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Review of PCS Billing

Explore detailed guidance on PCS billing procedures in NC Division of Medical Assistance as of January 2013. Learn about using NCECSWeb Tool for efficient billing practices.

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Review of PCS Billing

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  1. Review of PCS Billing NC Division of Medical Assistance January 2013

  2. NCECSWeb Tool Next slides will present Screen Shots of actual form on Web Tool Web Tool https://webclaims.ncmedicaid.com/ncecs Must have a HP login and password Don’t have a login? Contact HP ECS for login 1-800-688-6696, menu option 1

  3. https://webclaims.ncmedicaid.com/ncecs

  4. https://webclaims.ncmedicaid.com/ncecs

  5. https://webclaims.ncmedicaid.com/ncecs

  6. Do not provide history of

  7. Use the modifier listed in Decision Notice Provider receives from CCME

  8. What Billing Questions are directed to HP? • Denials • Incorrect or Missing Carolina Access Number • Incorrect CPT code • Assistance with the Web Tool • Request for on site visit

  9. RESOURCES • HP Enterprise Services (HPES) – Provider Services • Toll Free Number: 1-800-688-6696 • Division of Medical Assistance (DMA) - http://www.ncdhhs.gov/dma/index.htm • Basic Medicaid and NC Health Choice Billing Guide - http://www.ncdhhs.gov/dma/basicmed

  10. RESOURCES • The Carolina Center for Medical Excellence (CCME) - www.thecarolinascenter.org • CCME’s Call Center is available Monday through Friday from 8:00 a.m. – 5:00 p.m. • Toll Free Number: 800-228-3365

  11. RESOURCES • Special Bulletin Dec 2011 http://www.ncdhhs.gov/dma/bulletin/NCECSWebGuide.pdf • North Carolina Electronic Claims Submission/Recipient Eligibility Verification Web Tool https://webclaims.ncmedicaid.com/ncecs • www.nucc.org • Provides a crosswalk of paper CMS 1500 fields to electronic form equivalent fields

  12. RESOURCES • Place of Service Codes • General Bulletin Dec 2005 • http://www.ncdhhs.gov/dma/bulletin/pdfbulletin/1205bulletin.pdf • PCS Limitations or Requirements • 5.4.1 Place of Service • http://www.ncdhhs.gov/dma/mp/3L.pdf

  13. RESOURCES • www.cms.gov • http://www.cms.gov/medicare-coverage-database/staticpages/icd-9-code-lookup.aspx

  14. QUESTIONS?

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