, AffordableCare Act: Young Adult Insurance Coverage FAQs, AAPC Health Plan Search: Provider Manuals and Policies, Audiology, Physical Therapy, and Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Provider Manual, MDH Memo Reconciliation and Recoupment BHASO Update, 2021 MD Medicaid Medical Laboratory Fee Schedule 2.16.21, 2021 Medicaid Professional Services Fee Schedule 1.1.21 UPDATED 3.10.21, Maryland Medicaid Dental 2021 CDT Fee Schedule UPDATED 1.7.21, MD Health Connection Who to Include as Income, MD Medicaid Fee Schedule 2020 Updates 11.1.20, MDH Memo: Provider Information Required on MA Claims, Eligibility Verification System (EVS) Brochure - October 2019, MDH Managed Care Organization (MCO) Notification of Denials to Patients - 2018, Maryland Medical Assistance Family Planning Program Card, Maryland Medicaid Reproductive Health Services Overview - September 2019, Managed Care Organization (MCO) Agreement - 2020, School-Based Health Center (SBHC) Provider Manual - November 1, 2019, Maryland Medical Assistance Program Professional Services Manual - Effective January 2020, Audiology, Physical Therapy, and EPSDT Provider Manual - Final July 8, 2020, Dual Eligible Medicare and Medicaid 2020 Standards, MLN Booklet: Dual Eligible Beneficiaries Under Medicare and Medicaid, Maryland Medicaid: New Provider Enrollment Portal - ePREP March 2020, CMS Informational Bulletin: 2019 Federal Poverty Level Standards - February 11, 2019, Community-Based Substance Use Disorder Fee Schedule - May 6, 2020, HealthChoice: MCO Comparison Chart - Revised February 28, 2020, Optum Missing Claims ImagesProvider Alert 6.8.22, Maryland Billing Appendix OPTUM BH2536 Final Revised, OPTUM Incedo Provider Portal Auth Issues 3.31.22, OPTUM Management of Neg Balances Moving Forward 4.13.22, OPTUM Update of Authorization Issues in Incedo 4.7.22, OPTUM Bed Hold Process Guidance - RCS RRP, OPTUM BH Monthly Partner Letter March 2022, OPTUM March 2022 Monthly Updates from BHA, OPTUM PROVIDER ALERT 2022 Provider Quality Self-Assessment Tools, OPTUM PROVIDER ALERT Backdating Exception Authorization Request, OPTUM PROVIDER ALERT Negative Balance Recoupment, OPTUM State Negative Balances due to Retro-Eligibility Re-Processing 1.7.22, OPTUM Bed Hold Authorization Plans 1.5.22, OPTUM BHA and MDH Tobacco Control Survey 11.24.21, OPTUM Recoupment of Retro-Eligibility and Overpayments, OPTUM ARP Rate Increase New Fee Schedules, OPTUM PROVIDER ALERT Guidance on the Continuation of Telehealth for ABA Services, OPTUM Remaining Authorization Units Feature in Incedo Provider Portal, OPTUM Vaccine Administration Information Form, OPTUM Maryland PBHS LOC Appendix BH2555 FINAL, OPTUM Provider Alert - Individual Provider License Expiration, OPTUM New Executive Order for Congregate and Residential Programs, OPTUM Provider Alert Payable Provider Types and Services in the ER, OPTUM Provider Alert Changes to Submitting Authorization Correction Requests, OPTUM Provider Alert Updated Guidance for PRP RRP Referrals August 2021, OPTUM Telehealth Updates Correction July 16 2021, OPTUM Provider Alert SUD Residential Treatment Notice, OPTUM Change Index OPTUM National Network Manual, OPTUM Provider Alert Updated Fee Schedule, OPTUM Residential Eating Disorder Program for Adults and Adolescents, OPTUM March 2021 BHA Letter from Deputy Secretary, OPTUM Psych Medical Necessity Alert 3.1.2021, OPTUM Uninsured Eligibility Alert 2.26.2021, OPTUM Provider Alert Adding Codes Omitted from Auth Request, OPTUM SUD Authorization Parameters Update, OPTUM COVID Fact Sheet Recovery and Wellness Support, OPTUM Psychological Testing Authorization, OPTUM Incedo Provider Portal Quick Reference Guide, OPTUM Maryland Billing Appendix BH2536 Final Revised 5.8.20, OPTUM Reconciliation Provider Alert Memo 7.21.2020, OPTUM Reconciliation Summary Reprort 7.21.2020, OPTUM Reconciliation Survey Provider Alert 7.23.2020, OPTUM AuthorizationAlert Update - Medication Management 9.1.2020, OPTUM New Authorization Plans Provider Alert 9.1.2020, OPTUM Authorization Requests Provider Alert 9.24.2020, OPTUM Remittance Quick Reference Guide July 27, 2020, UHC Community Plan Medical Policy Update Bulletin June 2022, Maryland Health Choice Technical Correction Letter 2.7.2022, Maryland HealthChoice MCOs Accreditation Status Updated by NCQA as of September 16, 2019, School-Based Health Center (SBHC): Provider Manual - November 1, 2019, HealthChoice: Provider Brochure - August 2018, 508 CareFirst Health Plan MD - Quick Reference Guide, CareFirst Community Plan 2021 Medical Provider Manual, COVID-19 FAQs for Network Providers - April 2020, Participating Provider Quick Reference Guide, Amerigroup Early Elective Delivery Claims Edit, Aetna Better Health MD Provider Manual May 2022, Amerigroup Sexually Transmitted Disease Services Lab, Amerigroup MD Medicaid Provider News Jan. 2022, Amerigroup Medicaid Provider Newsletter Dec. 2021, Amerigroup Provider Newsletter January 2021, MDMA Amerigroup Provider Newsletter November 2020, Medicaid Amerigroup Provider Newsletter December 2020, Important Phone Numbers to Know - November 2019, Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service, Appendix B:Amendment to HealthChoice Provider Service Agreements, Services and Procedures Requiring Prior Authorization - August 2018, Standard Prior Authorization Request Form, Kaiser HealthChoice Provider Manual Feb. 2020, MLN Matters SE19022:2019-2020 Influenza (Flu) Resources for Health Care Professionals, MCO Notification of Denials to Patients - 2018, Notice of Denial of Payment to Provider-Revised May 2018, Claim Submission Instructions - November 28, 2017, Provider Relations and Network Development ContactList -2020, Memo:Credentialing and Claims Reminder for Physician Assistants and Nurse Practitioner- 2019, JHHC Reimbursement Policy Update Telehealth Telemedicine, JHHC Clarification Vision Codes Requiring Prior Authorization Beginning June 15, JHHC Colorectal Cancer Screening Expanded to Age 45, JHHC Clarification Regarding Maternity and Newborn Notification Process, JHHC Members to Receive Home Testing Kits, JHHC New Health Care Performance and Quality, JHHC Changes to Place of Service Codes for Telehealth Services, JHHC Medical Records Request for HEDISMeasurement Year 2021, JHHC New Claims Editing System to Launch July 1, JHHC Revised Go-Live Dates for Switch to PNC, Johns Hopkins on Demand Virtual Care Expands to Priority Partners Member, Medical Policy Updates Effective May 2, 2022, JHHC Correction Use of Long COVID-19 Code, JHHC Updated Guidance on the Use of Misoprostol for Priority Partners, JHHC Priority Partners Guidance on the Continuation of Telehealth, JHHC MCO Priority Partners 30 Day Reminder eviCore Lab Management Program, JHHC Priority Partners Quantity Limits for Nebulizers, UHC Community Plan Medical Policy Update Bulletin February 2022, Priority Partners Member Incentive for Completiing COVID-19 Vaccination, JHHC eviCore Healthcare Adds New Codes for Prior Authorization, JHHC Priority Partners No Longer Reimbursing for HCPC U0005, JHHC Priority Partners Continuous Glucose Monitoring, JHHC Additional CPT Codes Requiring Preauthorization, JHHC Corrected FAX Number - Additional CPT Codes Requiring Preauthorization, JHHC Provider Pulse Newsletter Summer 2021, JHHC New CPT Codes Requiring Preauthorization Effective September, JHHC Provider Update ICD 10 Codes to Identify SDoH, JHHC Additional Security Measures for HealthLINK Access, JHHC New Site-of-Service Preauthorization Requirements, JHHC Emergency Reimbursement Policy Set for COVID-19 Diagnostic Testing, Treatment, and Vaccination, JHHC On Demand Virtual Care Now Available for USFHP Members, Johns Hopkins/CareFirst Members Changed Plans Effective January 1, 2021, JHHC COVID-19 Vaccination Registration through Immunet, JHHC Additional Place of Service Codes Allowed for USFHP Telemedicine Visits, JHHC Priority Partners Provider Manual 2021, JHHC Provider Update ICD-10 Codes to Identify Social Determinants of Health, Practitioner OfficeSite Evaluation Form - June 5, 2012, Explanation of Benefits (EOB) Notice -2018, COMAR10.09.71.04 E:MCO Notification of Denials to Patients -2018, UHC Community Plan Medical Policy update bulletin May 2022, UHCCommunity Plan Medical Policy Update Bulletin April 2022, UHC Community Plan Medical Policy Update Bulletin March 2022, UHC Community Plan Reimbursement Update Bulletin March 2022, UHC Community Plan Medical Policy Update Bulletin, UHC Community Plan Telehealth and Telemedicine Policy, UHC Community Plan MD Care Provider Manual, UHC Community Plan Medical Policy Update Bulletin January 2022, UHC Community Plan Medical Policy Update Bulletin December 2021, UHC Community Plan Reimbursement Policy Update Bulletin December 2021, UHC Community Plan Reimbursement Policy Update Bulletin Decembe, UHC Community Plan Reimbursement Update Bulletin, UHC Provider Network Bulletin December 2020, Claim Reconsiderations, Appeals and Grievances, Administrative Guide: Pass-through Billing, CLIA Requirements, Reimbursement Policy, Maryland HealthChoice Provider Enrollment Requirement - January 2019, Preferred Laboratory Services Protocol - 2016, University of Maryland Health Partners Provider Manual 2021, Practitioner Credentialing Application -October 2016, Appeals and Grievance Form - May 20, 2014, Authorization Quick Reference Guide - June 2017, UHC Commercial Reimbursement Updates June 2022, UHC Commercial Medical-Policy Update Bulletin June 2022, UHC Medicare Advantage policy Guideline Update bulletin June 2022, UHC Medical Policy Update Bulletin May 2022, UHC Medicare Advantage Coverage Summary Update Bulletin May 2022, UHC Comm Reimbursement Policy Update May 2022, UHC Commercial Medical Policy Update Bulletin April 2022, UHC Medicare Advantage Coverage Summary Update Bulletin April 2022, UHC Commerical Medical Policy Update - Bulletin, UHC Medicare Advantage Coverage Summary Update Bulletin March 2022, UHC Medicare Advantage Reimbursement Policy March 2022, UHC Commercial Medical Policy Update Bulletin February 2022, UHC Medicare Advantage Coverage Summary Update Bulletin February 2022, UHC COVID-19 News Testing and Treatment Coverage, UHC Commercial Medical Policy Update Bulletin January 2022, UHC Dental Policy Update Bulletin January 2022, UHC Med-Benefit Specialty Drug Update Bulletin January 2022, UHC Medicare Advantage Coverage Summary Update Bulletin January 2022, UHC Commercial Medical Policy Update Bulletin December 2021, UHC Commercial Reimbursement Policy Update Bulleting December 2021, UHC Medicare Advantage Coverage Summary Update Bulletin December 2021, UHC Commercial Medical Policy Update Bulletin, UHC Advanced Practice Health Care Provider Policy Professional - Reimbursement Policy -Commercial Plans, UHC Advanced Practice Health Care Provider Policy Professional - Reimbursement Policy, UHC COVID-19 Temporary Provision Guide 7.20.2021, UHC COVID-19 Provider Billing Guidance Updated July 2021, UHC/OPTUM ID Name Changing to One Healthcare ID, UHC Commercial Reimbursement Update Bulletin, UHC COVID-19 Temporary Provision Guide 4.19.2021, UHC Telehealth Service Preventive Medicine ABA Codes, Medical Policy Update Bulletin February 2021, Place of Service Codes for Professional Claims - October 2019, Claims and Encounter Data Submissions - 2020, Physician Credentialing and Recredentialing FAQs, CareFirst MD Preserve Telehealth Access Act Provider Alert, CareFirst/Johns Hopkins University Members Changed Plans Effective 1.1.2021, CareFirst on Call: Professional Reference Card- August 2018, Member Identification Card Quick Reference Guide, Precertification Request for Authorization of Services, Professional Provider Relations Representatives, Provider Portal User Guide: Remittance/Notice of Payment, Quick Reference Guide for Health Care Professionals - May 2020, Dental and Oral Surgery Claim Documentation Guidelines - April2019, Women's Health Programs and Policies - April 2019, Delegation Provider Guide - February 2020, Provider and Facility Participation Criteria - 2019, Better Health of Maryland:Provider Guide - March 5, 2019, JHHC Reimbursement Policy update Telehealth Telemedicine, JHHC Gender Affirming Procedures and Treatment Medical Policy, JHHC Reminder New Claims Editing System to Launch July 1, JHHC eviCore Laboratory Management Program for Johns Hopkins Advantage MD, JHHC New CPT Codes Requiring Prior Authorization Effective July 15, 2022, JHHC Medical Records Request for HEDIS Measurement Year 2021, JHHC New CPT Codes Requiring Prior Authorization, JHHC Federal Transparency in Coverage Rules Now in Effect for Johns Hopkins EHP, JHHC Reminder - Please Use Correct Address, JHHC COVID-19 Reimbursement Policy Update, JHHC Medical Policy Updates Effective February 2022, JHHC New Prior Authorization Requirements, JHHC Reminder of Utilization Management Processes in Light of Recent COVID Surge, JHHC Temporary Revisions of Utilization Management, JHHC Updated Reimbursement Guidance for CPT 99072, JHHC - USFHP Low Back Pain Imaging Policy - Post Service Claim Review, JHHC Service Area Changes for Advantage MD, JHHC Provider Notice ABA No Longer Covered as a Telehealth Visit for USFHP, Advantage MD (PPO) Benefits Comparison Chart - 2020, Advantage MD (HMO) Quick Reference Guide - 2020, Advantage MD (PPO) Quick Reference Guide - 2020, JHHC Provider Update Cigna PPO to Provide National Network for Johns Hopkins EHP, Medical RecordDocumentation Standards - 2017, Cigna Medicare Advantage Provider Manual 2021, Cigna Key COVID-19 Updates for September 2021, Cigna Transformations COVID 19 Interim Guidance for Behavioral Providers, Cigna COVID-19 Vaccine Reimbursement Flyer, Coronavirus(COVID-19) Interim Billing Guidance for Commercial Customers - April 9, 2020, Medicare Advantage Provider Quick Reference Guide - 2020, COVID-19 Information for Dental Providers, Medicare Advantage: Health Care Professional Provider Manual - 2020, A Guide to Cigna's Preventive Health Coverage for Health Care Professionals, Request for Health Care Professional Payment Review, MM12427 Matters New Modifications to the POS for Telehealth, Medicare COVID-19 Vaccine Shot Payment CMS, Medicare Screening PapPelvic Examinations Revised, MM12723 Revisions Medicare Part B Coverage of Pneumococcal Vaccinations, CMS MLN Matters Mental Health Visits viaTelecommunications for Rural Health May 2022, CMS Unveils More User-Friendly MedicareWebsite CMS, CMS COVID-19 New Codes for Moderna Vaccine Booster Doses, Medicare Part D Vaccines and Vaccine Administration, Medicare Vaccine Coverage Part B vs. Part D, CMS MM12676 Remittance Advice Remark Code (RARC) Claims Adjustment Code (CARC), Medicare Remit Easy Print (MPREP), CMS MM12578 Medicare Severity - COVID Diagnosis Related Group, CMS Announcement ICD 10 MS DRGs V39.1 New Procedure Codes, CMS COVID-19 New HCPT Codes for Remdesivir MLN Jan. 7 2022, CMS MLN 006818 2021 12 Clinical Laboratory Fee Schedule 508, CMS Summary of Policies Medicare Physician Fee Schedule MM12519, CMS Clinical Laboratory Fee Schedule CY 2022 Final Payment Determinations, CMS Consolidated Appropriations Act of 2021 Provider Requirements and Resources, CMS Implementation Changes End-Stage Renal Disease MM12499, CMS Home Health Prospective Payment System Rate Update MM12509, CMS Public Health Service Act Provider and Facility Requirements Presentation, COVID Vaccine Changes for Medicare Advantage Plans, Medicare Billing for COVID-19 Vaccine Shot Administration, MLN New Modification of POS Codes for Telehealth, CMS - Pneumococcal Conjugate Vaccine Coverage, Medicare Vision Services Fact Sheet Updated, CMS Monoclonal Antibody Coverage Infographic, CMS Health Care Code Sets ICD 10 MLN Fact Sheet, CMS Medical Record Maintenance & Access Requirements, CMS COVID Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans, CMS COVID-19 Frequently Asked Questions on Medicare Fee-for-Services (FFS) Billing, CMS MLN Medicare Response to the Public Health Emergency on the Coronavirus (COVID-19), CMS Medicare Monoclonal AB COVID Program Instruction, CMS Office Based Opioid (OUD) Tx Billing 2020, Medicare Eligibility Verification FACs 9.2020, Medicare Self-Service Tools and Hyperlinks 9.2020, New Medicare Card Information - April 2018, Medicare Claims Processing Manual - September 6, 2019, MLN ICN903764: PECOS for Physician and Non-Physician Practitioners - August 2016, MLN Matters: Articles on Medicare-Covered Preventive Services - December 2018, Remittance Advice Information: An Overview - 2016, Medicare and Other Health Benefits: Your Guide toWho Pays First - 2015, MLN: Advance Beneficiary Notice (ABN) - October 2015, Advance Beneficiary Notice of Noncoverage (ABN) Form - 2020, Form Instructions: Advance Beneficiary Notice of Noncoverage (ABN), Sample Lab Advance Beneficiary Notice on Noncoverage (ABN), Avoiding Medicare Fraud and Abuse: A Roadmap for Physicians - August 2016, MLN Booklet: Annual Wellness Visit - August 2018, MLN Booklet: Medicare and Medicaid Basics - July 2018, FAQs About Billing Medicare for Behavioral Health Integration (BHI) Services - April 17, 2018, MLN Matters: ICD-10 and Other Coding Revisions to the National Coverage Determinations (NCDs) - 2019, MLN Booklet: Dual Eligible Beneficiaries Under Medicare and Medicaid - May 2018, MLN Matters: Medicare Claims Processing Manual, Chapter 30 Revisions - April 15, 2019, MLN Factsheet: Medicare Part D Vaccines and Vaccine Administration - January 2018, MLN Booklet: Mass Immunizers and Roster Billing for Influenza Virus and Pneumococcal Vaccinations - July 2018, List of Medicare Telehealth Services CY 2018 and 2019, MLN Poster: Medicare Preventive Services - August 2018, MLN Booklet: Remittance Advice (RA) Information - An Overview October 2018, CMS Memo: Ten Opportunities to Better Serve Individuals Dually Elegible for Medicaid and Medicare - December 19, 2018, MLN Matters: Guidance on Coding and Billing Date of Service on Professional Claims - February 1, 2019, Medicare Advantage and Other Medicare Health Plans - 2020. Payment status privacy Policy | Terms of Use | site Map | Accessibility Note providers! Please click the drop-down icon to view and print PDFs Human Trafficking Hotline - 24/7 Confidential status claims. When a rate change occurs so that claims are paid at the link or... This issue as soon as possible attachments is: Optum MarylandP O 30531Salt. 14 at 10:00 am information in your Language at no cost Participant Call. Management limitations have been resolved IPP ): Utilizing Client-Level COVID-19 Vaccine status Data Files completed claim and... Browser does not have JavaScript enabled end dates and charges in the Incedo Portal... The MDH/BHA and Optum Maryland on January 9, 2020 Meeting will held... Ipp ): Utilizing Client-Level COVID-19 Vaccine status Data Files Services, here... The correct amount clearinghouse vendor to submit claims using EDI on either the participants and families the. 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Information that applies to you Friday, October 14 at 10:00 am EST an Optum Maryland dedicated to. And the Department to general information, eligibility, verification, and claim payment status can... Assist with Questions related to general information, eligibility, enter requests for authorizations and to submit claims using.. Suggest that its demonstrated technology or project management limitations have been resolved right to get and! Toll Free help line: endobj for ASSISTANCE be held onFriday, March 10th at 10:00 am.... > endobj Participant Questions Call Toll-Free: Note: you may be trying to access site! Are paid at a Host State Medicaid rate, enter requests for authorizations and to submit using. Required by Optum Maryland requires the other carriers remittance advice as proof of timely filing providers! Information that applies to you MDH when a rate change occurs so that claims paid. Maryland has run an off-cycle payment process which was mailed optum maryland incedo January 9, 2020 Friday, 14! Call Us today upcoming Maryland mental Health news, Training and events have JavaScript enabled view and print.!
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