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Medicaid Reimbursement for Vision and Hearing Screens

Medicaid Reimbursement for Vision and Hearing Screens. Medicaid In The Schools (MITS). January 2008. Getting Started…. Vision Screens- Act 1438 (2006 school year)

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Medicaid Reimbursement for Vision and Hearing Screens

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  1. Medicaid Reimbursement for Vision and Hearing Screens Medicaid In The Schools (MITS) January 2008

  2. Getting Started… • Vision Screens- Act 1438 (2006 school year) It is the purpose of this requirement to establish eye and vision screenings for students enrolled in pre-k, kindergarten, grade 1, 2, 4, 6, and 8, as well as all transfer students. • With the law came the opportunity to bill for the mandated screens, and then some.

  3. What’s New? • Does not require a PCP referral for hearing or vision screens. • Screens completed by LPNs can be billed, if supervised by an RN. • Can bill for all students that have Medicaid, not just special education students.

  4. Reimbursement Rates • Vision Screen $14.08 • Hearing Screen $12.02

  5. Getting Set-up to Bill • Need provider number for vision/hearing screens • Must complete provider enrollment application • Submit to MITS when complete • Copy with instructions on our website at http://arksped.k12.ar.us/sections/medicaid.html

  6. Billing Methodology Two ways to bill for screens and other services: 1. EDS or 2. MITS

  7. EDS Billing • Requires the user to install software, install an external modem, have a customer service representative to set-up and train the district. • Free software, cost per transaction • User responsible for data entry, eligibility checks, and billing.

  8. EDS Contact Information • Provider Representatives:https://www.medicaid.state.ar.us/InternetSolution/Provider/provreps/provreps.aspx • See Vender Booth for more information

  9. MITS Billing Requires an Interagency Agreement with district and MITS; Requires district to complete a specific file and submit to MITS for effortless eligibility check and electronic billing. Electronic file includes student name, SSN, date of birth, and LEA #; Fee for service (5 percent change than what the district is currently paying, but without the ease and time savings).

  10. MITS Contact Information Tony Boaz tony.boaz@arkansas.gov Medicaid In The Schools (MITS) 2402 Wildwood, Suite 172 Sherwood, AR 72120 (866) 280-8300, option 1 (Help Desk) (866) 280-8300, option 2 or (501) 835-2093 (Program and Management Office)

  11. Arkansas Medicaid Resource Information Arkansas Medicaid www.medicaid.state.ar.us (800) 482-8988 ARKids First www.arkidsfirst.com (888) 474-8275

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